Week 9: Interventions With Adolescents

When working with adolescents, social workers must understand the difference between acceptable developmental behaviors and unacceptable risky behaviors. Developmental consideration should always be at the forefront when assessing and working with an adolescent. While adolescents present with many varied concerns and situations, two leading issues prevail: their relationship with their parents or guardians and their experiences with their peers. Both groups impact the adolescent’s sense of self and influence the individual’s mental and emotional health. Finally, navigating the 21st century as an adolescent in the digital age can be both exciting and overwhelming. Now, more than ever, adolescents are bombarded with media and technology that can stimulate the mind but sometimes cause harm.

Learning Objectives

Students will:

• Analyze online interventions for adolescents
• Analyze interventions for adolescent depression and suicide
• Apply interventions for adolescent depression and suicide

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

LeCroy, C. W., & Williams, L. R. (2013). Intervention with adolescents. In M. Holosko, C. Dulmus, & K. Sowers (Eds.), Social work practice with individuals and families: Evidence- informed assessments and interventions (pp. 97–124). Hoboken, NJ: Wiley.

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014a). Sessions: case histories. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].
The Bradley Family (pp. 17–19)

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014b). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

Working With Families: The Case of Brady (pp. 26–28)

Note: Depending on your concentration, you may not receive a case study book until a later term. Therefore, if you did not receive a copy of Social Work Case Studies: Concentration Year in your previous course, use the linked PDF provided here. If you did receive the book referenced above, you may find the cases there or use the PDF.

Centers for Disease Control and Prevention. (2018). Youth violence. Retrieved from https://www.cdc.gov/violenceprevention/youthviolence/index.html

Austin, A., Craig, S. L., & D’Souza, S. A. (2018). An AFFIRMative cognitive behavioral intervention for transgender youth: Preliminary effectiveness. Professional Psychology: Research And Practice, 49(1), 1-8.

Lindsey, M. A., Brown, D. R., & Cunningham, M. (2017). Boys do(n’t) cry: Addressing the unmet mental health needs of African American boys. American Journal Of Orthopsychiatry, 87(4), 377-383.

Required Media

Laureate Education (Producer). (2013a). Bradley family: Episode 2 [Video file]. Retrieved from https://class.waldenu.edu
Accessible player –Downloads–Download Video w/CCDownload AudioDownload TranscriptCredit: Provided courtesy of the Laureate International Network of Universities.

Optional Resources

Use this link to access the MSW home page, which provides resources for your social work program.

Discussion 1: Online Interventions

Adolescence is a time of trials and tribulations. Teens are dealing with the formation of self and identifying who they are in the world. They are also experiencing biological changes that create mood swings and at times emotional outbursts. Interventions for this group can be challenging, as adolescents often avoid asking for assistance. This avoidance is due to their desire to look normal and fit in. Online interventions might be one way to reach adolescents who need help.

For this Discussion, choose a concern that adolescents face, such as depression, suicide, self-esteem, eating disorders, substance abuse, or family dynamics and family conflict. Conduct research to find an online intervention that addresses this concern. 

By Day 3

Post a description of an Internet-based intervention used with adolescents to address the concern you identified. Describe the intervention and the underlying theory. Identify the target behaviors that this intervention is used to address. Finally, describe the strengths and weaknesses of the intervention.

Support your posts with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

By Day 5

Respond to at least two colleagues who identified a different internet-based intervention and provide feedback and/or expand on their post in some way.

 Sara Hale RE: Discussion 1 – Week 9COLLAPSE

Depression is one of the many leading causes experienced in adolescents. Twenty percent of all adolescents will experience a depressive episode by age 18, with potential adverse impacts on educational attainment, interpersonal relationships, and behavioral health (including increased risk of substance abuse, future depressive episodes, and suicide (Curry et. Al). Internet-based intervention found was Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training (CATCH-IT). (CATCH-IT), is used to evaluate a self-guided online approach to depression prevention and are conducting a randomized clinical trial comparing CATCH-IT to a general health education Internet intervention (Gladstone TG et, al 2015)

The CATCH-IT is a preventive intervention is a primary care and resources, technology-based depression prevention program targeting adolescents who are at risk for depressive illness (Tracy R. G. Gladstone, Ph.D. 2014). The CATCH-IT program includes 14 web modules that teach strategies from behavioral activation, cognitive behavioral therapy, and interpersonal psychotherapy to strengthen protective factors and reduce vulnerability to depressive disorder. It helps children decrease their depressive symptoms and disorders (Tracy R. G. Gladstone, Ph.D. 2014).

The target behaviors and adolescents they try and reach are those who are expressing pre-depression, depressed moods, those who have been diagnosed and symptoms are also present. This internet prevention is a module which is supposed to help adolescents along the way to alleviate these pre-depressive symptoms of depression and catch it early on.

A strength that was reported was that the completion rate was between 24% to 85%, and it was not necessary to complete the entire intervention for positive benefits to emerge (Merry  SN. 2013).  CATCH-IT allows for adolescents to maintain a track of how they want to complete the modules and provides a level of privacy so they won’t feel labeled.  A Weakness of the intervention I would say is that if they feel they don’t need to complete the whole module and stop mid-way.

