In my work with older adolescents and young adults, the question, "Why are these kids so complicated?" usually comes to me from parents in unspoken form. The parents have done everything. The child has been evaluated, diagnosed, medicated. He has attended special schools; she has had special tutors. Behavioral plans have been instituted at home and at school. "What's next? When will we be done?" they ask. I talk with them about 10-year plans as development is delayed and the brain is not fully developed until the mid-twenties. We discuss the limits of psychiatry and psychology as diagnosticc categories only give us a gross understanding of each particular child. Labels and diagnoses, in and of themselves, do not always tell us much. It becomes more important with young adults to understand each family's patterns of interactions and accommodations in order to support an effective launching plan. I tell parents, "The young adult can't do it without you."
Treatment with older teenagers and young adults with self-management disorders is about getting to know each young person, his or her family, and how they function, both individually and together. There is no "one size fits all" for the high school or college student with ADHD, Tourette's, learning disabilities, anxiety or depression--to name just a few. For example, the usual approaches to SAT/ACT preparation can be confusing, overwhelming, and defeating for the vulnerable teenager with ADHD or learning differences. That student may respond much better to working with someone who understands her learning strengths and weaknesses, as well as, how anxiety can derail her best cognitive skills on any given day.
Launching these complicated young people is not a generic process. It must become individualized in order to increase the potential for the incremental successes that keep the student and family going. Movement towards successful outcomes, such as a Bachelor's degree or vocational certifications, may seem glacial. Families can get discouraged when their young person is compared to friends, siblings, or cousins. The traumatic impact on these same students, however, of major failures, such as DWI's or Academic Probation, can add years to the launching process. It is a difficult, and sometimes, devastating process for the family of a failed student to pick him up and start over, sometimes, again and again. The toll on self-esteem, confidence, and courage to try again can make it all feel insurmountable to a vulnerable young adult.
The key to successful launching of young people with self-management disorders is to get them, and then keep them, engaged in their own growth as much as possible. This sounds easier than it is. It is also not linear. There are stops and starts, detours and road blocks. It is painful to observe a young adult who is stalled out with no movement in any direction. Parents in response tend to get fearful and frustrated which seems to immobilize the young adult even more.
Parents must believe in growth. They must believe that their young person can learn to make their way in the world. The developmental process and neuroplasticity are the family's main allies for growth, but they are not passive processes. Things to remember: 1) The brain learns. Learning is what builds a brain. 2) The brain grows new pathways in struggle; skills emerge out of active engagement. No learning occurs if a task is too easy or too hard. For each of us, it is about finding that optimal level of frustration with a task being just too hard, and then, figuring it out. Over and over again.
When children are young it can be easier to encourage growth. Their friends know how to swim or ride a bike. Parents say "You can have swimming lessons." Or, "We will teach you how to ride a bike." Your child does not want to get left behind. As children get older they are often very aware of what peers are able to do and they, themselves, can't. Parents may get tired of hearing what Annie gets to do, but at the same time, there is awareness that kids encourage each other's growth.
When vulnerable teenagers and young adults get stalled or derailed from their own growth path, it can be very difficult for parents to get them moving again in a good direction. It is an individualized process. The neurological differences which are subsumed under various diagnoses, interfere in ways that are hard to comprehend and make sense of by parents and even some mental health professionals. The goals for launching may be the same for your vulnerable young adult as it is for any of your other children. The path, the route may look much different. This is where parents need special help to get the young person engaged in growth.
A dear friend wrote to me and said, "Thanks for understanding, but how are you going to help me to help my child? I feel helpless and hopeless. I've done so much and here we are coping with another huge hurdle. The hurdles get bigger and bigger and never seem to end."
We start with opening up a dialogue. The parents are going through various stages of grief all the time. They need to be able to express their fears, resentments, sadness, and frustrations without the young person taking it on and feeling miserable, and without the parents feeling guilty or blaming each other. The family is living in a complicated launching process that no one planned or wanted. Each family member feels blamed, responsible, and stuck. This is where a therapist, experienced with these types of young people, is useful.
Meeting separately with parents and the young adult or teenager, the therapist begins to get a clearer sense of the family and where the work is. Learning Style, Self-Management, and Psychological Evaluations help to clarify how the young adult's brain processes information, where the self-managment skills are in place, and what needs to be developed. At the same time, the parents engage in a process of determining what they will and will not support, what is involved or required to live in their home, and what they will and will not pay for. We work together to distinguish between enabling and supporting the young person. Enabling is when the actions of others interfere with an individual experiencing the consequences of his or her actions. This sounds simple enough until the young person gets in trouble and looks to be rescued. Families feel the pull to rescue quite intensely, and sometimes, they should rescue. But, there is always a price to pay. It is a highly individualized process. There is no one way to do this!
The next step comes when the teenager and parents comprehend that growth is not about good intentions alone. The good intentions must become operationalized in daily life. It is not enough for the young person to say, "I want to get good grades." The intention must be partnered with hard work and persistent effort-by the student, not the parents. Teens will tell you they are ready to go away to college. If, during their senior year of high school, parents have to get them up and moving each day, monitor their medicines, track their tests and projects, then it is clear that they are not ready to leave home. Parents must help these young people appreciate how acquiring and implementing self-management skills at age-appropriate levels are in their best interest. The young people must be engaged in their own growth. But 20 years of experience has taught us that the vulnerable young adult can not do it without you.
You can also read more about Dr. Havasy on her blog at www.drhavasy.com
Sophia K. Havasy, Ph.D.