Teenagers can experience crises. Adolescence is a traumatic time. Parents may feel confused and frustrated in their interactions with the teenager. The parents may disagree and argue about what should be done, thus losing them credibility.  However, sometimes parents may feel the need to seek help from mental health professionals.  Schools may try to help, but may blame the student, who will eventually drop out if they feel school is boring, unsupervised or humiliating for them.  Some children may only go to school to be with friends who have access to drugs, cars, cigarettes and so on.  




The possibility of drug or alcohol use may be overlooked by doctors, counsellors or parents, as they are afraid or reluctant to give their child a drugs screen. They may take the child’s word that they are not using alcohol or drugs. Also, a teenager may admit to drinking, but not to taking drugs.  Drugs and a negative peer or social group can seriously affect a teenager’s life and put them on a negative pathway. 

Many health care and education models today do not adequately address the unique needs of teenagers in crisis.  A diagnosis is often made based on a few interviews and an impression. Thorough evaluations are often not completed. Family, teachers, friends and siblings are often not interviewed in an open and cooperative manner. The underlying cause for the crisis may not be understood or addressed, because the real issue often requires more effort than providing “symptom relief.”

It can take a great deal of time for a mental health professional to earn a teenager’s trust. After a few sessions, many teenagers do not want to go back to the “therapy” as it “isn’t helping”. Or they may simply refuse to stop doing what they are currently doing. Sometimes the symptoms the teenager is showing may go away when they first start to see a counsellor, but eventually they may resurface, such as failing school, missing classes, staying out late, sleeping all day, running off, being expelled, coming into contact with law enforcement and so on. 

Teenagers are learning to hide their behaviour and symptoms to manipulate doctors, counsellors, teachers and their parents. They may often seek advice and support fro other teenagers who feel the same way they do. However, teenagers may lack the experience and support to support another adequately and may simply give ways on how to avoid the consequences of their actions and manipulate others. 

A teenager may not understand that antidepressants may help, even if they have unpleasant side effects, or why they should avoid doing things that make them feel good. This is a real dilemma for parents and counsellors alike.  It is a real challenge to help a teenager in crisis to see this.  They may often focus on feeling better immediately and not be concerned about the long term impact on how they will feel.  For example, illegal drugs may instantly make them feel better, but psychiatric medications may not.  Although of course, prescription drugs are not necessarily the best option for a child or teenager in distress.

Teenagers may be sorry when they get in trouble, but they may feel they are invulnerable, so defy law enforcement and their parents.  They may not learn from their mistakes, but try to learn ways to avoid and escape the consequences of their actions.  Teenagers will often act like victims and become victims, or they become abusive and victimise others. This can cause problems for the teenager, ending up abused, assaulted, threatened or worse. 

Even more difficult, is that a teenager may suffer from an undiagnosed physical, mental or neurological disorder
Teenagers can experience crises. Adolescence is a traumatic time. Parents may feel confused and frustrated in their interactions with the teenager. The parents may disagree and argue about what should be done, thus losing them credibility.  However, sometimes parents may feel the need to seek help from mental health professionals.  Schools may try to help, but may blame the student, who will eventually drop out if they feel school is boring, unsupervised or humiliating for them.  Some children may only go to school to be with friends who have access to drugs, cars, cigarettes and so on.  

The possibility of drug or alcohol use may be overlooked by doctors, counsellors or parents, as they are afraid or reluctant to give their child a drugs screen. They may take the child’s word that they are not using alcohol or drugs. Also, a teenager may admit to drinking, but not to taking drugs.  Drugs and a negative peer or social group can seriously affect a teenager’s life and put them on a negative pathway. 

Many health care and education models today do not adequately address the unique needs of teenagers in crisis.  A diagnosis is often made based on a few interviews and an impression. Thorough evaluations are often not completed. Family, teachers, friends and siblings are often not interviewed in an open and cooperative manner. The underlying cause for the crisis may not be understood or addressed, because the real issue often requires more effort than providing “symptom relief.”

