Adolescent Substance Abuse, "What's Normal?"

Learning Mod 1.

ODYSSEY On-Line® Adolescent Substance Abuse: Part 1. Development and "Normalcy" Instructor: Michael Connelly, MA, CAC III
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bjObjectives of Learning Module_1
xO - Introduction OO- What's Normal and What's Not x x - Tasks of Adolescence x x - Adolescents "Then and Now"x x x - Stages of Development	x - Psychoactive Drugs xx- Summary and Conclusions xx- Evaluation Exam xx- Comments

Learning Objectives Part 1 - Adolescent Development, What's Normal?

Adolescence is a time of tremendous developmental changes. This module will examine the stages of normal adolescent development and challenges the young person experiences, cognitively, physically, emotionally and socially.

The student will:

- Demonstrate a knowledge of historical theories of development, including Piaget's stages of cognitive development, differentiating between Concrete and Formal operations.

- Identify the primary social/psychological task of adolescence according to Erikson's model and how adolescents accomplish that task.

- Gain an understanding of the impact of psychoactive drugs on adolescent development and identify specific differences between adolescent and adult substance dependency.

What's "Normal" and What's Not?

Few issues are as compelling as the impact of alcohol and drug abuse on
the lives of adolescents and its effect on families, schools, communities and society.

A person between the ages of 11 - 21 years is going through tremendously rapid: biological, social, emotional and cognitive changes. Adolescents are often viewed by society at large as a less significant and unformed members of the community, (Come back when you've finished growing!). This conflict and generation gap is inevitable and leads to misunderstandings, emotional isolation or more serious conflicts and maladaptive behaviors.

A willingness to discard preconceived ideas or myths about the process of adolescent development and separately personal prejudices and judgment from normal adolescent behavior is critical to understanding and dealing effectively with teen members of the community.

Common Myths:

- Adolescents are not quite normal
- Adolescents are all alike
- All adolescents rebel
- All adolescents hate their parents, authority figures

- Each adolescent grows in and predictable pattern
- Adolescents are still children
- Adolescents are irresponsible
- Adolescence is the best time of your life

Normal Behavior is Elusive.

Defining normal adolescence behavior is elusive. In the counseling field - it's very easy to get overly focused on dysfunctional kids and/or situations. Kids in trouble have "normal kid" tasks just like the rest - understand them so you can help in facilitating and validating those behaviors.

Why it's important in understand "Normal" adolescence first in any study of abnormal or abusive behavior:

1. Because it establishes a frame of reference for our clinical judgment.

2. Dispels myths about adolescents that may bias our judgment.

3. Helps separate personal histories from objective consideration of the facts.

Adolescence is a Period of High Conflict.

It's easy to misread normal behaviors for serious life problems. Therefore,
it's important for anyone working with youth to check for unresolved issues
within themselves.

When Does Your Buzzer Go OFF ?!

It's next to impossible to work with kids and not have a
few of your own buttons pushed. Do you know where they are for you?

Do you feel comfortable with resolution around things that you went through as a young person?

Because teenagers are what they are, it's important not to use labels that are inappropriate. They have a tendency to live up to them.

EXERCISE 1: List Three (3) Labels that help you describe teen behavior

*Tip!* Jot down your responses, you'll need them for the evaluation exam. 1. 2. 3.
How do labels limit your interactions with the adolescents around you, clients, children, nieces, nephews, or the group of teens that almost knocked you over while they raced through the mall?
Example. Belief: Teens are Sloppy. Limiting Statement: I have an idea about what it means to be neat and your sloppiness indicates how you care for your things, your life, attitude towards me! Result: Mixed messages, misdirected emphasis, muddled communications *Now, think of one belief that is true for you...*


Let's take a moment and consider how much the world has changed in the last 50 years. The following chart compares adolescent problem behaviors from 1950's with the present day. Los Angeles County, public school disciplinary problems - 1950 and 1998
1950	1998
Chewing gum	Talking Drug & Alcohol Abuse
Making noise	Gang Warfare
Running in the halls	Pregnancy/Suicide
Wearing improper clothing	Robbery/Assault
Getting out of turn in line	Rape
Not putting paper in wastebaskets	Vandalism / Extortion
The Differences are Dramatic!

