How Social Workers Help Struggling Teens

By Frederic G. Reamer, PhD, and Deborah Siegel, PhD, LICSW, ACSW, DCSW

Introduction

The adolescent years can be very challenging for some teenagers and their families. While adolescence can be an emotionally intense, stormy phase for virtually all teenagers, sometimes a teen’s struggles require special intervention. Many teens struggle with issues related to mental health, family relationships, friends, school performance, substance abuse, sexuality, and other high-risk behaviors.

Warning Signs

Struggling teens usually show signs of distress. Common warning signs include:

• Low self-esteem
• School failure and truancy
• Defiance towards authority (such as parents, teachers, police)
• Running away from home
• Choosing the “wrong” friends
• Impulsive behavior (such as speeding, taking other unsafe risks)
• Getting in trouble with the law
• Depression
• Abusing alcohol or drugs
• Social isolation
• Eating disorders (overeating, not eating, self-induced vomiting)
• Self injury (such as cutting)

There is help for these youngsters and their families through many avenues.

How to Find Help

There are many ways to locate and access programs and services for struggling teens. Initially parents can seek help by contacting school personnel (guidance counselors, social workers, administrators), family service agencies, community mental health centers, other community-based social service programs designed specifically for at-risk youngsters and their families, public child welfare agencies, family and juvenile courts, and specialty courts (such as truancy and drug courts).

Social workers can help parents and struggling teens identify and explore difficult and challenging family issues. Individual, family, and group counseling provided by clinical social workers may help parents and teens improve their communication skills and relationships, resolve conflicts, and address important mental health issues.

Professionals called “educational advocates” and “educational consultants” may be able to help parents and teens obtain needed services. Educational advocates, who are often attorneys, help people obtain specialized educational services. Educational advocates charge parents a fee and work with local, state, and federal education officials to ensure that students receive the services and “special accommodations” to which they are entitled by law. Advocates may file claims in court to force school districts to provide or pay for special-needs services and programs outside the school district.

Educational consultants help parents locate programs and services designed to meet their child’s needs. Educational consultants charge parents a fee, assess each teen’s unique strengths and needs, and help the family find the most appropriate schools or programs for their teen. Many educational consultants monitor students’ progress in the new program or school and, when necessary, advocate for the teen with that program or school when challenging issues arise.

Cost of Programs and Services

Programs and services for struggling teens can be very expensive. Some families are able to pay for these programs and services “out of pocket.” Some families have health insurance that pays for all or part of the program, or the public school system may pay the cost.

Many families cannot afford needed programs and services, do not have adequate insurance, and are unable to obtain funding from their public school department. In some instances families that cannot afford needed services agree to give legal custody of their teen to the local public child welfare agency, which then funds the services or programs (in several states the public child welfare agency will fund services without requiring that parents hand over legal custody). In still other circumstances, desperate parents may turn to the juvenile or family court and formally request that the teen be declared “wayward,” thus enabling the court to require the child to accept intervention. In these cases the state typically pays for needed services and programs. Some parents may be reluctant to use this route to services because the court, not they, determine where the child goes for help.

There is a wide range of services and programs run by private and public agencies for struggling teens and their families. Some programs may be available locally; however, some programs may be in other communities or states, which means that the teen must live away from home in order to receive needed services.

Crisis Intervention

A broad range of professionals and agencies offer crisis intervention and follow-up counseling services to teens and families. These services may be available through family service agencies, community mental health centers, hospital outpatient clinics, public child welfare departments, and psychotherapists in private practice (such as clinical social workers, clinical and counseling psychologists, mental health counselors, pastoral counselors, psychiatric nurses, and psychiatrists).

Many communities offer comprehensive counseling and family-intervention programs specifically for teens and families in crisis. These programs – known by names such as “comprehensive emergency services” or “comprehensive intensive services” – provide home-based assessment, emergency counseling, information, and referrals for longer term help.

Special Schools and Programs

A variety of alternative schools, therapeutic schools, and treatment programs serve teens who struggle with significant behavioral, emotional, mental health, and substance abuse issues. Some programs, such as alternative high schools, focus primarily on education while being sensitive to students’ mental health and behavioral challenges. Other programs, such as residential treatment programs, therapeutic boarding schools, and wilderness therapy programs, focus primarily on mental health, emotional and behavioral issues, while including an educational component. “Emotional growth” boarding schools address mental health, emotional, behavioral, and educational issues simultaneously. Other boarding schools focus on specific learning disabilities while also paying attention to the whole student. In short, different programs give different degrees of emphasis to personal and academic issues.

Parents of struggling teens – particularly teens who are oppositional and defiant – may be tempted to place their child in a school or program that promises to impose needed discipline and structure. Often these schools and programs – such as some military boarding schools and those that advertise their mission as “character education” – do not provide the mental health services many struggling teens need. These schools and programs can cause more harm than good for struggling teens who have personal and mental health issues that contribute to their challenges.

