Areas of Expertise: Life Changing Events and Transitions: Children, Adolescents and College Students

Does the period of adolescence cover more than a decade now?

The period of late childhood and adolescence is a time of accelerated growth and change. Coined the "tween years," early adolescence is now considered to begin at about age ten. Puberty starts about two years earlier than it did a century ago, and children also experience pressures to advance quickly in academic, cognitive, emotional, and social areas. Middle adolescence begins at age fifteen, a time when there is heightened desire for independence from parents, and efforts to earn respect from others and to be part of a social group. Late adolescence begins at age seventeen, and may extend into the early twenties because of requirements for more advanced degrees and delayed entry into adult roles. Adolescents in this group continue to build on their sense of self esteem and mastery of a variety of social and cognitive skills that contribute to their identities. They expand on the meaning of ethical behavior and ways of handling conflict, and continue to work on developing meaningful relationships with others, and the skills sets and capabilities that will enable them to find rewarding work. Attitudes, beliefs, and patterns of behavior established during adolescence may last a lifetime.

Why are turning points important?

It is important to pay attention to certain life changing events that occur during adolescence. Each event involves a change that is abrupt and that may have a long lasting effect. Transitions occur because of these life events or turning points. Many of the significant events in the lives of children, adolescents, and college students are associated with changes in family life, health, and school.

The challenges for children, pre-teens, adolescents, and college students at each turning point are to connect with others, and create a sense of safety out of the initial experience of uncertainty. Resilience in dealing with the stress of these life changing events, and making a smooth transition depend on the student's evolving sense of competence, self esteem and identity, and the support he or she gets from others. These are growth periods in which successes at one stage build upon another.

What are some examples of life changing events in family life and health?

Significant events within the student's family life include parent separation, divorce, and/or remarriage; physical illness and/or chronic health condition(s) in a family member; mental illness in a family member; the birth of a child; loss of a family member; grief; changes in parental work patterns; and financial stress. Health concerns for this age group include weight problems, obesity, and eating disorders such as bulimia, anorexia nervosa, and binge-eating disorder. Chronic health conditions affecting this age group, including obesity, ulcerative colitis, Crohn's disease, asthma, diabetes, and cardiovascular disease, are becoming more common. Other problems that set a student apart from others include learning disabilities, attention-deficit/hyperactivity disorder, and mental health conditions such as anxiety, mood disorders, adjustment disorders, and depression.

Why are turning points at school important?

The adjustments and changes required as children and adolescents move from one school level to another are numerous, and involve cognitive, social, physical, emotional, and interpersonal growth. School changes from elementary school to middle school, from middle school to high school, from high school to college, and from college to the work force or graduate school are major turning points. Each school transition involves excitement in meeting new people from different backgrounds, and also concerns about being isolated, lonely, or different. The enthusiasm about new intellectual challenges may be accompanied by anxiety about doing well academically. Growth occurs when concerns about isolation are replaced with interpersonal connections, and when anxiety about vulnerabilities is replaced with a sense of integrity and competence.

What kinds of concerns do students have when they enter middle school and high school?

The environments in middle school and high school are much more impersonal than in elementary school. While the elementary school student spends most of his or her time in one classroom with the same teacher or small team of teachers, the middle school and high school student has many teachers. The new student may feel unprepared and concerned about teachers' expectations in middle and high school in areas such as:

  • homework and project management
  • organizing time to accommodate commitments in school and out of school
  • study skills
  • abilities to work well in groups and socialize with peers
  • experience in analyzing and using more advanced information
  • dealing with the myriad differences in classroom experiences

Common concerns about peer group expectations include:

  • feeling overwhelmed by the numbers and physical size of students
  • in school and cyber-bullying, fitting in, and having friends
  • losing status as oldest and most powerful in the previous school

Students diagnosed with learning disabilities and attention deficit/hyperactivity disorder; students who have deficits in organization, study skills, and social skills; and students who are temperamentally more socially withdrawn, dependent, or shy may also experience more difficulty handling these turning points in school.

What challenges do students of all ages face during these periods of transition?