EXERCISE 2: Let's go back in time to when you were a teen. Remember what you
were like before you started wanting to do adult things and how you changed as you began experimenting being an adult.

TIP! You may want to take some notes. You'll be asked to respond
to a similar question as part of your final evaluation.

- What kinds of things did you do?
- What role did your friends/family play in your decisions, your life?
- How did your family or friends influence the way you dressed or the
c music you listened to?
- How old were you when you first used alcohol or a psychoactive drug?
- How did friends and family respond to your first experimentation
- What was your response to your friends when they experimented?

Close your eyes and remember yourself as an adolescent. Imagine yourself in high school perhaps your with your friends at the mall or with your parents at dinner, or by yourself in your room. Remember the music, the language, the feelings.

• Reflect on how your adolescence has shaped your attitudes and beliefs torregarding adolescent substance abuse issues today.
• How do your values impact your role and what do you believe about
c self-disclosure?
• How do you handle it when adolescents ask you about your past experiences cwith alcohol and drugs?

Being clear about our own adolescence experiences allows us to develop
a more objective understanding of the challenges confronting today's teens.

As the young person enters puberty they leave behind their childhood identity and begin the journey of finding one's identity. This journey is characterized by:

A. Shift in orientation from an acceptance of the PARENTAL WORLD
cc VIEW (AND SELF), to a more PERSONALIZED VIEW.

• Restructuring of Self concept
• Redefinition of concept of others and their influence on self
• Reappraisal of social standards and values

B. Broadening the Range of Social Contacts

• Movement from parents and adults as "guide" and "decision makers" to equals
• Movement toward behavior which allows him/her to function effectively outside cof family unit
• Movement from dependence to independence in thought and action

C. A Primary Task of Adolescence is Answering the question:

"Who Am I !?"

This period of intense self-examination is entails:

• Trying out various adult roles
• Evaluating the response of others to these experiments
• Adjusting to sexual maturity
• Learning to be a social adult
• Learning to adapt to the demands of new social relationships
• Changing the nature of peer relationships
• Exploration of vocational choices

And with feedback on the accomplishments and mis-steps by:

Parents - Peers - School - Community

Note: Module_3 goes into great detail on evaluating the many influences and influencers on adolescents and strategies for successful intervention.

EXERCISE 3: List three(3) tasks the adolescent must accomplish to successfully move on to the next level of development.
*Tip!* Jot down your responses, you'll need them for the evaluation. 1. 2. 3.

Human development is not governed solely by internal maturation or external teachings. It is an active construction process, in which children, through their own activities, build increasingly differentiated and comprehensive cognitive structures.
(William Crain, Theories of Development - 1992)

Erikson's Stages of Life - Psycho-Social Development pioneer Erik Erikson (1887-1949) is best known for his seven stages of human development segmentation. I will present a brief review of each with special emphasis on the adolescent and young adult stage.

Birth to one - Trust vs. Mistrust: *Establishing a Predictable World*
	At this first stage, as infants struggle to take in the things they need, and act on basic impulses, they interact with adult caretakers, who follow their own culture's ways of giving to them. What is important in these interactions is that babies come to find consistency, predictability, and reliability in their caretakers' actions.
During this formative period, when babies sense that a parent is consistent and dependable, they develop a sense of basic trust in the parent. The alternative is a sense of mistrust, the feeling that the parent is unpredictable and unreliable, and may not be there when needed.

