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Adolescents Diagnosed with Depression: Risk Factors and Interventions

Paper Type: Free Essay Subject: Psychology
Wordcount: 2046 words Published: 8th Feb 2020

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 Group and Diagnosis

An adolescent is someone between the ages of 10 – 19 years of age. Utah has a higher rate of depression among individuals in this age range than the national average. Such depressive symptoms in the age group could be presented as a lack of self-esteem, isolating self from peers, sleeping too much or too little, and often adolescents present as more irritable and impulsive rather than a with a depressed mood. Symptoms have to be lasting for a least 2 weeks for a depression diagnosis. This is important for mental health workers to note because if an adolescent is exhibiting emotional/behavioral problem at school, the child may be viewed as simply a ‘trouble maker’ and their depression may go undiagnosed.

Gender Differences

In Utah, studies suggest that girls are more likely to suffer from depression and attempt to commit suicide. Depression in boys may also go undiagnosed because in a recent survey, data showed that boys are less likely than girls to reach out for help when suffering from mental health issues. While boys are more likely than girls to talk to a family member about depression, there is still a stigma about males discussing emotions. Adolescent boys are faced with the challenge of ‘boys don’t cry’ while girls are told they are ‘too emotional.’ I believe that this could play a role to girls being diagnosed with depression at a higher rate that boys. What I can do was a mental health worker; normalize negative feelings and challenge gender roles when I with my adolescent clients. I also can discuss healthy emotional expression with caregivers of adolescent children because children often learn gender roles at home.  

  Risk Factors

         There are certain risk factors that we as mental health workers should look for when working with adolescents who may suffer from depression. Studies suggest that a lack of sleep may link to an increased chance of suicide and depression. Another factor is a family history of depression or another mental health diagnoses. If a parent is actively depressed, there could be a link to their child experiencing depression. Another risk factor is nicotine use in teens. A study done in 2010 found a link between teen nicotine use, depression, and suicidal ideation. An adolescent living with depression may also have emotional problems that could negatively impact their performance at school. As a mental health worker, I need to be aware of risk factors and symptoms of depression in teens to provide the correct therapy needed.

Intervention strategies

         When it comes to serving depressed teens, studies suggest that medication alone is not enough. In a recent study, researchers found that only a little more than 25% of teens were able to combat their depression without the help of therapy when using antidepressants. There are still disagreements on whether an adolescent should be prescribed antidepressants or not. I believe in the client’s right to self-determination and whether they choose to be on antidepressant medication is their choice. However, there are two types of therapy that have been proven to benefit adolescence: Cognitive behavioral therapy (CBT) and group therapy.

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The textbook Counseling Children and Adolescents discusses the effectiveness of this group therapy. During this setting, adolescents can be exposed to peers with similar challenges that they are facing. This allows them to feel less alone and more connected to those around them. Feeling a part of a group at this age is crucial to development and may decrease the chance of depressive symptoms. The text suggests that groups should involve more than simple discussions, there should be activities such as role plays and creative arts. This would allow for the clients to create relationships with peers their own age and practice appropriate interactions with others their same age.

 A study done in 2016 found that cognitive behavioral therapy is also effective with adolescents who are experiencing depression because it can improve coping skills and decrease symptoms such as negative self talk. Adolescents suffering with depression may experience feeling of worthlessness and loneliness. The with help of CBT, a therapist could provide psychoeducation and lessen the maladaptive, often untrue thoughts that a depressed adolescent could be suffering from. CBT does this by challenging one’s core beliefs about themselves and providing actual evidence against a negative thought. I have done a CBT thought log worksheet with one of my adolescents diagnosed with depression and have noticed progress in her treatment goals.  

Your own mental health recommendations

For this section, I interviewed two different social workers who have years of experiences working with adolescents for tips on how to be an effective youth therapist. The first therapist, who worked with adolescent boys, gave me the simplest yet most effective tip: Be who you needed. He told me to look back to my adolescents and think about what I needed to feel ‘okay’ during those trying years. He asked me if I needed someone to lecture me on CBT or if I needed a therapist who truly listened to my problems and offered support rather than judgement. I found this to be especially helpful because most of my teen girls feel that their problems are not important. “It’s just the Winter dance, I shouldn’t be upset that I didn’t get asked.” Having a simple reflection such as “Not having a date to a dance can be hard, a lot of us would be sad too.” Has made my clients open up to me quicker than I thought they would.

