Working With Young Families:

Working With Young Families: A Framework for Practice Jody Scanlon, LCSW

Overview: From Theory to Practice • Review of Adolescent/Infant/Toddler Development • Understanding the Dual Developmental Crisis • Preventing Subsequent Pregnancies • Utilizing parallel process in our work • Pulling it all together

Stranger in a Strange Land • Our work asks us to visit a foreign culture • Customs, language, world views are unique • Enter with respect • Learn to speak the language • Maintain sense of self

Here’s the Problem: • Teen years are no longer a convergence of puberty (physical maturation) and what we have termed adolescence (psychological maturity) • Teens now have physical capacity for reproduction long before they have emotional maturity for parenting

A Nod To Neuroscience • Adult decision-making and reaction utilize frontal lobes primarily • Adolescents often are accessing the amygdala (temporal lobe) • This explains a lot!

Adolescence: A Conceptual Framework • Erickson divides human development into discrete tasks to be accomplished during each stage • Task of adolescence is identity formation—critical in understanding teen pregnancy

Stage 1: (10) 12-14 • Movement toward independence • Peers replace parents as primary relationship and source of information • Actions take precedence over thought • Over-riding need for immediate gratification • Minor rule-breaking and experimentation while still tied into rules and expectations of parents

Stage II: 14-17 • Increased intensity of individuation • Increased conflict with parents • Heightened narcissism/grandiosity/sense of invulnerability • Increased risk-taking/impulsivity • More abstract thinking

Stage III: 17-19 (25) • Firmer sense of identity • Interest in career development (crucial to support this) • Independent decision-making • Increased regulation in emotional states and insight

Let’s Add Teen Parenting to the Mix • Statistics tell us that the preponderance of teen pregnancies are unintended (80%) however, there is a significant amount of ambivalence— “if it happens, it happens” • From a teen’s perspective, some legitimate reasons • Attention and care from pregnancy

Adolescence + Teen Parenting • Erroneous belief that FOB will stay (less than 20% result in marriage) • Psychologically—opportunity to provide the parenting she never had • Identity formation

Now on to Infant Development • Infants need to develop a sense of trust first and foremost • Require dependability from a primary caretaker • Require that their needs are seen as primary • Require stability and predictability

And Toddler Development…. • Sense of safety so that they can explore the world • Emotionally labile (temper tantrums) • Conflict between dependence/independence • Narcissism • Invulnerability and risk-taking through experimentation

The Dual Developmental Crisis • With infants: adolescents’ needs are in direct opposition to the infants’ needs • With toddlers: both the adolescent and the toddler are experiencing similar developmental stages simultaneously • Adolescence is in many ways a recapitulation of toddler years: push/pull, approach/withdraw • Desire for independence and need for security and parental guidance

So, A Teen By Any Other Name…. • Is still a teen • And a mom • Important for providers to work on both levels • Interventions are usually most successful when we put the teen before the mom

Preventing Subsequent Pregnancies • 25% of teen moms will experience a subsequent pregnancy prior to age 20 • From an adult perspective: this defies logic! • Teen moms know first hand the hardships

Why, Why, Why? Common Reasons given: • Spacing of children • New boyfriend • Desire of FOC • Complaints about contraception • Nostalgia for infant phase • Whoops!

Reasons Behind the Reasons • Competency: I can do this! • Lack of future orientation • Pregnancy was a time of care and support • Lack of efficacy re: family planning

Characteristics of Effective Interventions • Long-acting, low maintenance method • Involvement during first pregnancy • Sustained relationship with client • Close, high-quality relationship with client

IUDs and Adolescents • American College of Obstetricians and Gynecologists (2007): Because adolescents contribute disproportionately to the epidemic of unintended pregnancy in this country, top tier methods of contraception including IUDs ..., should be considered as first-line choices" for them. "After thorough counseling regarding contraceptive options, health care providers should strongly encourage young women who are appropriate candidates to use this method."

Home Based Contraception • Partnership with Boulder Valley Women’s Health Center • Provides Depo Provera shots to GENESIS teen clients in convenience of their homes • Eliminates barriers • Increases opportunities for case management

Supervisor Caseworker Teen Mom Parallel Process Baby

Working With Parallel Process • Parallel Process can teach us a lot about what is going on in the mother/infant dyad • Be aware of what you are feeling when with a client • This might be a reflection of what she is feeling with her infant • And, ultimately, what the infant is feeling

Use this information to guide interventions • Anxiety, dependency, ambivalence, avoidance • These clues also appear in the course of supervision • Awareness of parallel process enriches therapeutic and supervisory relationships and can result in more effective interventions

Some Techniques • Speak to the ambivalence • Be curious! • Work to understand the teen’s motivations • Empower the teen—they know better than you how they can change and what will work in their lives

Remember Developmental Issues • Work with not against their narcissism—it is developmentally appropriate and not a character flaw • Becoming moms does not make them adults—they don’t necessarily think like we do • Their brains are not fully developed—help them to see beyond the immediate and to recognize consequences of actions

Create Safety • Be genuine • Avoid the very real temptation to be parental • Always explain the rules up front • Change is scary and it is hard • Teens will respect you for setting limits—it might be the first time that anyone has done this for them

Use Supervision • This is where the parallel process is likely to play out—pay attention—and use these clues • Watch for burn-out and secondary trauma • Plant seeds and have faith they will grow • Celebrate successes—no matter how “small” • Remember your limits • Find ways to transition back home

Build a Future • Be a cheerleader—you might be the only one who has ever believed in them • Be a role model • Be calm • Cool, • And collected when they are acting out (remember the parallel process—it’s what you might do with a toddler and a temper tantrum)

When You Feel Stuck…. • Listen to the music, not the words • Avoid the temptation to “fix” • Always start with the assumption that EVERY parent wants to be the best parent they can be—our job is to reinforce this natural inclination • “Challenging clients”—what are they teaching you?

Remember Systems Theory • Ripple effect of our actions • Teen is part of a system larger than herself • Respect the power and significance of family, friends, environment • Work organically within the system

It’s All About the Relationship • Relationship is key to facilitating change • Read cues and pace accordingly • Respect boundaries—teens put them there for a reason • Patience • Don’t give up—they may be testing you because they expect you will not stay with them • You may be the first and only person in their life to model a healthy relationship

Remember: We make a living by what we get; we make a life by what we give. --Dr. Albert Schweitzer Life Enrichment

Working With Young Families: