Social Work

Practice with
Adolescents
 Outline

1. What is adolescence?
2. Adolescent Physical Development
3. Review of select theories that discuss
adolescence
4. Two common problems you may
encounter in work with adolescents
5. NASW Standards the Practice of Social
Work with Adolescents
What is adolescence?
Adolescence (lat adolescere, (to grow) is a transitional
stage of physical and mental human development that
occurs between childhood and adulthood. This
transition involves biological (i.e. pubertal), social, and
psychological changes, though the biological or
physiological ones are the easiest to measure
objectively. Historically, puberty has been heavily
associated with teenagers and the onset of adolescent
development. In recent years, however, the start of
puberty has had somewhat of an increase in
preadolescence (particularly females), and
adolescence has had an occasional extension beyond
the teenage years (typically males). This has made
adolescence less simple to discern.
What is adolescence?
The teenage years are from ages 13 to 19. However, the
end of adolescence and the beginning of adulthood
varies by country and by function, and furthermore
even within a single nation-state or culture there can be
different ages at which an individual is considered to be
(chronologically and legally) mature enough to be
entrusted by society with certain tasks. Such
milestones include, but are not limited to, driving a
vehicle, having legal sexual relations, serving in the
armed forces or on a jury, purchasing and drinking
alcohol, voting, entering into contracts, completing
certain levels of education, and marrying.
Adolescence is usually accompanied by an increased
independence allowed by the parents or legal
guardians and less supervision, contrary to the
preadolescence stage.
Adolescent Physical
Development
 Early physical maturation has a number
of benefits including better adjustment,
greater popularity with peers, and
superior athletic ability.
 In contrast, late-maturing boys are more
“childish,” exhibit more attention-seeking
behaviors, and have less confidence
(Crockett and Petersen, 1987)
Adolescent Physical
Development
 For girls, early physical maturation is more
likely to have negative consequences,
especially during the early adolescent years
 Early maturing girls tend to have a poor self-
concept, to be dissatisfied with their physical
development, to have lower academic
achievement, and to engage in sexual
precocious behavior and drug and alcohol use
(Stattin and Magnusson, 1990)
Adolescent Physical
Development
 Late-maturing girls also suffer some adverse effects as
the result of being treated like “little girls,” and they
tend to be dissatisfied with their appearance.
 In general, the negative consequences of early or late
maturation are most severe when adolescents perceive
themselves to differ from their peers.
 By adulthood, many of the effects of early or late
maturation have largely dissipated so that early-, late-,
and average-maturers are fairly indistinguishable
(Simmons and Blyth, 1987)
Adolescence according to
Freud
 Genital stage (age 12+): Libido is again
centered in the genitals, and successful
outcome in this stage occurs when
sexual desire is blended with affection to
produce mature sexual relationships.
 Failure to resolve this conflict as a result
of insufficient or excessive gratification of
the id’s needs can result in fixation at this
stage.
Adolescence according to
Erickson
 Ego Development Outcome: Identity vs. Role
Confusion
 Basic Strengths: Devotion and Fidelity
 Up to this stage, according to Erikson, development
mostly depends upon what is done to us. From here
on out, development depends primarily upon what we
do. And while adolescence is a stage at which we are
neither a child nor an adult, life is definitely getting
more complex as we attempt to find our own identity,
struggle with social interactions, and grapple with moral
issues.
Review: Erickson
 Our task is to discover who we are as individuals
separate from our family of origin and as members of a
wider society. Unfortunately for those around us, in this
process many of us go into a period of withdrawing
from responsibilities, which Erikson called a
"moratorium." And if we are unsuccessful in navigating
this stage, we will experience role confusion and
upheaval.
 A significant task for us is to establish a philosophy of
life and in this process we tend to think in terms of
ideals, which are conflict free, rather than reality, which
is not. The problem is that we don't have much
experience and find it easy to substitute ideals for
experience. However, we can also develop strong
devotion to friends and causes.
 It is no surprise that our most significant relationships
are with peer groups.
FOR CONTRAST: Young
Adulthood according to
Erickson
 Young adulthood: 18 to 35
 Ego Development Outcome: Intimacy and Solidarity vs.
Isolation
 Basic Strengths: Affiliation and Love
 In the initial stage of being an adult we seek one or more
companions and love. As we try to find mutually satisfying
relationships, primarily through marriage and friends, we
generally also begin to start a family, though this age has
been pushed back for many couples who today don't start
their families until their late thirties. If negotiating this stage
is successful, we can experience intimacy on a deep level.
 If we're not successful, isolation and distance from others
may occur. And when we don't find it easy to create
satisfying relationships, our world can begin to shrink as, in
defense, we can feel superior to others.
 Our significant relationships are with marital partners and
friends.
Erikson’s “Identity Crisis”