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The next social worker I asked works with at risk adolescent girls, she told me to “validate, validate, validate, and then work on reframing thinking errors.” She spoke of the importance of building rapport and trust with adolescent clients before you provide feedback. I believe that this is effective because during this stage of development, adolescents are shaping their identity and need to feel supported and accepted for who they are.

Assessment Tools

The textbook Child and Adolescent Mental Health Theory and Practice has a chapter dedicated to the assessment of adolescent. During the assessment, a mental health worker should be engaged with both child and caregiver to gather important information such as; the presenting problem, if the child is developmentally delayed or mainstream, protective/risk factors, and family relationships. Such information is crucial for a mental health worker to identify any mental health disorders or abuse that needs to be reported. From personal experience, the first interaction I have with adolescent and caregiver is essential for building rapport. A co-worker has stated that even appearance can ‘make or break’ a first impression with a teen client. To combat this, I dress business casual for the caregiver to show I am professional and keep pink in my hair to show I can be relatable to an adolescent.

 At my agency, before the first intake, we have the clients fill out a beck depression scale, CSSR suicide risk assessment, and an YOQ (youth outcome questionnaire) to effectively assess their needs. We use these strategies to create a treatment plan that best suits to help their presenting problem. They have been proven effective at our agency with a high rate of clients returning after the intake. Clients report that though the paperwork is time consuming, it helps them reflect on events that have caused them distress. I feel torn about them, I support them because I understand that some may feel uncomfortable voicing their concerns to a stranger and may feel more comfortable filling out a paper assessment. On the other hand, part of me knows that people may lie on them and I may get inaccurate information. The CSSR suicide risk assessment has been proven to be an effective tool to understand a client’s intent on committing suicide. With that information I can make the necessary decisions to keep my client safe, whether that is calling UNI or creating a safety plan with them.

Ethical Issues

         An ethical dilemma that I have faced at my agency is that we cannot even speak to a child without the consent from both guardians. This has been a challenging rule to follow. I have dealt with hurt and frustrated divorced parents who simply want their child to receive mental health services. This is challenging because there are times in which one of the parents has abused the child and the child does not want them to know they are in therapy. What we have done to resolve this? We explain to the parent that this is our policy and we have referred clients out to different agencies if we cannot get consent from both parties.

Another ethical dilemma that I have face while working with teens is choosing what I disclose to caregivers. To me, there are a few things that I will inform the caregiver, but I will do so with the client there. For example, if a young client is having suicidal thoughts, I will inform the parent with the client present and together we can create a plan that will keep my young client safe. However, at my agency, the therapists do not agree on all the we do not keep confidential. A few of us do not think it is necessary for us to inform a guardian if a teen client has smoked a few cigarettes or if a teen discloses “I drank once but I am not going to do it again.” I do not think that is necessary information for the caregiver. On the other hand, there is a therapist who will disclose all of this information with the caregiver, when the client is present. We have yet to come to an agreement on what it is client/therapist privilege vs client/therapist/caregiver privileged.

  • Chandra, A., & Minkovitz, C. S. (2006). Stigma starts early: Gender differences in teen willingness to use mental health services. Journal of adolescent health, 38(6), 754-e1.
  • Hockenberry, J. M., Timmons, E. J., & Weg, M. V. (2010). Smoking, parent smoking, depressed mood, and suicidal ideation in teens. Nicotine & Tobacco Research, 12(3), 235–242. https://doi.org/10.1093/ntr/ntp199
  • Kumara, H., & Kumar, V. (2016). Impact of Cognitive Behavior Therapy on Anxiety and Depression in Adolescent students. Journal of Psychosocial Research, 77-85.
  • Thompson, M., Hooper, C., Laver-Bradbury, C., & Gale, C. (2012). Child and Adolescent Mental Health Theory and Practice . London: Hodder & Stoughton Ltd.
  • Tucker, C., & Smith-Adcock, S. (2016). Counseling Children and Adolescents. Connecting Theory, Development, and Diversity. Los Angeles: SAGE Publication, Inc.
  • Utah Adolescent Mental Health Facts. (2018). HHS.gov. Retrieved 26 November 2018, from https://www.hhs.gov/ash/oah/facts-and-stats/national-and-state-data-sheets/adolescent-mental-health-fact-sheets/utah/index.html
  • Van Voorhees, B. W., Smith, S., Ewigman, B., & Hickner, J. (2008). Treat depressed teens with medication and psychotherapy. (Cover story). Journal of Family Practice, 57(11), 735. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=35265823&site=ehost-live



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