References

Curry J, Rohde P, Simons A, Silva S, Vitiello B, Kratochvil C, et al. Predictors and moderators of acute outcome in the Treatment for Adolescents with Depression Study (TADS). J Am Acad Child Adolesc Psychiatry. 2006;45:1427–39.

Merry  SN.  Preventing depression in adolescents: time for a new approach?  JAMA Pediatr. 2013;167(11):994-995. doi:10.1001/jamapediatrics.2013.2862

Tracy R. G. Gladstone, Ph.D. 2014 https://www.wcwonline.org/2014/preventing-depression-in-at-risk-adolescents-the-catch-it-intervention-program-4-24-seminar.

Gladstone TG, Marko-Holguin M, Rothberg P, Nidetz J, Diehl A, DeFrino DT, Harris M, Ching E, Eder M, Canel J, Bell C, Beardslee WR, Brown CH, Griffiths K, Van Voorhees BW.Trials. 2015 May 1;16:203. doi: 10.1186/s13063-015-0705-2.  An internet-based adolescent depression preventive intervention: study protocol for a randomized control trial.

Discussion 2

 Britney Fallen RE: Discussion 1 – Week 9COLLAPSE

Adolescence can be a difficult time to navigate through especially if an individual is not equipped with the appropriate support system to fall back on. Often, a lack of support can lead to aggression, depression, low self-esteem, and troubles within the home and school setting. I focused on low self-esteem and depression and identified an internet-based intervention that was used to counteract low self-esteem. The theoretical framework that was chosen for this study was self-determination theory and cognitive behavioral theory. According to the study of Developing an Internet-based Support System for Adolescents with Depression, it provided that the underlying theory focuses on the individual’s behavior being self-motivated and self-determined (Välimäki, Kurki, Hätönen, Koivunen, Selander, Saarijärvi, & Anttila, 2012). The population is adolescents who had been referred to an outpatient clinic. The intervention was called ‘Depis.Net’ and was used to support adolescents’ self-management and increase awareness with any issues associated with mental health (Välimäki et al., 2012). It was discovered that adolescents recover from their first depressive episodes and the probability of reoccurrence is from 20%-60% in 1 or 2 years after remission and 70% after 5 years (Välimäki et al., 2012). The development of this website would aid in the remission process by offering the adolescents the opportunity to learn about effective coping skills and other community resources within their reach.

To begin, the intervention consisted of sessions over six (6) weeks and once per week. According to Välimäki et al (2012), the first week focused on well-being, second week on home and family, third week on adolescent’s rights and responsibilities, fourth week on adolescent depression, fifth week was treatment of the adolescent depression, and finally the sixth week was a processing session. Throughout the course of the six (6) weeks the individuals were offered self-monitoring exercises, self-reflective exercises, and individualized and specific information provided from tutor directly correlate with life situations and events. The individuals were also asked to maintain a diary to discuss each week. The tutor also offered supportive text messages to the individual once a week to touch base with them. The article identified targeted behaviors being that adolescents can accept and be held accountable for their own actions (Välimäki et al., 2012). While doing so they can learn coping skills which would aid in their emotional regulation. The Authors Välimäki et al (2012), identified that a limitation of their study was that no systemic literature review was conducted. The focus was the adolescent’s needs and growth, so they used other studies including published reviews. A strength of the intervention was the use of theoretical framework. This allotted a structured aim toward the development of the website as well as being able to be flexible with adolescents.

References:

Välimäki, M., Kurki, M., Hätönen, H., Koivunen, M., Selander, M., Saarijärvi, S., & Anttila, M. (2012). Developing an internet-based support system for adolescents with depression. JMIR research protocols, 1(2), e22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3626154/

Support your responses with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

Discussion 2: Depression and Suicide Intervention

When working with adolescents you will likely be faced with issues of depression, anxiety, and suicidal ideation and even attempts. For youth between the ages of 10 and 24, suicide is the third leading cause of death in the United States (Centers for Disease Control and Prevention, 2012). It is essential to understand the risks associated with teen suicide and intervention strategies to address this issue.

By Day 4

Post a review of the literature on adolescent depression and suicide and identify an evidence-based intervention that addresses these issues. Then, apply that intervention to either the Brady or Tiffani case. Describe the possible risk factors the client presents that would make him or her at risk for depression and suicide. Then, plan an intervention for that client to address these issues.

Support your posts with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

By Day 6

Respond to at least two colleagues who identified a different client and provide feedback and/or support.

Response 1

 Nakesha Morgan RE: Discussion 2 – Week 9COLLAPSE

As adolescents face depression which can have a negative affect on how individuals feel and act.  There are highly stressed adolescents that display poor coping skills and negative emotions.  Depression can come with varies forms and have a chemical imbalance in the mind.  Depression ranges in varies levels which can lead to suicide or death if left untreated (APA, 2013).   