Prominent program options include:

• Alternative high schools provide education, including special education services to teens who have floundered academically or socially in traditional high schools. These schools may be freestanding or sponsored by a community mental health center, family service agency, school district, or a “collaborative” composed of several social service and educational programs.

• Youth diversion programs typically attempt to help struggling teens who have had contact with the police avoid more formal involvement in the juvenile justice system (juvenile courts and correctional facilities). Typical youth diversion programs offer first offenders individual and family counseling, links to other needed services (such as psychiatric medication), and education.

• Independent living programs are designed to help adolescents develop the skills they need to live independently. These programs primarily serve teens who do not have stable families and are in the state’s custody. Some independent living programs also serve teens whose families are able to pay for these services privately. Typical services include practice in daily living skills, money management, career and educational planning, mental health services, housing assistance, recreational, and social activities and case management.

• Wilderness therapy programs offer highly structured intensive short-term (three to six weeks) therapy in remote locations that remove adolescents from the distractions available in their home communities (such as television, music, computers, cars, drugs and alcohol, movies, delinquent peer groups). The challenges of living full-time outdoors and developing wilderness survival skills help teens develop self-confidence and pro-social behaviors. Often, families are advised to send their struggling teen first to a wilderness therapy program and then to a therapeutic or emotional growth boarding school, rather than return the teen to their home community environment.

• Boarding schools for teens with significant learning disabilities offer structured academic programs that focus on education and learning while addressing relevant emotional and behavioral issues.

• Emotional growth boarding schools offer structured academic programs and focus on emotional development and personal growth but do not provide the intensive treatment services offered by therapeutic boarding schools.

• Therapeutic boarding schools focus intensively on students’ mental health, substance abuse, and behavioral needs while also providing an academic educational program.

• Residential treatment centers offer highly structured treatment addressing substance abuse, family, and other mental health issues. In contrast with therapeutic boarding schools, residential treatment centers are more like a psychiatric hospital than a school, although they may have an academic/educational component in their program.

Substance Abuse and Truancy Courts

Many communities run substance abuse courts (sometimes known as drug courts) and truancy courts. These specialty courts use a supportive and nurturing approach rather than a punitive one to help struggling teens. Using case management, counseling, tutoring, mentoring, and parent education, the courts’ goal is to prevent future problems and more formal involvement with the juvenile justice system.

How Social Workers Help

Social workers can provide struggling teens and their families with:

• Assessment of the teenager’s and family’s needs and strengths
• Information about and referral to needed programs and services
• Information about financial and legal issues and resources
• Names of reputable educational advocates and educational consultants
• Crisis intervention counseling services
• On-going psychotherapy for the teen, the parents, and the family as a whole
• Case management (helping staff from multiple agencies coordinate and communicate on behalf of the teen, and advocating for the family with these providers)
• Information about important “warning signs” of teens who are on a downward spiral and the steps needed to get help

Resources

Information about services and programs for struggling teens and families is available from social workers, schools, public child welfare agencies, juvenile and family courts, family service agencies, community mental health centers, educational advocates, educational consultants, and lawyers. Useful Web sites include:

• Adventure and Wilderness Therapy Treatment Programs (http://www.wilderness-therapy.org/)
• Alcoholics Anonymous (http://www.alcoholics-anonymous.org/)
• The Association of Boarding Schools (http://www.schools.com/)
• Cocaine anonymous (http://www.ca.org/)
• The Drug Court Clearinghouse (http://spa.american.edu/justice/drugcourts.php)
• The Independent Educational Consultants Association (http://www.educationalconsulting.org/)
• Narcotics Anonymous (http://www.na.org/)
• National Association of Therapeutic Schools and Programs (NATSAP): (http://www.natsap.org/)
• The National Independent Living Association (http://www.nilausa.org/)
• The National Youth Court Center (http://www.youthcourt.net/)
• The Substance Abuse Treatment Facility Locator, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (http://findtreatment.samhsa.gov/)
• Woodbury Reports – a guide to programs for struggling teens (http://www.strugglingteens.com/)

Dr. Reamer and Dr. Siegel are the authors of Finding Help for Struggling Teens, A Guide for Parents and the Professsionals Who Work for Them available through the NASW Press. Dr. Reamer is also the author of The Pocket Guide to Essential Human Services which contains diverse resources compiled into a user-friendly guidebook appropriate for use by professionals, volunteers, and consumers.

### The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.Frederic G. Reamer, Ph.D., is professor at the School of Social Work, Rhode Island College, Providence, RI. His research, teaching, and social work practice focus on criminal justice, professional ethics, risk management, and mental health. Deborah H. Siegel, Ph.D., LICSW, DCSW, ACSW is professor at the School of Social Work, Rhode Island College, Providence, RI. Her research, teaching, and social work practice focus on clinical work with children and families, focusing especially on ADHD and adoption.