What works with adolescents
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What works with adolescents?. Family connections and involvement in interventions Lyndal Power ACWA Conference, 2-4 th August, Sydney. Adolescence. An incredible time of growth Physical development- brain research Identity, social and emotional development Cognitive development

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What works with adolescents

What works with adolescents?

Family connections and involvement in interventions

Lyndal Power

ACWA Conference, 2-4th August, Sydney


Adolescence

Adolescence

  • An incredible time of growth

    • Physical development- brain research

    • Identity, social and emotional development

    • Cognitive development

    • Sexual development

  • Not children, but not adults either


Family in adolescence

Family in Adolescence

  • Still important? Yes!

  • Family offers a “secure base”- a safe place to return – (caring, connectedness and belonging)- linked to positive outcomes (Luthar 2006)

  • Peer relationships develop but not at expense of family

  • Inter-dependence rather than independence-family, friends, partners (Daniel et al 1999)

  • Parents continue to advise and support young adults- parents underestimated their support- valued by young adults. (Vassallo et al 2009)


Adolescent attachment

Adolescent Attachment

  • Five elements of a secure parent-adolescent attachment:

    • Availability-helping young people trust;

    • Sensitivity-helping young people manage emotions and behaviour

    • Acceptance-building self esteem

    • Co-operation- helping young people to feel effective

    • Family membership- helping young people belong (Schofield & Beek 2009)


Service provision to young people

Service Provision to Young People

  • Traditionally, youth services have been focused on individuation and autonomy (Robinson & Pryor 2006)

    • Historically, family has been cast as irrelevant, then relevant in a negative sense eg the cause of the problem, the “enemy” Garfat (2003)


Involving family what works

Involving Family-What Works?

  • Research in its infancy, but showing promise

    • Family based interventions for adolescent psychiatric disorders, particularly depression

    • Also substance use eg.BEST-plus program

      • Improving communication skills

      • Increase in family-based problem solving

      • Addressing negative and critical interactions

      • Building family resilience and hope

      • Helping families manage depression/suicide risk


Types of therapies

Types of Therapies

  • Functional family therapy, structural family therapy and multisystemic therapy

  • Multisystemic therapies have most support

    • Strengths-based family intervention that sees problems as having multiple determinants- family therapy a key element


What is raps

What is RAPS

  • RAPS [Resources for Adolescents & Parents]

  • Established 1990

  • RAPS set up to prevent youth homelessness after Burdekin Report (1989)

  • Burdekin Report sees conflict as biggest issue leading to youth homelessness

  • RAPS works with issues which may lead to youth homelessness


Typical issues seen at raps

Typical issues seen at RAPS

  • Parent-adolescent conflict

  • Truancy

  • Running away

  • Violence

  • Substance use

  • Depression and Self harm


Seven principles behind raps work

Seven principles behind RAPS work

  • Adolescence-unique developmental stage

  • Balance between connection & limits

  • Effective work involves working whole family

  • Need a wider systems perspective

  • Early intervention is preferable

  • Staff have postgraduate training in family therapy

  • Staff need good consultation and supervision


Seven principles behind raps work1

Seven principles behind RAPS work

  • Adolescence- a unique developmental stage


Adolescence a unique stage

Adolescence- a unique stage

  • Brain changes take over a decade to complete

  • Last part of brain that develops is the part that makes good decisions

  • Common misconception-time of separation

  • Fragile sense of self and new intense feelings

  • Parents’ role is to help young person work through and manage themselves by empathising, guiding and setting boundaries


Seven principles behind raps work2

Seven principles behind RAPS work

  • Adolescence- a unique developmental stage

  • Balance between connection & limits


Balance between connection limits

Balance between connection & limits

  • Children/adolescents need parents to be in a position of hierarchy- they feel secure (limits)

  • For adolescents to reach adulthood- need balance between connection and sufficient limits from their parents

  • Parents may not be aligned- may undermine- staff assist parents to work as a united team

