My client is a 16 year old Latina. She has a history of depression and attempted suicide. The client was placed in a group home when she was 14 years old. However, her father managed to convince her to move back in with family. However, the family does not support the client. They usually taunt her due to her suicidal tendencies. This has made the client have low self-esteem. The client has managed to overcome some of the psychological problems she faces. She recently won her school elections on the student government. The win helped in improving her self-esteem. However, she still has certain problems that need to be addressed urgently.
The client has recently started to open up to me and express her feelings. This may be due the improvement in her self-esteem. The client has more disorganized. Over the past 3 months, she has lost several items. In addition, she is late to attend school or social events since she takes a long time to get ready. She has become restless and finds it hard to concentrate even on things that she enjoys. For instance, she it is hard for her to sit and watch a film to conclusion even if the film is enjoyable. She has also started to struggle academically. She also finds it hard to make and keep friends.
I had diagnosed the client with attention-deficit hyperactivity disorder (ADHD). Therefore, I was strived to determine whether she exhibited certain symptoms. According to Rutter, Bishop and Pine (2011), girls who have ADHD start having social deficits as early as preschool years. The social deficits reach their greatest impact during adolescence as the girls start separating from their family and their social life becomes more importance. Wheeler (2013) asserts that many women who have ADHD claim that they felt different from other girls when they were growing up. The girls yearn for self-acceptance during high school years is so intense that in some instance, it may lead to self-destructive behavior as the girls strive to “belong.” The client was 16 years old. Therefore, it was evident that she faced several social pressures due to the need to belong. Her election in the school government increased her social pressures.
It is a fact that family support is vital in the life of an individual. However, Rief (2015), asserts that family support cannot completely counteract the damage done to teenagers who feel that they have been rejected by their peer groups. Girls who have low self-esteem during their high school years by be haunted by the feeling later in their life. The client does not have family support. Her family taunts her due to her suicidal tendencies. In addition, they do not seem to support her endeavors. Lack of family support coupled with the need to belong increased the social pressures that the client is exposed to. The client yearns to have family support to overcome some of the challenges she faces. She feels that she is the black sheep of the family. Her father is the only person who has made an effort to integrate her into the family. However, the effort is not enough as she still has reservations for certain members of the family.
Wheeler (2013) acknowledges that despite the fact that teenage girls face self-doubt, the special challenges of girls who have ADHD heightens the feelings. For instance, the society encourages girls to be neat and “feminine. This requires them to be controlled and passive. In addition, girls are requires to be carefully groomed so that they may attract the attention of the opposite sex. They are also required to be sensitive to the feelings of other people. These feelings are directly opposite to the feelings of teenage girls who have ADHD. Teenage girls who have ADHD may respond anxiously, or in some instances, obsessively, to the society’s expectations that she is supposed to be well groomed and dressed fashionably. However, the girl may be unable to organize her room or personal life well enough to have clean, coordinated clothing for school.
According to Rief (2015), the hyperactivity of ADHD increases among adolescents due to hormonal fluctuations, which complicate and increase reactivity. Therefore, the self-doubts and competitiveness that is usually very intense among teenage girls, increases among girls who have ADHD. If the feelings of girls who have ADHD are hurt, they may have impulsive remarks or overreact. After the drama is over, the girls are usually ready to forgive and forget. However, the people who are hurt by the remarks usually become intolerant to the outburst of the girls. Therefore, they may resent them for a long period.
The social pressures of adolescents are so intense. Adolescents usually spend so much energy on peer analysis. They usually watch, imitate, compare or confront other people. This is usually an exhausting undertaking. Girls who have ADHD usually feel despair. Depression, which is common among women, usually starts during the pressure of their teenage years. It is easy to recognize this type of depression. Therefore, a significant number of girls who have ADHD are usually treated for depression while their ADHD remains undiagnosed.