Expanded by Marcia (1987):

 Four identity statuses (patterns)
1. Identity Diffusion: The adolescent has not yet
experienced an identity crisis or explored
alternatives and is not committed to an identity.
2. Identity Foreclosure: The adolescent has not
experienced a crisis but had adopted an identity
(occupation, ideology, etc.) that has been imposed
by others (often the same-sex parent)
Erikson’s “Identity Crisis”

 Four identity statuses (patterns)

3. Identity Moratorium: The adolescent experiences
an identity crisis and actively explores alternative
identities. During this period, an adolescent
exhibits a high degree of confusion, discontent
and rebelliousness.
4. Identity achievement: Adolescents who have
resolved the identity crisis by evaluating
alternatives and committing to an identity are
“identity achieved”
Erikson’s “Identity Crisis”

 Resolution: partially resolved by the shift from

dependence to increasing independence.
 Strategies used in early childhood to achieve
separation may return during this process – e.g.,
negativism, or resisting any form of control, may
reflect an adolescent's renewed efforts to assert
their independence.
 There may also be rebelliousness and acting out
Erikson’s “Identity Crisis”

 Parent factors associated with successful

adolescent identity formation include:
 A willingness to negotiate with their teenager.
 Providing the teenager with support and
reassurance.
 Allowing the teenager to develop his own point of
view.
 A family atmosphere that promotes individuation
Hauser et al., 1987
Levinson’s “Seasons of a
Man’s Life”
 The early adult transition (age 17 to 22): entails
leaving the world of childhood and forming the
initial foundation for life in the adult world.
Tasks include becoming independent from
one’s parents and getting involved in college,
the military, an entry-level job, etc. This
transition leads to the formation of The Dream,
the image of an ideal life that guides one’s
decisions and choices.
Gilligan’s Relational Crisis

 Girls ages 11 or 12 years old experience a

relational crisis in response to increasing
pressure to fit cultural stereotypes about the
“perfect good woman”
 As a result, they disconnect from themselves in
order to maintain relationships with others.
 Consequences: drop in academic
achievement, loss of self-esteem, increase in
vulnerability to psychological problems
Adolescent Self-Concept

 Concern for physical appearance and

how other perceive how they look.
 Self esteem lowest during early
adolescence (ages 12 to 14)
Adolescent Self-Concept

 Renewed egocentrism:
 Imaginary audience: Adolescents often feel
as though other are watching or paying
attention to them (i.e., as though they are
“on stage”)
 Personal Fable: Adolescents deeply believe
in the uniqueness of their own experiences.
This produces a sense of immortality and
invulnerability to harm.
Adolescent Emotional
Development and
Experience
 Critical tasks: learning how to cope with
rapidly changing moods, particularly
periods of feeling “down”
 At risk for responding to boredom with
unproductive activities.
 Encouraged to take part in activities that
allow them to experience feelings of
personal fulfillment.
What the more
recent literature
says…
AKA The Textbooks!
Hepworth, Rooney, and
Larsen: The importance of
rapport with adolescents
 Adolescents who have had little or no
experience of social workers have an
extremely limited grasp of their roles
 Adolescents, at least initially, are often
involuntary clients and perceive social
workers as adversaries, fearing that their
role is to punish or to exercise power over
them.
Hepworth, Rooney, and
Larsen: The importance of
rapport with adolescents
 Warm-up periods are also important in gaining
rapport with adolescents, many of whom are in a
stage of emancipating themselves from adults
and who are also frequently referred by those
adults.
 Consequently, they may be wary of social
workers, and this is a particularly strong
tendency among those who are delinquent or
who are otherwise openly rebelling against
authority.
Johnson and Yanca

 Inclusion and participation

 Group formats (discussion-activity-
discussion structure)
 Encourage prevention by reducing risk
factors
 Decision making and refusal methods
 Role plays, assertiveness training, and
similar techniques can be employed
Two common
problems in
adolescence
Delinquency (externalizing problems)
Self-harm and cutting (internalizing
problems)
Delinquency

 Child or adolescent engages in illegal activities

 Etiology based on the research: parental lack
of supervision and inconsistent (or harsh)
punishment as highly correlated with
delinquency and involvement with antisocial
friends.
 Also, young children identified as aggressive =
high probability of delinquency in adolescence
Delinquency
 Other risk factors:  Family history of
 Male gender incarceration, violence,
substance abuse and/or
 Low school expectations mental illness
 Low attachments to  Low income status
school
 Living in a rundown
 Low achievement in neighborhood with a high
school crime rate
 Poor verbal ability  Living in a dense urban
 Poor school conditions community
(rundown school, poor
monitoring) (Dryfoos, 1990; Loeber and
Farrington, 2001)
Delinquency
 Best predictor or recidivism is age at first
offense, younger the more likely they will re-
offend. Child delinquents have a greater risk of
becoming serious and chronic offenders than
juvenile offenders.
 Minor delinquent acts during adolescents are
fairly common and usually not a sign of
pathology – such acts are likely motivated by a
desire to be liked by peers or to increase one’s
self-esteem.
Self-harm and cutting

