Working With Young Families:
A Framework for Practice
Jody Scanlon, LCSW
Overview: From Theory to
Practice
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Review of Adolescent/Infant/Toddler
Development
Understanding the Dual Developmental
Crisis
Preventing Subsequent Pregnancies
Utilizing parallel process in our work
Pulling it all together
Stranger in a Strange Land
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Our work asks us to visit a foreign culture
Customs, language, world views are
unique
Enter with respect
Learn to speak the language
Maintain sense of self
Here’s the Problem:
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Teen years are no longer a convergence
of puberty (physical maturation) and what
we have termed adolescence
(psychological maturity)
Teens now have physical capacity for
reproduction long before they have
emotional maturity for parenting
A Nod To Neuroscience
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Adult decision-making and reaction utilize
frontal lobes primarily
Adolescents often are accessing the
amygdala (temporal lobe)
This explains a lot!
Adolescence: A Conceptual
Framework
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Erickson divides human development into
discrete tasks to be accomplished during
each stage
Task of adolescence is identity
formation—critical in understanding teen
pregnancy
Stage 1: (10) 12-14
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Movement toward independence
Peers replace parents as primary relationship
and source of information
Actions take precedence over thought
Over-riding need for immediate gratification
Minor rule-breaking and experimentation while
still tied into rules and expectations of parents
Stage II: 14-17
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Increased intensity of individuation
Increased conflict with parents
Heightened narcissism/grandiosity/sense
of invulnerability
Increased risk-taking/impulsivity
More abstract thinking
Stage III: 17-19 (25)
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Firmer sense of identity
Interest in career development (crucial to
support this)
Independent decision-making
Increased regulation in emotional states
and insight
Let’s Add Teen Parenting to the
Mix
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Statistics tell us that the preponderance of
teen pregnancies are unintended (80%)
however, there is a significant amount of
ambivalence— “if it happens, it happens”
From a teen’s perspective, some
legitimate reasons
Attention and care from pregnancy
Adolescence + Teen Parenting
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Erroneous belief that FOB will stay (less
than 20% result in marriage)
Psychologically—opportunity to provide
the parenting she never had
Identity formation
Now on to Infant Development
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Infants need to develop a sense of trust
first and foremost
Require dependability from a primary
caretaker
Require that their needs are seen as
primary
Require stability and predictability
And Toddler Development….
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Sense of safety so that they can explore
the world
Emotionally labile (temper tantrums)
Conflict between
dependence/independence
Narcissism
Invulnerability and risk-taking through
experimentation
The Dual Developmental Crisis
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With infants: adolescents’ needs are in direct
opposition to the infants’ needs
With toddlers: both the adolescent and the
toddler are experiencing similar developmental
stages simultaneously
Adolescence is in many ways a recapitulation of
toddler years: push/pull, approach/withdraw
Desire for independence and need for security
and parental guidance
So, A Teen By Any Other
Name….
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Is still a teen
And a mom
Important for providers to work on both
levels
Interventions are usually most successful
when we put the teen before the mom
Preventing Subsequent
Pregnancies
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25% of teen moms will experience a
subsequent pregnancy prior to age 20
From an adult perspective: this defies
logic!
Teen moms know first hand the hardships
Why, Why, Why?
Common Reasons given:
 Spacing of children
 New boyfriend
 Desire of FOC
 Complaints about contraception
 Nostalgia for infant phase
 Whoops!
Reasons Behind the Reasons
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Competency: I can do this!
Lack of future orientation
Pregnancy was a time of care and support
Lack of efficacy re: family planning
Characteristics of Effective
Interventions
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Long-acting, low maintenance method
Involvement during first pregnancy
Sustained relationship with client
Close, high-quality relationship with client
IUDs and Adolescents
American College of Obstetricians and
Gynecologists (2007):
Because adolescents contribute disproportionately
to the epidemic of unintended pregnancy in this
country, top tier methods of contraception
including IUDs ..., should be considered as firstline choices" for them. "After thorough
counseling regarding contraceptive options,
health care providers should strongly encourage
young women who are appropriate candidates
to use this method."
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Home Based Contraception
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Partnership with Boulder Valley Women’s
Health Center
Provides Depo Provera shots to GENESIS
teen clients in convenience of their homes
Eliminates barriers
Increases opportunities for case
management
Parallel Process
Supervisor
Caseworker
Teen Mom
Baby
Working With Parallel Process
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Parallel Process can teach us a lot about
what is going on in the mother/infant dyad
Be aware of what you are feeling when
with a client
This might be a reflection of what she is
feeling with her infant
And, ultimately, what the infant is feeling
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Use this information to guide interventions
Anxiety, dependency, ambivalence, avoidance
These clues also appear in the course of
supervision
Awareness of parallel process enriches
therapeutic and supervisory relationships and
can result in more effective interventions
Some Techniques
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Speak to the ambivalence
Be curious!
Work to understand the teen’s motivations
Empower the teen—they know better than
you how they can change and what will
work in their lives
Remember Developmental Issues
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Work with not against their narcissism—it is
developmentally appropriate and not a character
flaw
Becoming moms does not make them adults—
they don’t necessarily think like we do
Their brains are not fully developed—help them
to see beyond the immediate and to recognize
consequences of actions
Create Safety
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Be genuine
Avoid the very real temptation to be
parental
Always explain the rules up front
Change is scary and it is hard
Teens will respect you for setting limits—it
might be the first time that anyone has
done this for them
Use Supervision
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This is where the parallel process is likely to play
out—pay attention—and use these clues
Watch for burn-out and secondary trauma
Plant seeds and have faith they will grow
Celebrate successes—no matter how “small”
Remember your limits
Find ways to transition back home
Build a Future
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Be a cheerleader—you might be the only one
who has ever believed in them
Be a role model
Be calm
Cool,
And collected when they are acting out
(remember the parallel process—it’s what you
might do with a toddler and a temper tantrum)
When You Feel Stuck….
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Listen to the music, not the words
Avoid the temptation to “fix”
Always start with the assumption that
EVERY parent wants to be the best parent
they can be—our job is to reinforce this
natural inclination
“Challenging clients”—what are they
teaching you?
Remember Systems Theory
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Ripple effect of our actions
Teen is part of a system larger than herself
Respect the power and significance of
family, friends, environment
Work organically within the system
It’s All About the Relationship
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Relationship is key to facilitating change
Read cues and pace accordingly
Respect boundaries—teens put them there for a
reason
Patience
Don’t give up—they may be testing you because
they expect you will not stay with them
You may be the first and only person in their life
to model a healthy relationship
Remember:
We make a living by what we get; we make
a life by what we give.
--Dr. Albert Schweitzer
Life Enrichment