It is a fact that adolescents have so much pressure to mature. In some instances, parental expectations of the girls to show maturity may have a direct conflict with the neurocognitive patterns of ADHD. However, this does not imply that it is impossible for girls who have ADHD to become “mature.” It simply means that parents of the girls should ensure that they view maturity through an ADHD lens. This was one of the major problems that the client faced. The parents wondered why the client had suicidal tendencies. As such, the client’s father encouraged her to leave the group home and move back home. However, he did not put any effort to solve the problems that the girl faced. He may have wanted the girl to behave in a more mature manner and confront her problems instead of resorting to suicide. Viewing the behavior of the girls, and consequently her maturity, through an ADHD lens would have enabled the father to recognize the problems she faced.
Academic pressures are usually at their highest in high school. Wheeler (2013)asserts that the high school environment is structured in a manner that seems to be ADHD-unfriendly. A day in school starts too early and lasts for a long period. In addition, the high school environment demands students to have high level of concentration, which is beyond the capacity of most students even those who do not have ADHD. Students are also forced to read and study subjects that they are not interested in as they would not pursue the subjects after graduating from high school. Therefore, the high school environment increases the pressures that girls with ADHD face. The client faced the above pressures. In addition, her election in the school government exacerbated the pressures even further. However, her election in the school government also had a positive impact. It made her feel important as she played vital roles in various school activities.
It is a fact that teenagers have a high risk for pregnancy. The risk is even higher among teenage girls who have ADHD due to several factors. First and foremost, teenage girls who have ADHD have low self-esteem. Therefore, they try to find affirmation by gaining sexual attention from boys to compensate for their feelings of inadequacy in other aspects of their lives. In addition, teenage girls who have ADHD usually have difficulties controlling their impulses. They also have poor planning ability and are generally inconsistent. This increases the risk of the girls having unprotected sex, using birth control inconsistently, or having multiple partners. The client certainly faced some of the above problems. However, she could not open up to me since she may have been embarrassed by some of the issues. I made an effort to share my experiences in order to make her open up to me. However, she furnished me with very little information on her sexual experiences.
Mash and Barkley (2006) acknowledge that the risk for substance abuse and other addictive behaviors usually starts when an individual is in middle school in increase significantly during high school years. Teenage girls who have ADHD have a higher risk of substance abuse. It was evident that the client had a high risk of substance abuse. I strived to tackle this by informing her the negative impacts of substance abuse. I routinely gave her brochures that encouraged her to have positive behaviors that would help in reducing some of the risks she faced due to ADHD.
Rief (2015) asserts that it is vital to acknowledge the fact that the behavior of teenage girls with ADHD had a neurological basis. In addition, the reaction of the girls usually increases when they have stress, fatigue, PMS, or hunger. Therefore, it is vital for the teenage girl and her parents to recognize the high vulnerability that she faces. They should also ensure that they identify and manage various stress inducing issues that may worsen the girl’s reactions. Use of both medication and psychotherapy is the most effective method of treating ADHD. Medication should address various complex issues that the teenage girl faces instead of ADHD alone. Since peer issues and issues on self-worth are crucial among most teenage girls who have ADHD, it is vital for psychotherapy to be designed in a manner that would help in addressing these issues.
Parritz and Troy (2013) state that group psychotherapy is an efficient means of treating teenage girls who have ADHD. The group psychotherapy may be conducted in school by a school or in a private setting. In light of the above factors, I encouraged the client to enroll in group psychotherapy. She did not want to take part in group psychotherapy in school since she thought this may tarnish her image. Therefore, I enrolled her in group psychotherapy in a private setting.
Teenagers have significant hormonal changes. The hormonal fluctuations increase during the menstrual cycle, which complicates the confusion and unpredictability of teenage girls who have ADHD. It is a fact that pre-menstrual syndrome (PMS) is an annoying period of irritability and fatigue among a significant number of girls. However, girls who have ADHD have heightened emotional reactions and irritability. They also have low tolerance to frustration. These issues make the girls require active intervention. I encouraged the client to use anti-depressant medication to tackle the effects of PMS.
