Adhering to unifying principles of child and adolescent development

In situations where children may have diagnosable disorders such as on the autism spectrum, the core developmental task should not be lost sight of, since we are concerned with unifying principles of development, rather than what sets children and young people apart from each other. This comes particularly to the fore in working with children who have such diagnoses, where it is important not to become blinded by the symptom. Children who have obsessive behaviours, or high levels of anxiety, need to be able to live within their families, go to school and maintain relationships with peers where possible. An approach that works towards normalisation in the form of raising expectations for both the child and the parents can be useful. Many parents in these situations become encapsulated into the fearful inner world of the child and trapped there with the child. Whilst not denying the child’s difficulties, a focus on the developmental task enables us to support parents to normalise development for the child wherever possible. This in turn normalises the parenting task and gives parents permission to set more appropriate limits and boundaries without continual recourse to making allowances for the ‘disorder’.

At the opposite end of the age spectrum we meet adolescents who are struggling to find a sense of identity and are fearful of entertaining the idea of a life that does not include a lifeline to a significant parent whether father or mother. Here we may be dealing with a situation in which parents have come to believe that their adolescent boy or girl is devoid of inner resources. As a result, the parent is always called upon to clear the path. In one such example, a 15-year-old boy reflected that a group of parents had acted prematurely by rushing in to try to deal with a conflict that had arisen in his friendship group. We can see how in these situations, the wish on the part of the parents to be helpful can override and undermine the innate capacities of the children and young people themselves to address the difficulties. Helping with the developmental task of assisting the young person to move into independence therefore, also involves helping parents to manage this transition.

When we consider some of the current research on adolescent depression, there appears to be a growing assumption that adolescents represent an almost separate category, or clinical group that can be treated as though detached from their parents. However, clinical experience suggests that we should proceed with caution when it comes to de-coupling the adolescent from their family context. While it may be helpful for adolescents and young people to have therapy in their own right, it should not automatically follow that parents should be nowhere involved. The idea of the independent adolescent or young person may represent a neat subgroup for research purposes, but we need to keep in mind that it is the critical work involved in helping them through this period of transition that needs to come to the fore. This involves helping both the young person and their parents make sense of their relationships through this period of change. There are two important factors to be taken into account in working with adolescents: the first is that as a period of profound transition, adolescence inevitably throws up relationship and family problems that may not have been previously resolved; the second is that these problems as mentioned throughout the book represent the opportunity for exploration and understanding.

In many cases, understanding how the young person’s problem is embedded in the parental interaction can in itself produce dynamic and positive change for the first time in the life of the family as well as the adolescent. This takes into account the re-working of the alliances and attachment within the family. For example, a 17-year-old boy with hitherto compliant behaviour had become involved in school refusal and destructive behaviour. It emerged that he was struggling to avoid a ‘blueprint’ future mapped out for him by his controlling father. His mother, who had always maintained a passive position in the family, rose up for the first time to assert her authority to challenge the ‘blueprint’ which helped to free her son from the need to act out in an unhelpful manner. In this example, perceiving the symptom as the opportunity, and not becoming sidelined by the perceived need to get the boy back on track in relation to his schoolwork, enabled us to open up the potential for change that lay dormant within the mother, who could then act in the best interests of her son.

 
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