Many of the juveniles referred for services come with a package of delinquent behaviors that typically includes substance abuse of some sort. If substance use is not a referral behavior, it often contributes to the other referral behaviors. Research tells us that the same elements that predict other delinquent behaviors also predict juvenile subatnce abuse. Specifically, we know that associating with other juvenile delinquents is a direct predictor of delinquent behavior, whether that behavior is stealing, fighting or substance abuse. We also know that there are factors in the family and the school that, when not working well, are predictive of the aformentioned peer association.
From a treatment perspective, if we are able to work with the elements of the ecology to be more effective, family and school, then we can expect to see some changes in the peer association. By doing so, we reduce the probability that the youth will be stealing and fighting if we remove them from that social setting. By doing so, we also reduce the probability of substance abuse because the same relationships were supporting the substance abuse that were supporting the other behavior. Substance abuse is frequently considered a "superbehavior" that requires extraordinary measures, but the research on the causes and correlates of juvenile substance abuse tell us otherwise.
I worked with a child that I'll call Jeff. Jeff was referred for services for a package of delinquent behaviors that had resulted in his being placed on juvenile probation. The probation officer was clear that the main concern was Jeff's stealing. We knew that Jeff was using drugs as a result of urine screens but the level of theft was significant and needed to be controlled quickly, so that was our primary focus initially.
The bulk of the work centered around helping Jeff's mother, with support of family and friends, to be more effective in monitoring where he was and with whom he was associating. She also set firm limits on where he was allowed to go and with whom he could associate. In addition, she worked very hard to improve her discipline strategies. After a period of a few weeks, Jeff's mother was much more effective in controlling his whereabouts and peer asscociations. His probation officer was pleased that the theft seemed to have stopped and there had been no further complaints from local stores.
Following the reduction in the stealing, Jeff's probation officer administered a urine screen, and Jeff's test was negative for substance use. Continued random screens revealed the same result. How did this happen with no direct intervention on the substance abuse? Jeff's mother was successful in removing the influences that promoted or maintained the stealing behavior, and those were the same influences that sustained the substance abuse. If Jeff's rate of theft had not been so acute, the substance abuse may have warranted the referral itself, but that behavior was brought under control as a by-product of the focus on the stealing. This is because the same challenges in the family that were predicting the delinquent peer association and the the stealing, were having the same effect for substance abuse. Jeff's mother was able to address the behavior without sending him to an institution and without the high costs associated with such treatments. She was also able to do so without ongoing, time-consuming efforts that would actually prevent him from becoming involved with prosocial activities. In addition, the changes are more likely to last because the agent of change was a parent with improved awareness and skills that will always be present versus an intervention that ends on the discharge date.
Tuesday, June 11, 2013
Tuesday, May 14, 2013
Orange County Curfew Sweep Shows Parents' Help is Needed
A few days ago, police in Orange County, California conducted a sweep and picked up youths who were on the streets after the county's curfew without an adult. This sweep was focused on areas where criminal activity is high. and is an attempt to prevent youths from making decisions that lead them to criminal behavior.
While I commend the police for protecting the community, they need the help from parents and the community to be able to have any realistic chance of curtailing juvenile crime. First of all, they are only able to catch kids a fraction of the time offenses may be committed. If you consider the number of times people drive over the speed limit compared to the number of times they get caught, the lesson about effectiveness is clear. The more effective effort would be for parents to have a punishment at home for each time a child was out past curfew, their curfew or the legal curfew. If people received a ticket for each time their car crossed over the speed limit, they would stop speeding.
A second point is that there is no reason to believe that crime can not be commited by juveniles prior to the established curfew. They may make it home by curfew, but could have stolen, sold drugs, or commited any number of offenses prior to the curfew. It is noteworthy that the youths picked up in Orange County were in high crime areas. A big predictor of juvenile crime is the association with delinquent peers. These youths were clearly not under any meaningful supervision, as evidenced by their being out beyond curfew, and were in high crime areas. It's clear that they were not associating with kids intent on following the law. If we were successful in having these youths in their homes by the curfew, we still have no idea what they were doing until that time. It is extremely important that families understand where their kids are going, with whom they associate, and what they are doing.
This sweep is an example of a significant police effort, but it also shows that police are not able to accomplish the goals on their own. Many youths are arrested several times, which is the police role, before committing a significant crime. Parents are the most powerful forces in their child's lives. If the police could accomplish it alone, they would have done so by now. Parents can do the job, but many need help. They may have their own challenges that serve as barriers, may not be experienced in the necessary skills, may need practical or emotional support etc.There are evidence-based practices that can provide the training and support. The research community has proven it as has the service community. If we support such programs, parents, youths, communities, and police will appreciate it.
