ADOLESCENT EMOTIONAL / BEHAVIORAL PROBLEM: OUR EXPERIENCE AT ADOLESCENT HEALTH CLINIC, MEDICAL COLLEGE KOLKATA
Dr. Bharati Basu*
Consultant Psychologist *
The emotional and mental health needs to adolescents have only recently been recognized by society as a serious cause for concern. Recent epidemiological studies have estimated anywhere between 15 to 25 percent of children could be identified as suffering from a moderate to severe emotional/behavioral difficulties (Birmaher et, al. 1996, Rudof K.D. 2002).

At our adolescent health clinic, we have also experienced that nearly 80% of the client population came with the emotional/behavioural problems. Since the inception of this clinic, a large number of clients are undergoing psychological interventions. The total No. of clients was 610 and the clients came with emotional and Behavioural problem were 488. Most of the clients are coming from middle class, Bengali family, their age group ranges from 10-21 years. Educational status of these clients is from class V - XII. Sex ratio is males are 51% and females are 49% of the total population. They are unmarried.

The major and common complaints are as follows:
  1. Lack of concentration, Poor memorization, Deterioration in Academic Performance, Restlessness, Disobedient, Depression, Anxiety (including PTSD & Phobia), Habit disorder
  2. Adjustment problem

There are some cases with special problem also like:
  1. Somatoform disorder, Childhood schizophrenia and other Psychiatric illness, Substance abuse and related disorder, Gender identity disorder, Eating disorder
  2. Personality disorder

The following etiological factors may be considered important for above-mentioned problems:

ENVIRONMENTAL/SOCIAL:
Parenting style: Parental styles are global attitudes and emotional stores that influences the quality of relationship with children. Parental practices are specific strategies for gaining children's compliances, maintaining control and enforcing expectations. Parent adolescent relationship also play an important role in adolescent socialization by moderating and mediating the impact of influence in and beyond the family (Steinberg & Silk 2002). Therefore, relationships with parents remain the most influential of all adolescent relationship. Thus proper parenting like Authoritative parenting make the adolescent self-reliant, socially competent and responsible (Gear goules, et al 2003).

Family set-up and interaction: It was evident that adolescent's perception of high level of mutuality and stability in the family as well as lack of serious problem in family were predictors of adolescent global satisfaction (Rask. K. et. al. 2003).

Academic Pressure: Now a days academic pressure acts as a heavy burden and which creates stress and problems in the adolescents.

Role model and role identification: Lack of proper and appropriate role model also plays an important role in adolescent problem.

Peer group influence: Peer group is another significant factor which influence adolescent behavior to a great extent.

Influence of Media:

PSYCHOLOGICAL:

Stress at different sphere of life: Rapid urbanization, technological advancement and fast changes in life style and society have adversely affected the minds of a people specially that of adolescent, making mental illness or Behavioural problems in them.

Personality problems
Anxiety
Level of intelligence


BIOLOGICAL:
Problems originated from organic factor e.g., mild to moderate lobe dysfunction may cause some emotional or behavioural problem in adolescent.

It was evident from longitudinal studies that these difficulties or problems do not simply evaporate as the child/adolescent matures, a significant proportion of them continuing to show debilitating difficulties into adulthood. The overall cost to individual and society is vast and the need to identify effective and efficient psychological intervention has become a major concern in this area of clinical work. At present the best empirically supported child/adolescent therapies are Behavioural and Cognitive Behavioural in orientation.

THERAPEUTIC TECHNIQUE APPLIED:
  1. Behavioural Psychotherapy: It is a short term, collaborative problem oriented active and directive treatment and has been applied to a wide range of problems.
  2. Cognitive - Behavioural therapy : The central idea behind CBT is that interpretations of events influence or even determine the emotional experience we have, the behaviour we exhibit.

Counseling and Psychological therapies are more likely to be helpful, if the client accepts his or her problem and if client and counselor are able to negotiate mutually agreed goals and work collaboratively towards these goals.

At our Adolescent Health Clinic, we have applied the above mentioned techniques and a good follow up reports (68%) indicate a high success rate.
References :
  1. Birmaher B; Ryan N.D.; et al (1996) "childhood" and adolescent depression : A review of the past 10 yrs, Part I", Jr. of the American, Academy of child and Adolescent psychiatry, 35, 1427-1439.
  2. Georgoules, Georgious and Besevegis Elias (2003). Adolescents, view of their relationship with their parents Psychology; The Jr. of Hellirie Psychologic Society (Jun & Sep) Vol. 10 (2-3); 237-247. Leinecke, Mark A ; Daltilio, Frank M and Freeman, Arthur (Eds) (2003). Cognitive therapy with children and adolescent: A case book for clinical practice (2nd ed), Guild ford Press; New York, XVIII 476 PD. Rask K, et al (2003) Adolescent Subjective well being and family dynamics. Scandanavian Jr. of caring science Jun Vol 17 (2); 129-138.
  3. Rudoff, K.D. (2002). Gender differences in emotional responses to interpersonal stress during adolescent. Jr of Adolescent Health 30(4). Sept.1-3; 13.
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