Chapter 7Developmental CrisisEvolutional CrisisAdolescent CrisesTeen PregnancyInterventionsGangsFactors associated with gang involvementInterventionRunawaysSlide 11Eating DisordersTypes of eating disordersSlide 14CharacteristicsSlide 16Crises of Old AgeAlzheimer’s Disease and general senilitySlide 19Chapter 7Developmental CrisesDevelopmental Crisis1. Normal, expected, and often occur as we transition from one psychosocial stage of development to another.2. Erikson proposes psychosocial tasks which can precipitate a crisis.Infancy: Trust vs. mistrustToddlerhood: Autonomy vs. Shame and DoubtPreschool Years: Initiative vs. GuiltMiddle School Years: Industry vs. InferiorityAdolescence: Identity vs. Role ConfusionYoung Adulthood: Intimacy vs. IsolationMiddle Adulthood: Productivity vs. StagnationMaturity: Integrity vs. DespairEvolutional CrisisSubsystem Adjustment Boundaries RoleA. Marital Families of Origin SpouseB. Parental Children ParentC. Grandparent Adult Child and GrandchildGrandparentD. Siblings With Parents. Hierarchy1. Often occur as family structures change and adjustment in role functions are required.2. Minuchin offers the idea of subsystems and the need to meet evolving needs of family members as possible stages where crisis occurs.Adolescent CrisesNeeds for individuation and identity may lead to risky behaviors.Need both autonomy and nurturanceFailing family structures may lead to self-destructive behaviorsEither too controlling or to lax may lead to some of the following issuesTeen PregnancyAbout 433,000 teens gave birth in the U. S. in 2002.Highest rate in the industrialized world, California has the highest rate in the country.Often linked to dropping out of high school, dependence on welfare, substance abuse, child abuse, domestic violence, and unemploymentInterventionsClinics and residential facilities have been created to meet the needs of this group.Can go to schoolLearn parenting skillsParents may be available to helpMay provide information about adoption and abortion agenciesGangsGangs exist in most cities in the U. S.84% of larger cities have gang problems640% increase in reported gang problems in the past 30 years.Factors associated with gang involvementFamily dynamics, self-concept, & societal stressesParental neglect, abandonment, family dysfunctionLow self-esteem, absence of personal safety and adult guidance, social alienation and boredom, lack of job opportunitiesInterventionPrevention is key: it’s harder to intervene once child is in a gangEducation at elementary school levelEducate community and encourage involvementEducate parentsCreate programs in community that expose at risk kids to social activitiesRunawaysAbout 1,682,900 youths run away a yearSome are thrown away.Ages 15-17 make up the majority of runawaysWhy? Achieve autonomy, unable to establish a mature identity, sexual and physical abuse, substance abuseInterventionsTeen shelters: provide crisis intervention to teen and the familyTeach effective communication skills, and address the need for autonomyCultural differences must be recognized and compromise soughtFamily therapy is the model rather than blaming the teenDeparentifying the teen may be helpfulEating DisordersTeenage girls make up 90-95% of those with eating disorders7 million females and 1 million males86% of girls develop before age of 20, 10% before age of 10!, 33% between the ages of 11 and 15.Usually white and middle or upper class.Types of eating disordersAnorexia Nervosa: intense fear of gaining weight, refusal to maintain adequate nutrition, erroneous complaints of being fat, loss of original body weight at least to a level 85% of that expected based on norms, disturbance of body image and absence of at least 3 menstrual periods.Bulimia Nervosa: binges on high-calorie food then engage in self-induced vomiting, taking laxatives and overexercising. Take great efforts to conceal behaviors.CharacteristicsEmotionally reserved and cognitively inhibitedPrefer routine and orderConforming and show deference to othersAvoid risk, react to stress with strong feelings of distressFocus on perfectionism, negative self evaluation and fears of becoming an adultInterventionIf life-threatening, need physician involvement and perhaps hospitalizationAssess for suicideFamily involvement: must face the seriousness of the conditionExplore her role in the family, her identity as a growing woman and needs for individuationCrises of Old AgeNearly 36 million elderly people in the U. S., over 12% of the population.It is expected to almost double in 25 years.Alzheimer’s Disease and general senility4 million afflictedProgressive degeneration of the brainImpaired memory, thinking and behaviors.Personality changes and inability to care for oneself require caretakersCaretakers often seek crisis intervention because of the emotional drain.Feel guilty to put parents in a facility, but may have to.Respite care is available through the Alzheimer’s AssociationKnowledge of resources is