One to three years - Autonomy vs Shame: Will and Self Restraint
This stage is characterized by the conflict between autonomy and shame. Autonomy comes from within: biological maturation fosters the ability to do things on one's own - to control one's own sphincter muscles, to stand on one's own feet, to use one's hands, and so on. Shame and doubt,
on the other hand come from an awareness of social expectations and pressures. Shame is the
feeling that one does not look good in another's eyes. Erikson believes the resolution of this conflict is the development of one's will. He states, "Will is the unbroken determination to exercise free choice as well as self-restraint."

Three to Six - Initiative vs Guilt: *Achieving a Sense of Purpose* The child at this stage begins to have a sense of initiative. They make plans, set goals and preserve in attaining them. More then any other period, the child is ready to learn quickly and avidly pursue their imagination. This is also a period of limits
being placed on the child and they soon learn many of their plans are doomed to failure. Often they are punished for their unbridled acts of imagination and learn the meaning of guilt, as in 'did you do this'. The child learns to balance their initiative with internalized guilt achieving a sense of purpose in their behaviors.

Six to Eleven - Industry vs Inferiority: Competence and Acceptance
As a rule, this is a period of calm and stability where children are challenged to master important cognitive and social skills. Children are learning meaning work and are developing the necessary
	skills of steady attention and persevering in a task. They are also learning to play and work with their peers. This is also a time when a child can experience a sense of inferiority. The failure to achieve social acceptance or perform in school diminishes the child's sense of competence.

Adolescence - Identity vs Role confusion: Fidelity and Values
The adolescent's primary task is to develop a new sense of identity - a feeling for who one is and one's place in the larger social order. Adolescents experience rapid physical and sexual growth, so much so, that they that they can barely recognize themselves. Perhaps that is the reason they spend so much time looking in the mirror and pay so much attention to their appearance, they're trying to see who they are becoming. But identity problems are as much, if not more, a social matter.

In addition to all the physical changes, adolescents are concerned with the thought that that one might not look good to others or meet others' expectations. And, even more then this, they begin to worry about their future place in the larger social world. Adolescents with their rapidly expanding mental powers, feel overwhelmed by the countless options and alternatives before them. This uncertainty about who they are and where they belong leads adolescents to identity with specific peer groups.

In their hurry to find identity, They often stereotype themselves, their ideals and their enemies.This then is the young persons' search for values to which they can be true, or as Erikson calls it, "Fidelity." Identity formation is a complex and life long process that reaches its crisis in adolescence. Erikson describes several avenues through which one establishes an identity.

Identification: we tend to identify with those who appeal to us and therefore become like them. Each person's identity is a synthesis of various partial identifications.

Accomplishments: we develop a sense of who we are through our accomplishments. The ability to stand up, walk, run, play sports, music, read, write or get high on drugs all contribute to a sense of identity.

Commitment: As a result of so many drastic changes in their lives, adolescents often experience an inability to make lasting commitments. It is at this time that so many inner changes are taking place, and so much in terms of future commitment is at stake. At this time, one's earlier identity seems inadequate for all the choices and decisions one must make. Often adolescents feel that there is too much to decide too soon, and that every decision reduces their future.

Adolescence is a time of turbulence. Not only is the young person experiencing dramatic physiological changes, but they also experience tremendous confusion caused by new social conflicts and demands.

The adolescent's primary human task is establishing a new sense of self identity. This means developing a sense of who one is and ones place in the larger social order. The task then is to develop a sense of self and to find some way of life to which they can make a commitment to living. Fidelity is the ability to sustain one's freely chosen values and lifestyle. Even though identity formation is a lifelong process, the problem of identity reaches its crisis at adolescence.

Young Adulthood - Intimacy vs Isolation: Love and Intimacy
The adolescent stage of development is one of self-focused attention. The adolescent is primarily concerned with how they appear in the eyes of others and what they will become. Despite becoming

sexually attracted to one another and even falling in love, most often these are really efforts to at self-definition. The adolescent then is too preoccupied with who she or he is to take up the tasks of young adulthood-the attainment of intimacy. Real intimacy is only possible once a person has established as sense of self. To the extent that people fail to attain their own identify and become capable of intimacy, they experience the opposite pole of this stage - isolation.