 Behaviors involving self-harm (self-

mutilation) often have onset in
adolescence
 “the deliberate destruction or alteration of
one’s own body tissue without conscious
suicidal intent” (Favazza, 1987, p. 225)
Self-harm and cutting

 Associated with (rule out):

 Sexual and physical abuse
 Compulsive disorders
 Eating and body images disorders
 Difficulties with impulse control
 Peer conflicts
 Exposure to alcoholism and violence
Self-harm and cutting

 Usually performed in secret

 Addictive quality
 Evoke strong feelings in the person,
including shame and guilt
 Many theories about reasons, most
agree that it may be a means of
emotional expression and control.
Self-harm and cutting
 Other theories
 Provide relief from feelings
 Prevent dissociation
 Elicit euphoric feelings
 Express pain
 Method of coping
 Form of communicating with others
 Self-nurturing or self-punishment
 Re-enact experiences of being abused
 Way of establishing control
NASW Standards the
Practice of Social Work with
Adolescents
1. Knowledge of Adolescent Development
2. Assessment
3. Knowledge of Family Dynamics
4. Cultural Competence
5. Self-Empowerment of Adolescents
6. Understanding Adolescents’ needs
7. Multidisciplinary Case Consultation
8. Confidentiality
9. Work Environment
10. Advocacy
11. Policies of Effective Practice
Knowledge of Adolescent
Development
Essential areas of knowledge and understanding about positive adolescent
development include:

■ human growth and behavior, including developmental stages, human needs,

motivations, feelings, behaviors, activities of children and youths, and cultural
differences
■ the role of adolescence in individuals’ social, physical, emotional, and sexual growth,
including adolescents’ striving for and ambivalence about independence,
competence, achievement, personal identity, and sexuality
■ the critical role of education in healthy adolescent development and the barriers to a
successful educational experience
■ the necessity to recognize the needs of adolescent development
■ the impact of substance abuse and violence on adolescents’ development and on
their families
■ the family, school, community, and cultural process for allowing and helping
adolescents become independent
■ the importance of opportunities for adolescents to establish positive relationships
with open expression of thoughts and feelings with family members, peers, and
role models such as teachers, clergy, and sports team coaches
■ the significance of adolescents’ steps in establishing an identity, which may include a
natural form of rebelliousness and rejection of authority.
Assessment
Social workers shall possess the following fundamental knowledge and skills
to work effectively with adolescents and their families:
■ the history and development of social work and its person-in-environment
perspective
■ the theory, principles, and methods of social work, including casework,
group work, community organization, administration, supervision,
planning, and research
■ the influence of cultural beliefs, background, lifestyles, and ethnicity
■ the interrelationships among the individual and the family, the group, the
neighborhood, the community, and social
systems
■ the purpose, structure, legal mandates, and services provided by public
and voluntary social welfare, child welfare, and youth services agencies;
schools; and health, mental health, juvenile justice, and law enforcement
organizations
■ an ability to coordinate with other professionals and community
organizations and advocate for their involvement on behalf of youths
Assessment
■ the political and economic factors affecting adolescents, their families, and
their communities
■ multidisciplinary and team approaches for working with children and
youths, and the contributions from biomedical, psychological, social
sciences, legal, educational, law enforcement, and other disciplines
■ opportunities available to adolescents for training to increase job-related
skills
■ an understanding of the importance of working with adolescents in the
environments in which they feel comfortable, including nontraditional
environments
■ familiarity with groups who provide peer education and improve youths’
decision making and leadership skills
■ understanding of and ability to develop a case plan jointly with youths and
their families
■ an understanding of how to develop programs that provide comprehensive
services to adolescents to prevent fragmentation
■ an understanding of how to develop programs that will increase the
likelihood that youths will use available services for the range of issues
that affect adolescents (for example, reproductive health, HIV/AIDS and
other STIs, violence, and abuse).
Knowledge of Family
Dynamics
NASW defines families as two or more people who consider
themselves “family” and who assume obligations, functions, and
responsibilities generally essential to healthy family life.