While I commend the police for protecting the community, they need the help from parents and the community to be able to have any realistic chance of curtailing juvenile crime. First of all, they are only able to catch kids a fraction of the time offenses may be committed. If you consider the number of times people drive over the speed limit compared to the number of times they get caught, the lesson about effectiveness is clear. The more effective effort would be for parents to have a punishment at home for each time a child was out past curfew, their curfew or the legal curfew. If people received a ticket for each time their car crossed over the speed limit, they would stop speeding.
A second point is that there is no reason to believe that crime can not be commited by juveniles prior to the established curfew. They may make it home by curfew, but could have stolen, sold drugs, or commited any number of offenses prior to the curfew. It is noteworthy that the youths picked up in Orange County were in high crime areas. A big predictor of juvenile crime is the association with delinquent peers. These youths were clearly not under any meaningful supervision, as evidenced by their being out beyond curfew, and were in high crime areas. It's clear that they were not associating with kids intent on following the law. If we were successful in having these youths in their homes by the curfew, we still have no idea what they were doing until that time. It is extremely important that families understand where their kids are going, with whom they associate, and what they are doing.
This sweep is an example of a significant police effort, but it also shows that police are not able to accomplish the goals on their own. Many youths are arrested several times, which is the police role, before committing a significant crime. Parents are the most powerful forces in their child's lives. If the police could accomplish it alone, they would have done so by now. Parents can do the job, but many need help. They may have their own challenges that serve as barriers, may not be experienced in the necessary skills, may need practical or emotional support etc.There are evidence-based practices that can provide the training and support. The research community has proven it as has the service community. If we support such programs, parents, youths, communities, and police will appreciate it.
Tuesday, May 7, 2013
ADHD Diagnosis Warrants Scrutiny
As professionals prepare for the new DSM-V, the Diagnostic and Statistical Manual of Mental Disorders, Dr. Winston Chung, a psychiatrist with Sutter Pacific Medical Foundation, appropriately labeled his concerns with the criteria for ADHD. ADHD is a disroder characterized by symptoms of inattention and hyperactivity. ADHD has been diagnosed when a person exhibits six of nine possible behaviors, but the DSM-V will reduce that to a threshhold of five. This presence of a package of behaviors may be enough to yield the diagnosis without consideration of the context of the behavior which may explain it and lead to a different approach than medication. The new standards will increase the probability of such a diagnosis and the likelihood of a prescription for stimulants where it could be avoided.
I worked with a case involving an eight-year-old boy who had been referred due to impulsive behavior in school. The referral indicated that he was never in his seat, never completed assignements, did not follow instructions and was generally disruptive in class. In order to fully understand the behavior, I requested to observe the class; I was very curious to see how the child's behavior could be as disruptive as described.
When I observed the class, I did notice that the child was out of their seat and not following directions as described, but I also saw that everyone in the class was behaving the same way. The students in this class were literally walking around the rooom, stepping over desks and generally using the classroom as a playground; it may have been a safety risk to be seated in the class. I was unsure of why they singled out this one child - perhaps they didn't.
In this case, which is admittedly an obvious one, the context of the behavior explained it more than a disorder, or at least made it difficult to diagnose under those conditions. Rather than pursue a medical intervention, the parents requested a change in classrooms and we worked to develop parenting skills to help them administer discipline at home and to coordinate with school.
As stated previously, this is an obvious example, but children's behavior is often maintained by elements of their ecology that include influences at school, parenting strategies, peer influence etc. It's important to understand the sequences of behavior and the contexts that maintain behavior in order to diagnose it well and treat is as safely and effectively as possible. This is increasingly important as the diagnostic criteria are weakened.
I worked with a case involving an eight-year-old boy who had been referred due to impulsive behavior in school. The referral indicated that he was never in his seat, never completed assignements, did not follow instructions and was generally disruptive in class. In order to fully understand the behavior, I requested to observe the class; I was very curious to see how the child's behavior could be as disruptive as described.
When I observed the class, I did notice that the child was out of their seat and not following directions as described, but I also saw that everyone in the class was behaving the same way. The students in this class were literally walking around the rooom, stepping over desks and generally using the classroom as a playground; it may have been a safety risk to be seated in the class. I was unsure of why they singled out this one child - perhaps they didn't.