At each turning point, the child, pre-teen, teenager, and college student is challenged to:

  • be more independent in handling the details of daily life
  • integrate what he/she has learned about himself/herself during earlier school years with the demands of the new school or social setting
  • balance the expectations of family members with pressures to fit in with peers
  • make new friends with students he/she meets at school while maintaining old friendships
  • fit in with social groups during meal times, classes, sports, extracurricular activities, and social events
  • recognize his or her similarities and differences with others, based on cultural heritage, gender, family, and personal characteristics
  • cope with the inevitable experience of losing connections with some friends
  • connect with people he/she admires without losing a sense of who he/she is
  • maintain closeness to parents while striving for autonomy and independence.
  • experiment with a variety of types of relationships and friendships
  • develop increasingly more intimate relationships, close friendships, and trust in others
  • learn conflict resolution and ways of balancing one's own needs with others
  • internalize notions of right and wrong, develop a system of values, and apply this value system to situations at school, home, and other settings.
  • build on particular abilities, skills and talents, and let go of some previously developed skills and extracurricular interests due to time constraints
  • define him/herself in cognitive, physical, emotional, and social ways.
  • explore, make more choices of his/her own, experiment, take risks, test, and try out new ways of doing things
  • think critically and form personal opinions
  • handle the increasing academic pressure and hard work required to meet expectations at school, home, and other settings
  • become more confident and competent inside and outside of school.
  • display a set of personality traits and character strengths that define who he/she is
  • envision occupations for which he/she is suited based on interests and capabilities

What are particular challenges students face during college years?

Many college students find that the transition to college brings new friendships with the same sex and opposite sex; more intimacy; more social pressures; and the need to be vigilant about physical safety, eating disorders, sexual activity, STDs, binge drinking, and drug use. There is greater academic focus, intellectual and social stimulation, and pressure to develop a career direction. College students look forward to the freedom of living independently but also experience more pressure to manage their time well in social, academic, work, and extracurricular areas. They must make informed decisions with regard to their health and safety, maintain connections with others, develop competencies, and build toward the next transitional stage in which they enter the job market or pursue graduate school.

What assessment tools do you use to understand a student's concerns?

During the first session, I discuss the challenges associated with the transitional period with the parent(s), and the child, pre-teen, teenager, or college student, take a complete history, and provide information and answer questions about the assessment tools. Parents are usually present at the initial interview. Adolescents and college students are given the following tests to complete at home: the Personal Problems Checklist, Health Problems Checklist, Incomplete Sentences Blank, Minnesota Multiphasic Personality Inventory (MMPI), and an assessment of character strengths. Children are given a Personal Problems Checklist to complete, and parents fill out the Health Problems Checklist. These testing tools, available only to licensed clinical psychologists, are provided at no additional cost.

The results of testing, including the MMPI graph, are reviewed in subsequent meetings, and form the basis for treatment goals and planning. The MMPI identifies elevations in areas including depression, anxiety, need for attention, somatic concerns, reality testing, interpersonal trust, energy level, and relative tendency toward introversion or extraversion. The character strengths assessment identifies core strengths. During turning points in life, the particular individual traits and character strengths identified by the client may help him or her to develop and expand on aspirations, connect with others, and achieve a new level of well-being that will add to his or her resilience.

What techniques do you use in treatment?

Depending on the presenting problems and diagnoses, I use particular cognitive, behavioral and insight-oriented techniques. Topics commonly discussed include self-control and self-regulation; problem solving; vigilance in areas of nutrition, diet, body image, exercise, and sleep; and stress management techniques. Social relationships are discussed within the framework of understanding how particular self-views, views of others, cognitive beliefs, perceptions of threat and vulnerabilities, strategies, and affect have an impact on the way in which people interact with one another. Coping, decision-making, and interpersonal skills are reinforced in order to resist peer pressure, find constructive ways to deal with conflict, identify bullying behavior or harassment, resolve conflicts, determine when it is and is not feasible to exert control in a particular situation; reduce risky behaviors; and connect with others. I may work with an adolescent and parent in some of the sessions in order to set and enforce limits; address the needs of other siblings or family members; build family respect, warmth, and support; and open up channels of communication.

The "positive psychology" approach enables clients to use unique talents, abilities, character strengths, and insight gained through our collaboration to resolve problems, and achieve greater fulfillment and happiness in life. The general goals of this assessment, treatment and support model include problem solving; enhancing self esteem, competence, and interpersonal connections; and gaining a greater sense of self determination.