Essential areas of knowledge about family dynamics include

■ family dynamics in traditional and nontraditional families, including
two-parent, single-parent, and foster and adoptive families and
unrelated individuals living together as a family, and acceptance
and understanding of such family constellations
■ the impact of adolescents’ parents’ growth experiences, attitudes,
and behaviors and culturally relevant ways for parents to ask for
help
Knowledge of Family
Dynamics
■ an understanding of how to bring about changes in family
functioning
■ the concept of family culture, including the role of the family in
meeting the changing physical, mental, spiritual, and emotional
needs of adolescents
■ cultural attitudes toward the responsibilities of each family member
■ the impact of impairment and disability, including mental and
emotional disabilities, chemical dependency, and abusive
conditions on positive adolescent development and family
dynamics
■ an understanding of changing parental roles and the diversity
among those roles
■ the impact of economic, social, and cultural conditions on parental
ability to meet family responsibilities.
Self-Empowerment of
Adolescents
Social workers should demonstrate the necessary knowledge and
skills to ensure the participation of adolescents in decisions about
the programs and services designed to meet their needs. This
includes
■ encouraging youths and their families to be active participants in
their case planning and service delivery
■ developing adolescent leaders to provide peer support to other
adolescents and supporting their efforts
■ advocating for youth positions and roles of influence on agency
boards or committees and providing training for youths to develop
the skills needed to improve existing services and develop
necessary services
■ working with youths and their families to help them assume
responsibility for following through on a plan of action and for
securing and using planned services
■ providing or brokering the training and support to help youths
develop independent living skills.
Understanding
Adolescents’ needs
Social workers who work with adolescents should respect and work
to strengthen the many protective factors that are sometimes
overlooked or ignored. Appropriate and effective work with
adolescents requires an understanding of the developmental skills
and tasks characteristic of the age, an awareness of the
psychosocial and emotional phases of adolescence, and clinical
knowledge of inappropriate behavior and symptoms of mental
illness or stress. Social workers should be aware that adolescents’
behaviors and attitudes may provoke ambivalent or negative
feelings in those who work with this age group.
Social workers need to be aware of adolescents’ multidimensional
lives, regardless of service focus. This includes the family,
siblings, extended family, individuals with whom the adolescent
may reside, peer group, friends of the opposite sex, religious
affiliation, physical and mental health, cultural and economic facts,
refugee status, discrimination experiences, and exposure to
violence in the community or family or from war experiences. In
advocating for adolescents, social workers must work to ensure
that
Understanding
Adolescents’ needs
■ continuing education is available for providers, professionals, and
families of adolescents to develop skills and a knowledge base, to
acknowledge and enhance adolescent protective and resilient
factors, and to strengthen empowerment capacities and decision-
making skills
■ community services are responsive to the mental health, physical,
medical, educational, vocational and occupational training,
housing, and other needs of adolescents as articulated by
adolescents and their families
■ agencies provide opportunities for staff to recognize and take
appropriate actions to resolve their own biases, fears, or antipathy
about behaviors exhibited by adolescent clients
Understanding
Adolescents’ needs
■ policies and programs adjust, change, or accommodate to meet the
needs of adolescents in different settings and with different
disabilities or mental or physical limitations
■ opportunities are provided for adolescents to discuss, learn about,
and appreciate the uniqueness of different cultures, personalities,
and interactions
■ knowledge is increased about medical and substance abuse
issues, methods of fostering healthy attitudes, interventions, and
behavior toward drug use among targeted youths
■ improved school connections are encouraged to improve academic
performance, school attendance and behavior, and attitudes
toward learning and achievement
■ opportunities for strong relationships with adults and peers for
positive and supportive interaction are available
Understanding
Adolescents’ needs
■ information about model programs for prevention and treatment is
available
■ information is disseminated on the effects of alcohol, substance
abuse, domestic and dating violence, and HIV/AIDS to families
and communities
■ information, news, and updates about pressures on adolescents
from different cultures, income levels, and ethnic groups are
routinely provided
■ opportunities to identify and address risk-taking behavior are
available in community forums and parent groups, as well as with
educators, juvenile justice staff, and law enforcement officials
■ opportunities for collaboration among community, religious, and
athletic groups are supported
■ opportunities exist to recognize adolescent achievements.
Confidentiality
Respect for the client as a person and for his or her right to privacy
underlies the social worker–client relationship. Except for federal,
state, or local legal and other overriding requirements, the social
worker will share information only with the informed and signed
consent of the youth, the family, or both. Although assurance of
confidentiality enhances the relationship and the willingness of the
youth to develop and adhere to a case plan, the youth should be
advised that there are circumstances in which confidentiality
cannot be maintained. These situations may include
■ suspicion of child abuse or neglect, which requires that appropriate
authorities be notified
■ suspicion of danger to the youth or to others.
In all such situations, the social worker shall advise the youth of the
exceptions to confidentiality and privilege, shall be prepared to
share with the youth the information that is being reported, and
shall appropriately address the feelings evoked.