Adolescent Counseling - Northern, VA & Nashville, TN 

Adolescent Mental Health

Childhood and adolescence are critical times to promote mental health - as more than half of mental health problems start at these early stages in life. Many of these issues persist throughout adulthood.

An estimated 11% of American children have a mental health issue – and the prevalence is increasing in recent years. 

There are many benefits to seeking treatment for mental health as an adolescent, such as decreasing depression and anxiety, or improving social skills. 

Common Struggles of Mental Health  

Depression is a common and high-priority issue in adolescent mental health. This is due to the increased risk of self-harm and suicidal behavior.

• Occurs in approximately 13% of adolescents, with 8-10% having severe depression.
• The presentation of depression can often be masked by other problems, such as behavioral issues, substance use, failure at school, and fatigue 

Symptoms of Depression:

• Persistent sad or irritable mood
• Loss of interest in activities once enjoyed
• Substantial change in appetite or body weight
• Difficulties with sleep
• Loss of energy
• Feelings of worthlessness or guilt
• Difficulty concentrating
• Thoughts of death or suicide

Anxiety disorders often develop during adolescence, including generalized anxiety, panic disorder, and social anxiety.

• Occurs in approximately 32% of 13-18 year-olds.
• Generalized anxiety is marked by uncontrollable and excessive worrying, difficulty concentrating, irritability, sleep problems, and fatigue. 
• Panic disorder is characterized by spontaneous panic attacks, often coupled with physiological symptoms.

Eating disorders are characterized by extreme and abnormal eating behaviors, such as insufficient or excessive eating. Examples include anorexia nervosa, bulimia, and binge eating.

Attention deficit disorders present severe concentration or attention problems, and sometimes also coupled with hyperactivity.

• Consequences include diminished academic performance and behavioral problems, and present an increased risk of depression and other psychological problems.
• Impacts an estimated 5% of adolescents, with six times as many boys as girls affected.

Conduct disorders are defined when a young person repeatedly violates the rights of others, or other age-appropriate norms. 

• Common symptoms include damage to property, lying or theft, skipping school, violating rules, and aggression towards animals or people. Consequences include school disciplinary action, academic failure, and problems with the law.
• Often seen with oppositionality and defiance in early years, becoming increasingly more disruptive during adolescence.
• Individuals with conduct disorders often have comorbid issues such as depression, suicidal behavior, and poor relationships with peers or adults. 

School Refusal is a persistent irrational fear of going to school, and is often seen with increased anxiety symptoms when at or near school.

• It can be a serious emotional problem and often linked to anxiety or depression.
• School refusal develops over time, often after the individual has tried to quietly suppress increased negative feelings before attending school. Common negative symptoms include separation anxiety, social anxiety, generalized anxiety, and depression.

Common signs of school refusal:

• Tantrums or lashing out with physical force
• Frequent physical complaints such as headaches, stomachaches, chest pains, muscle pains, etc.
• Regular trips to the school nurse for no medical reason
• Illnesses on important academic days, such as test days 
• Refusal to engage with peers or participate in social activities

Appointments

Kemet Health's Approach To Mental Health  

Cognitive Behavioral Therapy (CBT) 

CBT focuses on the activities in an individual’s life, rather than the events that lead up to their difficulties. It is based on the following: 

• Psychological problems are based on faulty or unhelpful ways of thinking. 
• Psychological problems are based on learned patterns of unhelpful behavior. 
• Coping skills can be learned to deal with psychological problems. This relieves negative symptoms and allows individuals to lead more effective lives. 

CBT is based on the core principle that what we think, how we feel, and how we behave are all closely connected.  

With CBT we identify and change thought patterns that have a negative influence on behavior or emotions.

Raising awareness of negative and often unrealistic thoughts can be effective to help patients overcome a wide variety of maladaptive behaviors.

Some examples of CBT exercises include: 

• Develop a better understanding of others’ behavior and motivation
• Use problem-solving skills to cope with difficult situations 
• Develop stronger confidence in your abilities 
• Role play to prepare for potentially difficult interactions with others 
• Calm your mind, relax your body 
• Develop coping skills for the difficulties of life
• Identify and pacify negative thoughts, set new goals and self-monitor

CBT is problem-oriented, short-term and requires less time investment than other forms of therapy. 

CBT is one of the most utilized and studied forms of therapy. Research suggests that CBIT leads to significant improvement in functioning and quality of life – and has been demonstrated to be as effective as, or more effective than other psychological therapy or psychiatric medications. 

Motivational Interviewing (MI) 

MI is non-confrontational. It is used to strengthen personal motivation and foster a commitment to a specific goal. It is a goal-oriented and collaborative style of counseling. 

MI encourages an empathetic and open discussion about an individual’s life, as well as their substance use. The goal is to explore the individual’s interest to change, any potential roadblocks and the path to improve motivation. 

Motivational Interviewing values individual autonomy. It does not require the individual to admit to anything before considering behavioral changes. 

Important exercises to encounter with Motivational Interviewing: 

• Self-examination: What might be gained through positive change? 
• Encouraging reflection: Why do you want to make the change? 
• Looking to the future/past: How might you go about it to succeed? 
• Examining self-confidence: How confident are you to make this change, and why? 
• Importance of change: How important is it for you to make this change, and why? 
• Positivity: Did you feel good about the experience? 

Motivational Interviewing meets the American Psychological Association’s criteria for promising treatments of adolescent substance abuse.  Individuals with co-occurring mental health & substance abuse issues can benefit from MI techniques to improve psychiatric outcomes. 

Trauma-Informed Care (TIC)

Trauma is an external event with long-lasting effects on mental well-being - and is highly correlated with mental health outcomes. 

Trauma can negatively affect your well-being, including your physical and mental health. 

Trauma is widespread across society. Many people who seek help for mental health have histories of trauma, but often don’t recognize the effects of trauma in their lives.

Trauma comes in many forms:

• Childhood physical or sexual abuse, neglect
• Serious accidents or natural disasters
• Homelessness
• Involuntary psychiatric hospitalizations
• Drug overdoses
• Interpersonal violence
• Traumatic Grief

Trauma-informed care is a holistic approach, a change in perspective: the focus shifts from “what is wrong with you?” to “what happened to you?”. 

Practices trained in TIC have many benefits to you:

• Compassionate witness and acknowledgement to the pain underlying your distress and behaviors
• Sensitivity to abuse and connecting the individual with the support needed
• Safe environment that reflects the need for physical and emotional safety
• Problem Solving. Improve understanding of the past and extract wisdom to better approach the future
• Cultural Competency ensured across all our interactions
• Strengths Based. Belief of strength as an individual, to be an expert in their own life and have/develop the resilience to survive difficult circumstances

What To Do About Mental Health?

There are many options for treatment before considering medication, including educational strategies, behavioral interventions, cognitive behavioral therapy, and family therapy

Adolescent development is critical and it is important that mental health interventions take into account developmental issues, including:

• The ability to healthily manage thoughts and emotions
• Social abilities in establishing relationships
• Learning aptitude
• Resilience and coping skills to deal with the stressors of daily life