ADJUSTMENT DISORDERS

According to psychoanalytic theory, these children are fixed in the separation-individuation phase of development, ego development is retarded, and id behavior is prominent. Certain family patterns contribute to disruptive behavior. They include parental rejection, inconsistency, rigid, or harsh discipline, an unstable spousal relationship, and a lack of feeling security within the family system. History of symptoms often appear during the adolescent period. 

The child may also in addition to mood swings and disruptive behavior have a history of poor school work. Projection of blame to others is a prominent defense mechanism. Their dress may reflect fashion trends or be atypical. They may also be involved in drug abuse, alcohol abuse, the use of cigarettes, chewing tobacco, etc.  Affect may be liable. Physical characteristics/development may not be normal for age range.

1. Drug screening is often useful to rule out substance abuse a contributing factor to behavioral problems.

2. Promote development of strategies which regulate impulse control and promote a feeling of self worth and security.

3. Teach appropriate methods of dealing with stressors and frustration.

4. Help the adolescent learn to express legitimate feelings of anger and aggression in more appropriate ways.

5. The parents and family may also need to be involved in therapy and participate in the treatment program. Parents need to develop adequate structure at home until the child can learn to develop more internal control to regulate behavior.

6. Assist the client to recognize the reality and no productivity of his maladaptive behaviors (failing grades, running away, etc.).

7. Focus on specific behaviors (poor academics, anti-social behavior) which are amenable to change.

8. Reinforce client positively when changes in behavior indicate effective coping through behavior modification system. Anticipate and accept occasional aggressive behaviors.

9. Help the child identify frustrating situations and learn to avoid them. Also, help the child learn socially acceptable ways to obtain desired goals, such as peer approval, acceptance, recognition, in more positive rather than negative ways. The adolescent also needs to understand that the feelings and motives are OK and that it's his behavior rather than how he feels which is causing difficulties.

10.  Finally, help the child understand that there is no such thing as a wrong feeling, there is only wrong behavior.