Informed Strategies for Engaging Adolescents

Allan Rosales, Jenne Newman& Carmen Dodsworth

March 24, 2011

Quote

• You don't have to suffer to be a poet; adolescence is enough suffering for anyone. – John Ciardi

US poet (1916 - 1986)

“Normal” Adolescent

Brain Development

• Adolescent rate of brain growth and reorganization is second only to neonatal period

• This rapid change and entailing demands comes like a “tidal wave” after the long period of slow growth during childhood

• This change involves both overproduction and pruning of synapses

• Executive functioning is last part of the brain to develop (18-21)

Time of Identity Formation

• Try on different roles, make decisions about sexual orientation, what kind of person they are going to be???

• A time of risk taking

• The critical time of the day 4:00-6:00

Physical Changes

• Testosterone and Estrogen are responsible for the physical changes = fixation on sex and social standing.

Brain Changes

• Major reorganization of systems that regulate;– Emotional reactivity– Stress regulation– Identification of emotional state from facial

expressions– Self-regulation– Stress coping mechanisms

ZZzzZZZzzZZ?

• Circadian Rhythm changes

• No sleep = Less REM = Less Memory

• Chronic problems >20-30% Memory loss everyday, but also greater risk for depression

• Sleep Hygiene (Trauma and Sleep)

Nutrition

• Affects onset of Puberty• Positive and Negative Affect on Mood• Caffeine >Upper, psychomotor stimulant,

increased alertness, heart rate, and faster breathing; also releases cortisol >stress >dehydrates you >brain functioning

Teens Today

• This is the FACEBOOK Generation• This is the TEXTING Generation• This is the GOOGLE Generation• This is a Multimedia Generation with Media

aimed directly at Children and Youth

MEDIA…

Smoking, Drugs, and Alcohol

• Addictions are likely to get hardwired in adolescence• Alcohol is a disinhibitor, downer, depressant• Alcohol damage hippocampus in the developing

brain (Memory and Learning) and your liver• Also kills the brain cells in the left hemi-sphere

(Language and Logic)• Regular Marijuana results in “amotivational

syndrome”• Ecstacy > Parkinson’s disease

Time of Disorder

• Anxiety Disorders• Eating Disorders• Substance Abuse• Schizophrenia

Suicide

• Second leading cause of death amongst teens• 18/100,000• Highest rate of completion among males• Females are more likely to be hospitalized• The ones to worry about• The contract

Self Harm

• Self mutilation can lead to dissociative states similar to the adaptive state of the trauma the youth experienced in his/her past

• These acts are linked to the natural release of opioids (endorphins and enkaphalins) which are natural pain killers and produce a calming effect

• Opioids help prepare the body to deal with physical and emotional suffering

Trauma ModelPast Trauma

Sensitized Nervous System

Current Stress

Intolerable Emotional States

Retreat

Self-Destructive Action

Destructive Action

Characteristics

• Brain disorganization is characterized by a highly negative state

• Adolescents rely on caregivers in order regulate their affective reactions– The brain grows by organization and

disorganization, and at this time both hemispheres are dominant and ‘offline’

How to Intervene

• Promote Emotional Intelligence• Practice patience, understanding, and

guidance. • Bring it back to the group.• Brainstorm potential risks.• Brainstorm alternative choices.• Give them appropriate amounts of freedom

and responsibility

Treatment Approach

• Strengthen Resiliency– Help client stay connected to or regain connection

to positive others (Sources of Strength)– Internal Locus of Control (Control of Choices)– External Attribution of Abuse– Develop Self Esteem (Circle of Courage)– Cause and Effect and Personal Responsibility

Modern Self Esteem

Anger • Is it okay to feel ANGRY?

• Types of Anger– Directed Inward (not expressed)– Directed Outward (can lead to rage)– Anger associated with Sadness– Anger that can be used to remove an obstacle

(Positive)

Anger continued… • What makes Teens Angry?• What do you think was going on for that person?• How do you know when you are getting angry?• What are your triggers?• How do you know when you are past the point of

no return?• Who is responsible for your anger?

The Use of Art in Therapy

• Explore inner world, conscious and unconscious, perceptions, thoughts and feelings

• Problem solve, Bring visual form to ideas

• Communicate verbally and non-verbally

• Express one’s unique identity

• Establish a sense of control and involvement in their own treatment and healing

• Develop self-esteem and coping strategies

• Record experience and therapeutic process

“Art Expression, in this sense, is not really a means of diagnostic evaluation, but a modality for allowing children to relate their experiences in an age-appropriate manner. The goal is therapeutic interventionrather than assessment.”

Taken from Understanding Children’s Drawings by Cathy Malchiodi

Environment

FurnitureMovementMessSafety

Relationship to Therapist

Trust WitnessHold safe spaceNurtureTime keeper

Finding Meaning in the Artwork

Asking questions:• What is going on in

this picture?• What title would you

give it?• How do the people or

animals feel in this picture?

• If they could speak what would they say to each other?

• Etc…

I HAVE A DREAM…

Links

• Love the Way You lie• http://www.youtube.com/watch?v=uelHwf8o7_U

• Dove• http://www.youtube.com/watch?v=Ei6JvK0W60I

• I Have a Dream…• http://www.youtube.com/watch?v=CGe4FfRA61E