Introduction – Challenges of Adolescence

Adolescence is the ‘transitional phase of growth and development from childhood to adulthood‘  that occurs between 10 and 19 years. (World Health Organization) The obvious alterations in the individual physical, psychological, emotional, and social are often so compelling and obvious that they mask other changes that are equally if not more important, when addressing difficulties that present in these years. These are the changes that occur in the family and social world of the young person as they move beyond the boundary of the world into which they were born. 

As the young person is adjusting to changes in their body, mind, and community, so the family is realigning relationships, expectations, and patterns of being. This life phase can be as, if not more challenging, than that which goes with a baby becoming a toddler or a toddler a school child. Like these life phases it requires a complete alteration in how the developing person is perceived and a rebalancing of requirements for both managing their own conduct and that which they contribute to those around them. The balance of authority, that which a person can reasonably do for themselves and others and responsibility, that which a person will take ownership of managing for themselves and others, is being renegotiated in line with new developmental ability. This can become a major source of conflict in some families where the young person is not given the space to take responsibility for their choices and be allowed to struggle and fail and find a positive way through the experience. Alternately the adolescent may be reluctant to forgo the care and protection of childhood and continue to demand and expect services beyond those normally required for their age. Parents may become frightened by the increasing risk taking and violent outbursts that go with attempts to encourage responsibility. Expectations on both sides must be recalibrated to allow the young person to make choices with a sense of support behind them. 

Families present to therapy for a range of reasons that focus on the young person. These may be highly relational like conflict with parents or siblings or seemingly more individual including eating disorders, self-harm, anxiety, depression, conduct disorders, substance misuse and addiction. Yet we know that even the most skin bound difficulty can be positively or negatively impacted by the arrangement of relationships around the symptom bearer. For example, there is a substantial evidence base to support the value of ‘systemic interventions either alone or as part of multimodal programmes for conduct problems, emotional problems, eating disorders, somatic problems, and first episode psychosis. (Carr 2018) 

In exploring the presenting difficulty the practitioner will locate the  symptoms in relation to past and current patterns of parenting, the adults relationship with each other and the children, family history both in this and previous generations and  the hopes, dreams and expectations for the future of the young person as they intersect with the family and wider world. 

Mapping this complex array of factors with recognition of the very real brain and body turmoil of the young person presents the practitioner with a challenge as they work to effect change. 

Carr,A (2018) Family Therapy and Systemic Interventions for Child-Focused Problems: Journal of Family Therapy; Vol 41(2);pp153-213