In this case, which is admittedly an obvious one, the context of the behavior explained it more than a disorder, or at least made it difficult to diagnose under those conditions. Rather than pursue a medical intervention, the parents requested a change in classrooms and we worked to develop parenting skills to help them administer discipline at home and to coordinate with school.
As stated previously, this is an obvious example, but children's behavior is often maintained by elements of their ecology that include influences at school, parenting strategies, peer influence etc. It's important to understand the sequences of behavior and the contexts that maintain behavior in order to diagnose it well and treat is as safely and effectively as possible. This is increasingly important as the diagnostic criteria are weakened.
Monday, May 6, 2013
Utah Referee Case - Sports/Jobs Not Always the Answer for Delinquent Teens
I have spoken before about the fact that the two direct predictors of delinquent behavior are past offenses and associating with delinquent peers. In attempts to remove some of that peer influence, therapists and families often work to involve kids in prosocial activities, and they should. However, not all activities are created equal.
The recent case of the soccer referee in Utah who was killed when he was punched by a player reminded me of a caution I give to therapists and families. In the Utah case, there was a history of violence in the soccer league toward officials in the form of player violence and fan fury. In such situations, the soccer team and the fans may support violent behavior and negate the effort to remove the child from such an influence.
In other cases, it's very common for parents and therapists to push for a child to be employed, a seemingly good choice. However, there may be other kids employed at the same place who are also getting into trouble and use breaks at work as a time to use drugs.
I don't want to suggest that sports are bad or that employment is bad. I am suggesting that if your child has a history of getting into trouble, you may not want to accept at face value that the new activity is a step in the right direction. I have had clients say they wanted a job and found out that their friends all worked at the same place, and the manager sold drugs. Just as you should diligently assess your child's friends, you must also assess the new activity. Are the kids on the team violent or is that prevalent in the league? Who are the child's coworkers? What do they do on breaks or when they take out the trash at work? Each of these questions may require you to go and investiage, take names, ask about people, watch what's going on and make your assessment.
If you are trying to get a child involved in a prosocial activity; that's great. I only offer these words of caution so that your tremendous effort yields the result you want for you and your family.
The recent case of the soccer referee in Utah who was killed when he was punched by a player reminded me of a caution I give to therapists and families. In the Utah case, there was a history of violence in the soccer league toward officials in the form of player violence and fan fury. In such situations, the soccer team and the fans may support violent behavior and negate the effort to remove the child from such an influence.
In other cases, it's very common for parents and therapists to push for a child to be employed, a seemingly good choice. However, there may be other kids employed at the same place who are also getting into trouble and use breaks at work as a time to use drugs.
I don't want to suggest that sports are bad or that employment is bad. I am suggesting that if your child has a history of getting into trouble, you may not want to accept at face value that the new activity is a step in the right direction. I have had clients say they wanted a job and found out that their friends all worked at the same place, and the manager sold drugs. Just as you should diligently assess your child's friends, you must also assess the new activity. Are the kids on the team violent or is that prevalent in the league? Who are the child's coworkers? What do they do on breaks or when they take out the trash at work? Each of these questions may require you to go and investiage, take names, ask about people, watch what's going on and make your assessment.
If you are trying to get a child involved in a prosocial activity; that's great. I only offer these words of caution so that your tremendous effort yields the result you want for you and your family.
Friday, April 19, 2013
Vandalism in Joshua Tree
I just read an editorial in the Press-Telegram in Long Beach, California about vandalism in Joshua Tree National Park. Vandalism is a seemingly senseless crime that can take any number of forms from completely destroying property to simply writing a name on something; no matter the extent, the property owner feels violated and is often faced with expensive and time-consuming repairs (if possible). In the case of Joshua Tree National Park, we are all the victims since the park is a national treasure for us all to visit.
Vandalism, like most crimes that juveniles commit, is often done in a group setting. If your child is involved in vandalism you should be concerned about what else they may be doing. Vandalism often comes with a package of other behaviors like substance use, stealing or any number of other problem behaviors.
If a child is committing such acts, a few things come to mind immediately. First, it tells us that they were probably spending time with people that promote property destruction. It also reveals that they were unsupervised at the time or were supervised by someone that isn't promoting responsible behavior. It is often the case that the vandals were not concerned about facing any type of punishment either because they did not think they would be caught or because they have learned to expect a response from their parents and/or law enforcement that they do not find very concerning.
