Working with Adolescents and their Families

Bower(Method) provides a template to explore and order the multifaceted nature of presenting adolescent difficulties and devise effective responses to them at the individual, family, school, and community level.  

Politics

In all matters it is important to begin with the metaframe of politics which focusses on issues of inequality and disadvantage which pertain to the case. This incorporates, among others, economic, political, social, and   racial aspects that make this client’s life more unequal than that of another citizen. (see Inequality – Justice– Authority–Responsibility in Service Delivery and Practice Theory) This leads naturally to questions of authority and responsibility, as the proper management of inequality is central to the effective resolution of all difficulties. Problems arise when there is a split between authority and responsibility with those holding responsibility not being ceded the authority to effectively exercise it. Where the young person is made responsible to manage their productive, peer, sexual and family identity but not the authority to do so it is inevitable that difficulties will arise. A different variant is where the adolescent claims all authority to take the advantages and freedoms of adulthood but exercises no responsibility in how they do this. The split around the young person and questions of authority and responsibility may be between them and parents, them and school or school and family.  

Space

The meta-frame of space, the inside/outside world of the young person encompasses their neurobiology, physiology, and the ‘village’ they inhabit. It is particularly focused on patterns of interaction that develop between the inside physical world and outside social world and become recursive and self-reinforcing. Major changes are happening in the brain with a proliferation of synapses which initially slows down and degrades functioning and then, at around 16years, synaptic pruning where pathways that are more used are strengthened and infrequently used paths eliminated resulting in better within brain speed and clarity. There is an increase in myelination, the coating of the neuronal processes and fibers, meaning neural signals travel faster and more strongly through the brain. The implications of these physical changes on behaviour are that adolescents often show a ‘bump’ in development with a plateau or reversal in a range of cognitive abilities as a result of the synaptic proliferation with executive functioning improving as synaptic pruning occurs. While adolescents are as capable as adults at making safe choices in a laboratory setting in real life and under the influence of social pressure decision processes evaporate. Broadly, adolescents can make good decisions under conditions of low arousal and calm emotions, but poor choices are made in situations of high arousal and strong emotions. This is a powerful argument for urging parents to deal with young people in a calm respectful and non-escalating fashion, so they can be expected to exercise responsibility in their interactions. The age at which they can understand cognitively that a choice is right or wrong is different from the capacity to prevent strong feeling overturning this. 

The interaction between inside and outside is crucial and this can be a time when families begin to ‘reap what they sow.’ A child who has had no choice but accept a parent’s violence is in a quite different position as an adolescent. Now are they are bigger, stronger, and smarter and less unequal to the adult, but their internal brain functioning will make it harder to exercise control in the face of heightened emotions. Add to this the learning from their parent about how to conduct relationships and deal with conflict and the mix can be literally explosive and dangerous for all parties. A particularly difficult dynamic occurs in separations involving domestic violence, where most often boys may act protectively towards their mother and be violent to their father but in conflict with sisters and the mother act out the aggression in the way they have learned.  

This is the phase where families are reorganizing their relationships to begin to share more authority with the young person in the hope that they will actively exercise greater care for and responsibility over their lives. Authoritative parenting, which combines warmth and acceptance with reasonable demands for maturity in conjunction with firm monitoring of activities is most like likely to achieve this outcome. Families that are less flexible and efficient and where boundaries are less well delineated have more difficulty adapting to changing roles and developing coping processes. It is estimated that approximately 10%of families experience seriously troubled relationships with escalating conflicts over major issues. 

This is also the time where fractures in the couple relationship can be played out in destructive ways through the young person, often continuing a pattern from the past. 

As the adolescent moves further from the inside of the family to the outside world of school, peers, and employment clashes over engagement with outsiders and introduction of new conduct, appearance and ideas may occur. Interestingly family relationships are instrumental in the type of group the young person joins with anti-social conformity related to a high conflict family atmosphere that emphasized achievement with a lack of support for intellectual development. By contrast young people who join groups that offer instrumental and social support tend to come from families that supported independence and did not push achievement.  

Time

Attention to the meta-frame of time allows exploration of how the patterns of the past both between the adolescent and family members and others are now played out in the present. Identification of major turning points or punctuations in the life of the family may help explain the current patterns with parents siblings, peers, and other authority figures. Attention to time future is also important both individually in terms of the expected trajectory of adolescence but also in relation to the family’s expectations for themselves. This may be particularly relevant if members are facing significant health issues.  

Development

The last metaframe, development, specifically addresses physical developmental aspects that shape and constrain the presenting issues. These include biological and genetic aspects that may affect physical appearance and capacity but also the developmental stage of the whole family. Together these create the identity of the growing person which comprises productivity (earning or learning), attachment to family or family like group, peer relationships and sexuality. 

A thorough assessment through each meta-frame will position the practitioner to begin to address the presenting concerns for the young person and their family. Broadly this requires ’giving up the struggle’ to locate all responsibility for difficulties in the young person and demanding they change. Work with adolescents and their families is intense, emotional, and sometimes frightening. Accepting that this is a dynamic time in the life of a family, and it is incumbent on the outside to change first is often the most productive approach. This may involve other family members reflecting on past events and mistakes and being willing to redress past wrongs while also expecting the adolescent to take their proper share of responsibility commensurate with the authority they wish to exercise. Theoretical and practical approaches to specific issues informed by thinking from Bower Place will be explored in this section.