The emotions of a teenage girl with ADHD may tip very quickly if environmental stresses overwhelm the girls system, which is already distressed. As such, an accidental pregnancy, breakup of a relationship, or a college rejection letter may be enough to heighten the girl’s anxiety and depression levels such that they may require medication and psychotherapy. It is vital for parents and professionals to monitor the emotional roller coaster of a teenage girl with ADHD to determine whether the anxiety and depression levels have tipped over the edge making the girl require professional help. Anxiety and depression of girls with ADHD can be successfully treated together with the ADHD. However, it is vital to ensure that the teenage receives the right prescription. This is due the fact that certain medication for ADHD may increase anxiety.
The activities of the student government increased the pressures that the client faced. This increased her risk of having heightened anxiety levels. Therefore, I monitored the behavior of the girl closely to determine whether her anxiety levels had tipped over the edge. I asked her father to also monitor her behavior and call me when she felt that the client’s levels of anxiety were very high. The client’s father called me when she thought the girl had high anxiety levels. The girl was enjoying her time in school. However, the family decided that they would move to Texas. During one of our previous sessions, the girl had claimed that she would kill herself if her family decided to move to Texas. The relocation would have a significant impact on her social and emotional well-being. Her election in the school government had helped in improving her self-esteem. Relocating to Texas would force her to enroll in a new school. This would make necessitate her to form new friends. The client is not good at making and maintaining friends. Therefore, the relocation would have a negative impact on her wellbeing. After meeting the client, I strived to explain to her the importance of relocating to Texas. Her father had found a new Job in Texas. It would be hard for her to keep commuting to and from Texas to be with the family. I also strived to view the issues from the girl’s perception. I was sympathetic her plight. However, there was nothing I could do since the relocation of the client’s family was beyond my control. Therefore, it was vital to make the girl accept that the family had to relocate. However, the family planned to relocate to Texas in the next 3 months. Therefore, I would continue our sessions with client for the two months. I planned to recommend her to seek the services of a certain profession in Texas when they relocate.
Rief (2015) acknowledges that girls who have a special ability or talent in a certain area are less likely to have low self-esteem. Therefore, helping a teenager girl with ADHD to develop and recognize her areas of competence and talent is one of the most efficient approaches of dealing with ADHD. Making the girls be in touch with their areas of competence helps in reducing their vulnerability to the criticism and frustrations that are usually associated with ADHD. The teenage girls have various areas that the girls may develop their sense of competence and ability. Part-time work, volunteer work, and participation in various school activities are some of the activities that may be vital in building a sense of self-confidence among the girls. I actively helped the client to recognize her areas of competence and talent. I encouraged her to run for the school government, which she ultimately won. I personally congratulated her upon her victory. I strived to highlight and develop her leadership skills. I noted that she was enthusiastic to certain issues that the school faced.
Mash and Barkley (2006) state that high school years are the right moment for girls to develop their self-advocacy skills, which are vital in their independent life after high school. This is regardless of whether it is in an educational setting or in their workplace. This is due to the fact that the girls would have to know how to express their needs confidently and convincingly to their professors or future employers who may not have the right information on ADHD. Running for school government elections was one of the most important events in the client’s life. It enabled her to develop her self-advocacy skills. She expressed her opinions in a constructive and effective manner during the campaign period, which enabled her to ultimately win the elections. As such, the school elections enabled the girl to learn how to be more assertive. It also improved her self-advocacy skills. This would be vital in the future independent life of the client.
According to Rief (2015), it is vital for teenage girls to receive support and encouragement. This is due to the fact that they are trying to become more independent. Parritz and Troy (2013) state that in some instances, it may be more helpful when someone else apart from the teenage girl’s parents to provide support and encouragement. I strived to provide support and encouragement to the client. This enabled the client to know how to be on time. It also helped the client improve her organization skills. I encouraged the client to set priorities instead of staying in a reactive mode. The development of these skills would not only help the client tackle ADHD, but also help in improving her wellbeing in other aspects of her life.
In conclusion, high school years may be very challenging to girls who have ADHD. For the girls to tackle the challenges, they need support from their parents, peers and school, which should be combined with the right medical and psychological treatment. The support and treatment is dependent on the particular needs and issues of the girls. Having the right support and intervention would make the girl overcome the challenges and make a smooth transition from chaos and self-doubt to competence and high self-esteem in their young adult life. I hope my intervention would make my client make the smooth transition.
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