Experimentation with Drugs, Trying On Adult Roles
For the adolescent, experimentation with drugs is often a means to try on adult roles, alter their perceptions and thoughts in new ways and ease the emotional turmoil of so much change. Often, drug use is a way for an adolescent to imitate their role models, especially in the music and entertainment industry.

Obtaining and getting high on alcohol and drugs is viewed as an accomplishment. Particularly for the young person who is struggling in school and has few accomplishments, getting high can feel like accomplishing something.

Frequently their peers evaluate this feat by heaping praise and social rewards on the adolescent for the simple behavior of using psychoactive substances. Many young adults compensate for their sense of isolation by turning to psychoactive drugs. Drugs or alcohol create the illusion of intimacy. It allows the person to interact socially and sexually while sedating the pain of isolation. Many young adults compensate for their sense of isolation by turning to psychoactive drugs.

Drugs or alcohol create the illusion of intimacy. It allows the person to interact socially and sexually while sedating the pain of isolation. They experience the uninhibited effects of alcohol or drugs as liberation from their inner world of self-doubt and confusion.. While high they discover that they're capable of many social behaviors and often receive reinforcement from their peers for their use of drugs or alcohol.

Adulthood - Generativity vs Stagnation: Care
Once a person has established some measure of intimacy, their interests begin to expand outward. Generativity is a broad term that refers not only to the creation of children, but also the production of things and ideas through work.

Old Age - Ego Integrity vs Despair / Wisdom

old couple

This is a period of adjustment and loss; loss of physical strength, productivity and friends and family. However, for Erikson, emphasis is not on external adjustments, but on the inner struggle of this period - a struggle that holds potential for growth and wisdom. As older people face death, they engage in what has been called life review. They look back on their lives and wonder whether they were worthwhile. The result may be either despair or wisdom.

Like Erikson, Jean Piaget's (1904 - 1972) was a pioneer in segmenting human development stages, although Piaget placed more emphasis on cognitive development traits than to Erikson's social and cultural conditions.

Birth to two years - Sensori - Motor Intelligence. Babies organize their physical action schemes, such as sucking, grasping, crying, smiling and hitting, for dealing with the immediate world. The primary purpose in development is to meet their basic needs. Children at this stage do not grasp

permanence in their reality. This is demonstrated in the game almost every parent and infant play
called peek-a-boo. The parent hides, under a blanket and the infant does not realize they are still present. When the parent takes the blanket off to suddenly reappear, the child is delighted.

Two to seven years - Preoperational thought. Children learn to think - to use symbols and internal images - but their thinking is unsystematic and illogical. It is very different from adult thinking.

Children at this stage do not grasp the laws of conservation. This is demonstrated by pouring liquid of the same volume from a tall narrow glass into a short wide glass. When asked which glass hold more liquid, the child invariably believes the tall glass holds more. This despite repeatedly pouring the liquid back and forth, the child simply cannot grasp that both glasses hold the same amount of liquid. Piaget believes that the child cognitive functioning is limited to a single perspective. They can only see the world through one view, their own.

This stage of development is most often described with the term egocentric, meaning that children see themselves as the center of the universe.

Seven to twelve years - Concrete operations. Children develop the capacity to think systematically, but only when they can refer to concrete objects and activities. Children at this stage cannot easily grasp the concept of time, they focus on the immediate reality. Just ask any 9-year-old to guess the ages of a variety of people. They typically make wild guesses, particularly of older adults. Important developments at this stage are the understanding of social and procedural rules.

As a result of their concrete thinking, strict adherence to rules, especially in games is often the case. The saying, 'If you're not going to play by the rules then I'm taking my ball and going home' surely must have originated on the playground by children at this stage.

Piaget believes that at this stage children develop the capacity to view reality from more then one perspective. They cannot only focus on what they are saying but also be aware of the needs of the listener.

