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 – Sexual development Not children, but not adults either

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 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 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? 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 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 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 Parent-adolescent conflict Truancy Running away Violence Substance use Depression and Self harm

Seven principles behind RAPS work 1.Adolescence-unique developmental stage 2.Balance between connection & limits 3.Effective work involves working whole family 4.Need a wider systems perspective 5.Early intervention is preferable 6.Staff have postgraduate training in family therapy 7.Staff need good consultation and supervision

Seven principles behind RAPS work 1.Adolescence- a unique developmental stage

1.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 work 1.Adolescence- a unique developmental stage 2.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

Seven principles behind RAPS work 1.Adolescence- a unique developmental stage 2.Balance between connection & limits 3.Effective work involves working 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 work 1.Adolescence- a unique developmental stage 2.Balance between connection & limits 3.Effective work involves working whole family 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 work 1.Adolescence- a unique developmental stage 2.Balance between connection & limits 3.Effective work involves working whole family 4.Need a wider systems perspective 5.Early intervention is preferable

Early intervention in problem behaviours is preferable Staff also work at the serious end Example- substance use

Therapist Parents Young Person ResigningToleratingNormalisingReassuring & Normalising Strengthening vs Empowering vs Escalating & Confronting vs Inquiring & Educating vs Rehabilitating vs Resigning Taking charge vs Enabling Networking vs Normalising Reacting vs Minimising FailingPlottingPartyingExperimenting Desperate times Necessary times Good timesCurious times Stage 4Stage 3Stage 2Stage 1

Seven principles behind RAPS work 1.Adolescence- a unique developmental stage 2.Balance between connection & limits 3.Effective work involves working whole family 4.Need a wider systems perspective 5.Early intervention is preferable 6.Staff have post graduate 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 work 1.Adolescence- a unique developmental stage 2.Balance between connection & limits 3.Effective work involves working whole family 4.Need a wider systems perspective 5.Early intervention is preferable 6.Staff have post graduate training in family therapy 7.Staff need good consultation and 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 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 Lyndal Power AFRC Briefing No.16- “What works with adolescents?” 16.html 16.html Elly Robinson, Lyndal Power and David Allan