In the case of Tiffani she witnessed drug usage and experienced sexual trauma.  She was in a home without food and had to care for her younger sister.  Tiffani ran away from home and was exposed to underage drinking and drugs.  She was in care from a man who picked her up off the streets during a vulnerable time.  She was exposed to prostitution from the man whom she seen as a caregiver.  Tiffani became very attached to this man and had no communication with her family members (Plummer, 2014).

When planning an intervention in the case of Tiffani implementing an Attachment Based Family Therapy (ABFT) is a type of family therapy in which a mental health professional aims to help a parent and a child repair rapture in their relationship along with working to develop or rebuild an emotionally secure relationship.  Arranging family sessions that are included with her mother is very important.  Attachment Based Theory has a focus on seperation distress in which she will need for her strong attachment she has for Donald (her pimp) although she looked at him as a caregiver and grew a strong attachment to him she fail to realize that the relationship they had wasn’t healthy in any way.

Tiffani will benefit both from Attachment Based Family Therapy to help build relationship with family members and also Cognitive Behavior Therapy which is psycho-social intervention that aims to improve mental health and emotional regulations.  CBT will help with her personal coping skills (Beck, 2011).

Plummer, S. B., & Makris, S. M. (Eds. 2014b). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

Beck JS (2011), Cognitive behavior therapy: Basics and beyond (2nd ed.), New York, NY: The Guilford Press, pp. 19–20

Response 2

 Breanna Henry RE: Discussion 2 – Week 9COLLAPSE

A review of the literature on adolescent depression and suicide and identify an evidence-based intervention that addresses these issues.

In 2014, Arsarnow & Miranda gave an account of the mental health status in the United States of America that entailed the category of depression and suicide among its adolescent population.  The literature describes the major clinical advances for utilizing psychosocial and pharmacologic combined treatments to improve care for clinically diagnosed depression and suicide among the youth.   The presenting problem within the literature reports as, “Do we have interventions for youth depression and suicide prevention that are ready for incorporation within our communities?” (Asarnow & Miranda, 2014, p. 279).  Arsarnow & Miranda (2014) reply to the presenting problem with measures of an innovative model that “focus on the transdiagnostic processes-an unified protocol for transdiagnostic treatment of emotional disorders” (pg. 289). This approach targets the broader dimension of negative emotionality, which encompasses both anxiety and depression, that can transform the care of the adolescent youth who experience depression and suicide by understanding that treatment is most effective when “increasing the dose of transdiagnostic psychosocial medical care to achieve the “prescribed” target dose” (Asarnow & Miranda, 2014, p. 279).  The awareness of “suicide is a leading cause of death in young people worldwide, and data point to worldwide increases in suicide rates and increases in suicide deaths among youths, with youths representing the age group at greatest risk in one-third of nations” innovative transdiagnostic models with careful distinctions between suicidal and non-suicidal self-injury attempts can configure a protocol to form a specific intervention (Asarnow & Miranda, 2014, p. 280). 

A review of the literature reveals that Arasnow & Miranda (2014) report becoming professionally aware and effective with improving care for depression and suicide risk in adolescent youth through the evidence-based innovative model of transdiagnostic care treatment begins with expanding the sites by implementing the services within schools, homes, communities, and to the primary health-care team (2014). A continuation of research to improve the care for depression and suicide among adolescent youth through transdiagnostic care will strengthen the practice as well as communities through the use of this evidence-based practice.

Apply that intervention to either the Tiffani case. Describe the possible risk factors the client presents that would make him or her at risk for depression and suicide.

The case of Tiffany Bradley a 16-year-old female, who has experienced sexual abuse from a family member and friend, who fled to be introduced into the world of being a sexually exploited teenage youth (Plummer & Makris, Eds. 2014b). Tiffany (16) has had previous interventions of being locked up in jail due to the charge of prostitution.  Tiffany (16) risk factors are parents involved in drugs, domestic violence in the home and with her partner, sexual abuse of her sexual violator “pimp” as well by her father and his friend, no parental support, and no food in the home(Plummer & Makris, Eds. 2014b).  The intervention of the evidence-based innovative tool transdiagnostic care will approach the “target of the broader dimension of negative emotionality, which encompasses both anxiety and depression” (Asarnow & Miranda, 2014, p. 289).

Plan an intervention for that client to address these issues.

The transdiagnostic protocol plan is to “incorporate advances in emotion regulation, motivational interviewing, mindfulness techniques, and exposure-based procedures to enhance  Tiffany’s (16) ability to respond adaptively to intense emotional past and present experiences, down-regulate intense negative emotional past and present experiences, and extinguish anxiety and distress associated with intense emotions” to help Tiffany (16) become empowered by understanding and monitoring her negative past and present emotions due to the factors of her social history (Asarnow & Miranda, 2014, p. 289).

References

Asarnow, J. R., & Miranda, J. (2014). Improving Care for Depression and Suicide Risk in Adolescent: Innovation Strategies for Bringing Treatments to Community Settings. ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, 10(10), 275-303. http://dx.doi.org/doi-org.ezp.waldenulibrary.org/10.1146/annurev-clinpsy-032813-153742

Plummer, S. B., & Makris, S. M. (Eds. 2014b). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].