Working with Distressed Young People

Bob Harris

• Publisher: Learning Matters
• Year: 2011
• Print ISBN: 9781844452057
• eBook ISBN: 9781844456369
• Edition: 1
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

Anyone working in the caring professions and education who wishes to understand the causes of difficult, disturbing and dangerous behaviour in young people and to find out how to change it, will find this book useful.

It shows how distress and disturbance is created in young people, causing their behaviour to become difficult and problematic not only to adults but also to themselves and to wider society. Using the latest evidence-based theories, the reader will learn how to detect and diagnose problems and work out strategies for helping young people in distress.

Part One

Setting the scene

Chapter 1

Young people in their social, relational and cultural context

CHAPTER OBJECTIVES

By the end of this chapter you will have:

• understood how the young person’s social, relational and cultural environment affects their development;
• understood the major causes of distress in young people;
• explored some of the manifestations of distress in young people;
• understood why an understanding of groups and group work skills are essential in work with distressed young people.

Introduction

Distressed young people often exhibit difficult and problematic behaviour and they are frequently miserable, angry, anxious and unhappy. Their behaviour is disturbed and disturbing for others close to them. They can be deeply troubling and worrying to those in contact with them, especially parents and others who have family, community or professional responsibility for them. Suffering the consequences of a child’s disturbed and disturbing behaviour is always painful and difficult.

Some distressed young people become very quiet and compliant, silent and withdrawn. They do not make their feelings heard and do not complain. They may become almost mute and invisible. Sometimes they develop a strange symptom such as self-starvation, self-harm, maybe an obsessive preoccupation, or perhaps odd or delinquent behaviour that both calls attention to their pain and distress – and hides its true nature at the same time.

Problems may be hidden or pushed out of awareness because they are too difficult to articulate or too painful to face.

In this chapter, we will explore the nature of a child’s basic needs, and the distress that is caused to the growing child and young person when these needs are not met. We shall look at some of the ways in which distress is expressed behaviourally and psychologically, and outline some basic approaches to helping distressed children. These approaches will be discussed in more detail later on in the book.

Throughout, I take the view that human psychological needs are primarily relational, that is, they are in relation to and connected to relationships with other people. This is part and parcel of the fact that human beings exist in complex societies, which are made up of many interrelated parts.

This is not a new idea.

This thou must always bear in mind, what is the nature of the whole, and what is your nature, and how this is related to that, and what kind of part it is to what kind of a whole . . .

(Marcus Aurelius, about AD 121, quoted in Long, 1982)

Trust and safety

Young people need the experience of being able to get close to and maintain a relationship with an adult who they can trust and feel safe with. The relational context in which this essential connection can occur is largely the topic of this book.

The group comes first

During the course of this chapter, you will be invited to consider the viewpoint that young people, and human beings generally, are primarily social, a word which in this context is used to describe the way people in groups behave and interact. Young people grow up and learn how to behave in a social environment that develops and shapes them, and which can produce outcomes both good and bad.

The immediate social and relational environment that a child grows up in is also in the context of a wider culture, which in turn carries ideas about behavioural norms, beliefs and values. This social and cultural environment exerts a powerful influence on social learning, and consequently, social behaviour.

Distress in young people is the result of problems that the growing child experiences in relating to other people in the child’s immediate environment. This includes difficulties in relationships with parents, other children and problematic aspects of the wider social and cultural network of which the child and their immediate caretakers are a part.

. . . a baby is formed in the womb, an individual is formed in a relationship.

(Rifkin, 2010)

Rifkin might have said, ‘within a matrix of relationships’.

Or we might say, along with Winnicott, that there is no such thing as a mother and baby as separate beings. You can only really think about a mother and baby pair, and that pair is intimately connected to the wider network that supports it (Winnicott, 1965).

I will use occasional case studies in this text, which will be discussed, and which will then be used to raise questions for the reader to consider. The case studies are, of course, modified and condensed to protect confidentiality and for the sake of brevity, but the situations are all taken from real experiences in real encounters in professional work with real young people. They are selected from work with young people from different socioeconomic classes and cultural backgrounds in order to show that, although the apparent and ‘surface’ features may appear to be very different, the psychological fundamentals are very much the same.

A boy who has spent much of his life as a boarder at a top public school may experience the same sort of feeling of disconnection, rejection and depression as a girl who has spent much of her life in care.

A developmental ‘cascade’

I’ve come to realise, as I get older, that actually, at any one time, I am all the ages I have ever been.