It is not within your power as a parent to determine how the legal process will respond, but you can address your own response, which could help avoid legal consequences in the future. If you are in this situation, it is crucial for you to do some investigation of the peer relationship and set some limits on those. You must also figure out the gaps in supervision and develop a strategy to monitor those times. Finally, you must consider how you respond to an offense when you catch it. This sounds like a lot of work, and it is, but a child that's vandalizing property may be getting into more significant trouble, or danger, or at least be on that path.
If you are aware that your child has damaged property, address it now before the problems become larger and more serious. If you are concerned about your child's friends or where they spend time, you should address that as well; hopefully, before they become a vandal.
Vandalism, like most crimes that juveniles commit, is often done in a group setting. If your child is involved in vandalism you should be concerned about what else they may be doing. Vandalism often comes with a package of other behaviors like substance use, stealing or any number of other problem behaviors.
If a child is committing such acts, a few things come to mind immediately. First, it tells us that they were probably spending time with people that promote property destruction. It also reveals that they were unsupervised at the time or were supervised by someone that isn't promoting responsible behavior. It is often the case that the vandals were not concerned about facing any type of punishment either because they did not think they would be caught or because they have learned to expect a response from their parents and/or law enforcement that they do not find very concerning.
It is not within your power as a parent to determine how the legal process will respond, but you can address your own response, which could help avoid legal consequences in the future. If you are in this situation, it is crucial for you to do some investigation of the peer relationship and set some limits on those. You must also figure out the gaps in supervision and develop a strategy to monitor those times. Finally, you must consider how you respond to an offense when you catch it. This sounds like a lot of work, and it is, but a child that's vandalizing property may be getting into more significant trouble, or danger, or at least be on that path.
If you are aware that your child has damaged property, address it now before the problems become larger and more serious. If you are concerned about your child's friends or where they spend time, you should address that as well; hopefully, before they become a vandal.
Wednesday, April 17, 2013
Permissive Parenting and Substance Abuse
Permissive Parenting and Substance Abuse
As described in the last entry detailing statistics about youth substance abuse, there is plenty of data to support the concerns about the drug use and the effects it has on the youth in our country and on our broader communities. There are multiple influences on the behavior of children so we must be careful not to blame parents for a youth's behavior, but we must not ignore the fact that the parents have more ability to change the child's behavior than others. We should also consider that families have more desire to see a change in the behavior than the child or the child's peers. Consequently, it makes sense to consider how a parent can help address the concerns.
There are many influences that can contribute to juvenile substance abuse and many parenting styles that parents may exhibit that have their own strengths and weaknesses. One parenting style that we often associate with juvenile substance use does have support from research and that is permissive parenting. Permissive parenting has been associated with impulsive behavior and a child that may become difficult to control, especially in the face of disappointment. They may develop aggressive behavior and discover drugs and alcohol as they get older.
Permissive parents can be described as having high warmth in their relationship with their child combined with low control. The element of warmth in a parent-child relationship is obviously extremely important and should be a goal for families. When this warmth interferes in the enforcement of reasonable rules and expectations, parents run the risk of becoming overly permissive and exhibiting the elements of permissive parents. There are many points to consider to assess whether or not you may be a permissive parent, but a general guideline to consider is whether your plans to administer discipline are thwarted by concerns about the child being angry, guilt or concerns over the well-being of the child.
If you fall into this category, it will be important for you to address your own concerns if you are to promote a change in your child's behavior. It will be important to identify your specific thoughts and concerns and to assess whether or not they are helpful in your goals for your child.
Wednesday, April 10, 2013
Patrick Duffy, Psychologist Blog
The Office of Juvenile Justice and Delinquency Prevention reports that in 2006 alone, law enforcement officers made an estimated 2.2 million arrests of people under the age of 18. The report also shows that juveniles accounted for 17% of all violent crimes and 26% of all property crimes in 2006. These numbers are staggering yet do not account for the youths who are exhibiting challenging behaviors that have not been arrested.
The data regarding juvenile substance abuse does little to ease concern. According to the National Institute on Drug Abuse, 28.3% of kids between the ages of 12 and 20 reported drinking in the month prior to the survey and 12.4% reported having driven under the influence within the previous year. The data does suggest a decline in marijuana use, but 24.6% of tenth-graders reported use in the past year while 31.7% of twelfth-graders reported use. While marijuana use has seen a recent decline, the use of cocaine has remained stable among children 12 and older. A more troubling finding is the decline in perceived harmfulness of hallucinogenic drugs and an increase in the abuse of prescription drugs.
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