The person in concrete operations lives primarily in the here and now. They have difficulty constructing a future where they are different from how they are right now. The present is the only and lasting reality, which is frequently expressed in the intensity and drama they experience around day to day events.

Twelve years to adulthood - Formal operations. Young people develop the capacity to think systematically on a purely abstract and hypothetical plane.

The capacity for abstract reasoning can be seen in responses to questions such as the following: If Lewis is shorter then Jay and Lewis is taller then Alex, who is the tallest. At the level of concrete operations, the young person can handle this problem only if they place people in order and compare their heights; beyond this they simply guess. At the level of formal operations, however, adolescents can order their thoughts in their minds alone and come to the correct conclusion.

The shift between these stages is reflected in the young person's perception of time. As the young person enters Formal operations, they begin to think about more far reaching problems - about their futures and the nature of society they will enter. They now grasp abstract principles and ideals, such as, liberty, justice and love, and they envision hypothetical societies very different from any that presently exist. Thus adolescents become dreamers! The ego-centrism of earlier stages re-emerges with the adolescent attributing unlimited powers to their own thoughts.

EXERCISE 4: Describe two differences between Erickson's and Piaget's analysis of Human Development.
*Tip!* Jot down your responses, you'll need them for the final evaluation. 1. 2. .

Click for HINT!

Adolescent Substance Abuse
"Normalcy" continued...

Odyssey Training Center

The leader in classroom and on-line substance abuse training for professionals.

Tuition : Adolescent Substance Abuse Issues Online

Part I - Seven credit hours = $90

Part II - Seven credit hours = $90

Parts I & II – Fourteen credit hours = $170

Registration : You can register for classes by calling us directly at 303-657-0996 or toll free at 1- 877- 657- 0996.

Password: Upon receipt of payment each student will receive a User ID and Password which will allow them to enter the class. The password is active for 30 days and the student must complete the course during that time.

Course Format: This is a self directed course that should take the student approximately the number of hours to complete including the final exam that the student registered to take.

Proctored Exam for CAC credit : Students taking the course for CAC II or III elective credit must have their exam proctored. The course exam must be taken and passed with a minimum score of 70% in order to receive your certificate of completion. It is the student's responsibility to locate an ADAD approved facility in their area and request that a CAC III or a staff person in a supervisory role serve as the proctor. Once the student has contacted an appropriate proctor, e-mail or call Odyssey and provide the person's name , facility name, address, email address and phone number . Odyssey will arrange to have the exam delivered to the designated Proctor. That person will verify that they observed the student taking the exam and return the exam and verification to Odyssey.

Continuing Education Exam: The course exam must be taken and passed with a minimum score of 70% in order to receive continuing education credit for their NAADAC or NBCC credential. The exam consists of multiple choice and short essay questions. When the student is ready to take the exam contact Odyssey and an exam will be sent to you.

Certificate of Completion: Upon successful completion of this class, a personalized Certificate of Completion will be sent to you for official documentation of your course credit.

CAC and Continuing Education Information:

Alcohol and Drug Abuse Division (ADAD):

General Information # 303-866-7480

All CAC classes at Odyssey are ADAD approved for CAC level I, II, and III certification requirements.

National Board of Certified Counselors (NBCC):

Odyssey Training Center is an approved NBCC provider (#5521) and all the workshops are NBCC approved for continuing Education credit.

National Association of Alcoholism and Drug Abuse Counselors (NAADAC):

Odyssey Training Center is an approved NAADAC provider (#344) and all the workshops are NAADAC approved for Continuing Education Credit.

Michael Connelly, MA,CACIII

Mr. Connelly is Program Director for Odyssey Training Center. He has been a trainer for a variety of CAC workshops since 1982 and has worked in the substance abuse field for over twenty years. Michael has experience working in detox, inpatient, outpatient, administration and private practice. He received his Master's Degree in Educational Psychology from the University of Colorado and specializes in adult education.

E-mail M. Connelly