  • Staff may be working with parents to improve their connection or limits or both


2 balance between connection limits

2. Balance between connection & limits


Seven principles behind raps work3

Seven principles behind RAPS work

  • Adolescence- a unique developmental stage

  • Balance between connection & limits

  • Effective work involves working whole family


3 effective work involves whole family

3.Effective work involves whole family

  • ‘Web’ of attachment-all the family relationships

  • To understand one relationship, must consider other relationships

  • Example- family where father dies and older son moves closer to mother, younger daughter feels on the outer and runs away

  • Staff see whole family initially- may later split sessions eg couple, adolescent


Seven principles behind raps work4

Seven principles behind RAPS work

  • Adolescence- a unique developmental stage

  • Balance between connection & limits

  • Effective work involves working whole family

  • Need a wider systems perspective


4 need a wider systems perspective

4. Need a wider systems perspective

  • RAPS assessments include the wider system surrounding the young person

  • Staff identify parts of the system that offer risk or protective factors and develop interventions

  • Risks=peer group; parent undermining a school; separated parents undermining the other parent

  • Protective=extended family or significant others

  • Structure is important-work and school

  • Example- helping parents align with school


Seven principles behind raps work5

Seven principles behind RAPS work

  • Adolescence- a unique developmental stage

  • Balance between connection & limits

  • Effective work involves working whole family

  • Need a wider systems perspective

  • Early intervention is preferable


5 early intervention is preferable

5. Early intervention is preferable

  • Early intervention in problem behaviours is preferable

  • Staff also work at the serious end

  • Example- substance use


What works with adolescents

Stage1

Stage2

Stage 3

Stage 4

Curious times

Good times

Necessary

times

Desperate

times

Young

Person

Experimenting

Partying

Plotting

Failing

Parents

Reacting

vs

Minimising

Networking

vs

Normalising

Taking charge

vs

Enabling

Rehabilitating

vs

Resigning

Therapist

Inquiring &

Educating

vs

Escalating &

Confronting

vs

Empowering

vs

Strengthening

vs

Reassuring & Normalising

Normalising

Tolerating

Resigning


Seven principles behind raps work6

Seven principles behind RAPS work

  • Adolescence- a unique developmental stage

  • Balance between connection & limits

  • Effective work involves working whole family

  • Need a wider systems perspective

  • Early intervention is preferable

  • Staff have post graduate training in family therapy


6 staff have training in family therapy

6. Staff have training in family therapy

  • RAPS staff are social workers and psychologists with post-graduate training in family therapy

  • Staff need to be competent in engaging both parents and adolescents, managing them in the room together and conceptualising what is occurring between them

  • Family therapists also have the skills to work with the parents’ couple relationship


Seven principles behind raps work7

Seven principles behind RAPS work

  • Adolescence- a unique developmental stage

  • Balance between connection & limits

  • Effective work involves working whole family

  • Need a wider systems perspective

  • Early intervention is preferable

  • Staff have post graduate training in family therapy

  • Staff need good consultation and supervision


7 staff need good supervision

7. Staff need good supervision

  • Stakes are high working with at-risk young people- great demands on staff

  • Regular and back-up supervision is needed

  • RAPS uses an external consultant who provides “live” supervision of family work and develops best practice with the whole team

  • RAPS staff work in teams where a therapist behind a one-way screen phones in questions- shared responsibility


Conclusion

Conclusion

  • Adolescence is a unique developmental stage

  • Adolescents still need parents in two ways-

    • Connection

    • Limit setting

  • Importance of parents working together

  • Importance of parents and wider system working together

  • Importance of whole of family approach

  • Staff need training and support for family work


Contact details

Contact details

  • Lyndal Power

    [email protected]

  • AFRC Briefing No.16- “What works with adolescents?”

    • http://www.aifs.gov.au/afrc/pubs/briefing 16.html

      Elly Robinson, Lyndal Power and David Allan


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