Risk factors in adolescence

and clinical data

 Methodology

Risk factors and clinical data

Our clinical and research work has pointed out the following risk factors for mental disorders in adolescents:  

1.          The family charge, that is giving support to the parents (particularly to the mother)

2.         The reduced amount of activities and personal interests

3.         The lack of extra-familiar relationships

4.          Context's judgements devaluing the adolescents

5.         Low self-esteem about personal capabilities

6.         A  personal project representing the context's expectations

7.         Attention to occasional  ailments

The passage from a risky situation to a mental disorder   takes place if there if all factors exist at the same time (copresence) and if they reach the saturation point.

Clinical data

We present, here, a tab containing data on annual report about the number of the new users (between 10 and 19 years old) , who arrived at the Adolescents Service, between 1992 and 1995.

It necessary to specify that, since 1996, we have taken in consideration, concerning the female users, an extra age range: between 20 and 24 years, which seems to become, more and more clearly, a peculiar life time for the onset of psychic disorders.

During this age, in fact, we can find conditions of objective dependency, typical of adolescents, which could interact with some problems non correctly faced previously.

 Methodology

Our clinical treatment has a preventive approach since we take care of the disorder at its first onset, aiming to stop it  and impede it  become chronic.

  We adopt a psychological counselling protocol  wich includes , normally, 4 meetings (one a week) and a follow-up  3 months later.

 In the first meeting we welcome the adolescent, we listen to what she/he says and we assess the problems. If we evalue the necessity of extending the treatment's time, we propose a cycle of 8 psychotherapy sessions.

Counselling is, anyway, the treatment we use the most for adolescents in our Service .

During first meeting adolescents decide to continue or not their relationship with the Service according to the kind of conditions and atmosphere they find around themselves.

Operators, therefore, try to create, for the guy/girl, some kind of appealing surrounding : they do not provide pre-set interpretations of the adolescent's problem neither  immediate therapeutic solutions, but they mainly offer a space to freely talk, about inner problems and difficulties, to somebody who doesn't judge, doesn't have pre-made  remedies, but is willing to listen and sharing the research of a possible approach to the problem, together with the person.

       The methodological instrument we use during first meeting is the " Evolutive Age Model" (CNR, 1995), which we have elaborated with a dual purpose:

¨      to collect , through specific evaluation indexes, information on adolescent, and his family, social conditions and on the problems which lead the request of help to the service

¨      to quickly reveal  the possible presence and intensity of risk factors within the different areas of the adolescent daily-life conditions.

The elements wich come out through this "Model" approach, give to the operator a guide-line to figure out which ones will be next meetings topics so that he can turn the adolescent's attention on specific "risk zones" in her/his life. The adolescent is helped in visualizing overloads and pressures wich could be connected to his own problem.

Events which could be more frequently related  to the onset of the psychic problem are, according to our point of view: affective loss/disappointing, mourning, school failure, a work/affective project failure, the start of an emotional relationship,  the start of a new activity, a serious illness event regarding himself or a relative, a move, a change in family composition, a temporary separation from family, sexual abuse.

Each of these events is taken in consideration as a cause of a worsening of the adolescent's daily life quality,  that is an increase of family charge on the adolescent's shoulders and a more restricted chance of having a life outside the family .

We explore areas outside of the family context: school, interests and friends, to find out, together with the adolescent, if the weight of his/her  family-supporting role has had any effect on reducing or blocking his/her activities. This analylis helps the adolescent not to relate the stoppage to his/her incapability and inferiority.

             We have found out that the lack or the decrease of friendship relations is a constant condition in adolescent's life before the onset of a mental disorder.

 For this reason we promote, since the very beginning of our treatment, a specific protection factor such as the friends relationships  which we immediately assay to support and  encourage.