(Youth work trainee in his late 40s)

Throughout this book it is assumed that child and adolescent development is best thought of in terms of cascade of developmental processes. The development of an individual human being may appear to have a linear trajectory in terms of chronological age and ‘developmental tasks’, but in fact proceeds in a far more complex manner as each developmental stage, or competence, always involves navigating a complicated set of fluid and often unpredictable series of relationships and processes. It is not a ‘one-off’ learning event.

Fortunately for us, although the day-to-day picture is complicated, the underlying principles are quite easy to understand. For instance, it was observed decades ago (Kohlberg et al., 1972) that some indicators of childhood problems consistently predicted adult adjustment across multiple domains of outcome, especially ‘socialised conduct’ versus ‘anti-social behaviour’. ‘Anti-social behaviour’ is indexed by persistent rule-breaking behaviours.

It is easy to grasp the fundamental assertion that effectiveness in one domain of competence in one period of life effectively becomes the scaffold on which later competence in newly emerging domains develops; in other words, competence at one stage of life creates the conditions for competence in later stages. It is an incremental process.

For instance, behavioural problems arising in the family in pre-school years, in response to inept unempathic or misattuned parenting, are carried forward into the school context by the child, leading to problems in new domains of academic and especially social competence. Failure in these domains contribute significantly towards depressive responses. Especially in the case of social competence, this frequently causes rejection by peers (who may have helped to normalise problematic behaviour) which in turn amplifies depression and raises the risk of a drift into relationships with deviant peers who may reinforce antisocial, depressive, avoidant or self-destructive behaviour (Masten and Cicchetti, 2010).

The concept of developmental cascades is of great help when assessing what kinds of interventions one might choose to make with distressed young people, so that any intervention is targeted as precisely as possible at the developmental ‘domain’ that needs attention. It can help us be more precise with our interventions.

Plumber to customer: ‘I know I’ve just charged you £75 to whack your pipe with a hammer to clear the blockage. But it’s taken me 25 years to learn where to whack it’.

You will almost certainly be required to explain to fund-holders and others exactly why you need money for a certain type of intervention or activity, so precise thinking in this area is very important. It is not enough any more to justify expenditure in terms of rectifying a perceived developmental deficit or vague ideas about countering the effect of social deprivation; you may have to show with evidence how your intervention impacts on the wider picture and possibly on political policy and ideology, especially if there are resource implications.

For instance, it is known that problems in peer relating has an impact on academic achievement and delinquent behaviour. So if academic achievement or delinquent behaviour is an issue with the young people that you are involved with, you may consider that an intervention that specifically addresses peer relations in depth would be a good idea. This will almost certainly involve groupwork of some kind.

This book is primarily about the domain that could be called ‘social relationships’ rather than academic or other learning. In work with young people, peer relationships are, of course, mainly what we are working with in one form or another.

We are social animals

Human beings are intrinsically social animals. It is probable that we evolved in smallish tribal groups that wandered, hunted and gathered food. Couplings and marriages were made, children born, old and young would die, there would be fighting with competing tribes and groups; young and old would work, hunt and gather. Babies and young children would be looked after by parents and grandparents, sometimes by older brothers and sisters and when they could walk would tag along with anyone who would make them feel safe and protected from predators of various kinds, human and animal.

Growing a little older they would play in groups, probably largely of their own sex, and when they were strong enough, joining in with the men or women in their particular activities, maybe going through some sort of initiation ceremony before being recognised as full adults. Children had plenty of opportunity to see what adults did, as life was visible and communal in most aspects. Parenting, sexuality, coping with death and birth, dealing with conflicts and relationships with other people generally, finding, preparing and eating food, rituals and ceremonies would be, by today’s standards, relatively visible and social. They would be group experiences. All human cultures have evolved to deal with basic aspects of human existence. And all human cultures are based around relationships in groups in relation to the environment in which they live.

How we learn and develop

Human children learn by watching and imitating; learning from experience, exploring the nature of the world and learning from others how to cope with life. As Marcus Aurelius observed earlier, humans are the most social of animals and the most complex, especially in their mental abilities. It is the ability to learn and play with ideas that enables humans to adapt imaginatively to complex, changing environments and it is the ability to learn that creates new possibilities. Human cultures have evolved to deal with the most diverse and challenging environments; this is one of the most remarkable aspects of our species.

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Table of contents

• Cover
• Title
• Copyright
• Dedication
• Contents
• Foreword from the Series Editors
• Preface
• Acknowledgements
• Part One: Setting the scene
• Part Two: Practical help
• References
• Index