It can take a great deal of time for a mental health professional to earn a teenager’s trust. After a few sessions, many teenagers do not want to go back to the “therapy” as it “isn’t helping”. Or they may simply refuse to stop doing what they are currently doing. Sometimes the symptoms the teenager is showing may go away when they first start to see a counsellor, but eventually they may resurface, such as failing school, missing classes, staying out late, sleeping all day, running off, being expelled, coming into contact with law enforcement and so on. 

Teenagers are learning to hide their behaviour and symptoms to manipulate doctors, counsellors, teachers and their parents. They may often seek advice and support fro other teenagers who feel the same way they do. However, teenagers may lack the experience and support to support another adequately and may simply give ways on how to avoid the consequences of their actions and manipulate others. 

A teenager may not understand that antidepressants may help, even if they have unpleasant side effects, or why they should avoid doing things that make them feel good. This is a real dilemma for parents and counsellors alike.  It is a real challenge to help a teenager in crisis to see this.  They may often focus on feeling better immediately and not be concerned about the long term impact on how they will feel.  For example, illegal drugs may instantly make them feel better, but psychiatric medications may not.  Although of course, prescription drugs are not necessarily the best option for a child or teenager in distress.
Teenagers may be sorry when they get in trouble, but they may feel they are invulnerable, so defy law enforcement and their parents.  They may not learn from their mistakes, but try to learn ways to avoid and escape the consequences of their actions. Teenagers will often act like victims and become victims, or they become abusive and victimise others. This can cause problems for the teenager, ending up abused, assaulted, threatened or worse. 
Even more difficult, is that a teenager may suffer from an undiagnosed physical, mental or neurological disorder


Causes of Teenage Crises
A crisis will usually take some time to become critical or life threatening. A pattern of crises has usually taken place before a crisis becomes dangerous.  At some point, a counsellor should be able to trace one or more factors that have led to the current serious crisis. Identifying the factors can help the counsellor or mental health professional to characterise the evolution of the crisis, which in turn helps them to find the appropriate response and duration of any required intervention.  
 
Previous potential crises may include:

  • Drugs
  • Alcohol
  • Peer and social pressure
  • Parental alcoholism, drug abuse or mental disorder that is untreated.
  • Failure by the parents to provide rules, discipline and a bonded relationship with the child.
  • Family conflict and discord
  • A traumatic experience
  • A fragile emotional state
  • Parental separation or divorce

Interventions
Once we understand the potential cause of the crisis, this can lead us to think of potential, comprehensive interventions. There are a range of potential interventions, which should be tailored to the unique needs of the individual. Interventions may include:

  • Education and training for parents
  • Education and training for teenagers
  • Self help
  • Group counselling/therapy
  • Individual counselling/therapy
  • Family counselling/therapy
  • Change schools
  • Outdoor adventure programmes
  • Wilderness therapy programmes
  • Increased parental supervision and involvement
  • Move to a new area
  • Move in with other family members
  • Foster care
  • Private school
  • Boarding school
  • Day treatment programme
  • Therapeutic boarding school
  • Residential treatment programme 
  • Psychiatric hospitalisation
  • Police or law enforcement response


The duration and choice of intervention and the competence of the professionals involved are crucial to the success of any intervention. The intervention must also be appropriate to the level of risk and responsive to the underlying problem or potential cause. The level of risk needs to be determined and the likelihood of the problem escalating or continuing considered. 

The Adolescent Clinical Screening Questionnaire is one of the most systematic and reliable methods for assessing risk with teenagers.  When a crisis first occurs, it is important to stabilise the teenager and provide any symptom relief. But after that, there must be sufficient structure and follow-up to prevent further crises or relapse. Parents and family members must keep it in mind that an inappropriate intervention can make matters worse and can undermine their relationship with their child, and create another crisis.
 
An inadequate response can prolong a problem and reduce the likelihood of future interventions succeeding.  There is often a cycle to the crisis that teenagers experience. The crisis tends to grow, escalate, subside and resurface in a pattern of increasing emotional, psychological and behavioural problems.  Typically, with teenagers, there may be brief periods of normalcy between crises. At those times, the teenager may be cautious, reflective and remorseful.  Whether a crisis represents a turning point or not will depend on whether an appropriate intervention is designed and followed through.