Categories: General
Date: Jan 13, 2010
Title: At-Risk Youth Part II
By Sonya M. Thompkins and Robert C. Schwartz, PhD
Recent evidence suggests that personal resilience can have positive therapeutic implications for guiding youth at risk toward improved coping skills and enhanced functional outcomes. Various clinical issues presented by child and adolescent clients are particularly challenging for psychotherapists. It is not uncommon for psychotherapists to feel helplessness, frustration and confusion regarding the issues that children and adolescents manifest in therapy.
Defining and Identifying Youth at Risk
Ultimately, one of the most important aspects of helping youth improve their psychosocial well-being is the identification of who is at risk. In this regard, defining “youth at risk” is a challenge in itself. A thorough literature review has shown that various authorities distinguish youth at risk status using different definitions and parameters. According to Capuzzi and Gross (2008), tracing the original conception of the phrase “at risk” is nearly impossible, however, the term has appeared in the American educational system for over 35 years. The term “at risk” appears to have originated in and continues to linger in educational literature, reports composed by the federal government and education-related legislation. One report noted that by 1988 three out of four states had established or were prepared to accept a formal definition for at-risk youth. It is now known that nearly every state has instituted an official classification for this populace, although specific criteria vary widely (Minga, 1998).
Capuzzi and Gross (2008) pose the question, “How can we realistically identify youth who, based solely on their behaviors or circumstances, are more at risk that others?” The literature suggests that there are more opinions than facts in this regard. It appears that one of the primary issues creating confusion is the ever-changing definition of “at-risk youth.” As shown in the statistics reported above, at-risk youth are often defined by their academic deficits (e.g., tardiness, truancy, poor grades, low math and reading scores, failing in school), drug and alcohol use, physically and sexually risky behaviors, and other risk factors (Dynarski & Gleason, 2002; Hermann, 2004; Walker & Sprague, 1999). In the broadest sense, at-risk youth could include all juveniles who may vacillate in and out of “at-riskness” depending on negative personal, social, educational, and family dynamics (Capuzzi & Gross, 2008).
These inclusive criteria have both benefits and limitations. In one regard they foster early mental health intervention aimed broadly at all at-risk youth. However, because the criteria for at-riskness are so broad, they may limit the validity and reliability of identifying existing problems and may inadvertently reinforce stigma among already susceptible persons. For the purpose of this article, we define at-risk youth as juveniles who have recently been exposed to adverse psychosocial life events which, based on prior psychotherapeutic theory or research, lead to a significant future risk of negative mental health consequences. Because “youth” can be broadly interpreted, with various meanings that depend on the culture and age of the person perceiving the client, the term “juveniles” is used to more clearly denote that we are speaking about persons under the age of legal consent. To be at risk for adjustment difficulties, the adverse event should have occurred recently. Although “recent” has a different meaning for each patient (and depends on the patient’s personal vulnerability, social support, culture, and life history), evidence does suggest that in most cases, adjustment difficulties and associated symptoms lessen over time (American Psychiatric Association, 2000).
Finally, because at-riskness implies future potential for negative consequences, the psychosocial problems associated with the event may not have occurred yet. However, an evaluation of how at risk a client may be should be based on clinical theory or research rather than solely on the psychotherapist’s personal or intuitive perceptions. If clinical interventions following an assessment of at-riskness are not based on professional evidence, psychotherapists may have difficulty justifying their interventions (a requirement by most state licensure boards and professional ethical codes). Professionals are also at heightened risk themselves for countertransference, bias, and other non-therapeutic factors to enter the clinical decision-making process. Therefore, psychotherapists should become familiar with the youth-at-risk literature when working with this vulnerable population. The statistics reported earlier are offered only as a cursory overview.
Tags: Robert O'Block, Psychotherapy, youth at risk, at-risk youth, resilience