Surviving adolescence - a toolkit for parents, teachers, young people and anyone who works with young people

The teenage years can be an emotional assault course for all concerned. A gulf can grow between parents and their children during adolescence. One of the reasons many of us find it so hard is because it's a time of rapid physical development and deep emotional changes. These are exciting, but can also be confusing and uncomfortable for child and parent alike.

Rapid changes can occur physically and emotionally. There are also changes socially (attending secondary school, spending more time with peers) which can present with new challenges like using drugs/alcohol and sexual relationships.

The process of rapid physical changes in adolescence is called puberty. It starts gradually, from around eleven years for girls and thirteen for boys. The age at which puberty starts has been dropping in most countries, probably due to better nutrition. So, your children may hit puberty earlier than you did.

The hormone changes responsible actually begin some years earlier and may produce periods of moodiness and restlessness. Girls start these changes before boys and will, for the first three or four years, appear to be maturing much faster. After this, boys catch up.

These changes include: 


• For girls: menstrual periods, growth of under-arm, body and pubic hair.
• For boys: voice breaks (becomes deeper), growth of body and pubic hair, facial hair, erections and wet dreams. For both: Rapid physical growth.

By the age of 17, they'll be young men and women who may be bigger than their parents and capable of having children themselves. In spite of this, they often still need support from you.

It is not surprising that, with the speed of these changes, some adolescents become very concerned about their appearance. They may feel worried, especially if these changes happen earlier or later than their peers. It’s important to remember that there’s a lot of difference in the ages at which these changes occur and adolescents need to be reassured about this.

Growth and development uses a lot of energy, and this may be why teenagers often seem to need so much sleep. Their getting-up late may be irritating, but it may well not be just laziness.

As well as growing taller, starting to shave or having periods, people of this age start to think and feel differently. They make close relationships outside the family, with friends of their own age. Relationships within the family also change. Parents become less important in their children's eyes as their life outside the family develops.

Real disagreements emerge for the first time as young people develop views of their own that are often not shared by their parents. As everybody knows, adolescents spend a lot of time in each other's company, or on the telephone or internet to each other. Although this can be irritating to parents, it is an important way of becoming more independent. These friendships are part of learning how to get on with other people and gaining a sense of identity that is distinct from that of the family. Clothes and appearance are a way of expressing solidarity with friends, although teenage children are still more likely to get their values from the family.

Parents often feel rejected, and in a sense they are. But this is often necessary for young people to develop their own identity. Even if you have rows and arguments, your children will usually think a lot of you. The rejections and conflicts are often not to do with your personalities, but simply with the fact that you are parents, from whom your children must become independent if they are to have their own life.

As they become more independent, young people want to try out new things, but often recognise that they have little experience to fall back on when things get difficult. This may produce rapid changes in self-confidence and behaviour - feeling very adult one minute, very young and inexperienced the next.

Being upset, feeling ill or lacking confidence can make them feel vulnerable. They may show this with sulky behaviour rather than obvious distress. Parents have to be pretty flexible to deal with all this, and may feel under considerable strain themselves.

Adolescence is the time when people first start in earnest to learn about the world and to find their place in it. This involves trying out new experiences, some of which may be risky or even dangerous.

• Young people can crave excitement in a way that most adults find difficult to understand - and exciting activities may be dangerous. Fortunately, most people manage to find their excitement in music, sport, or other activities that involve a lot of energy, but little real physical risk.
• When they do experiment - with drink or drugs or smoking - it is usually with friends. If a young person does this alone, they are in much greater danger. Warnings from older adolescents will usually be taken more seriously than those from parents.

It’s important to note that despite the popular myth of ‘difficult teenager’, the majority of adolescents do not have significant or severe difficulties.

Emotional Problems

• Over-eating, excessive sleepiness and a persistent over-concern with appearance may be signs of emotional distress.
• Anxiety may produce phobias and panic attacks. Research suggests that emotional disorders are often not recognised, even by family and friends.
• At some time, 4 out of 10 adolescents have felt so miserable that they have cried and have wanted to get away from everyone and everything.
• During their adolescence, more than 1 in 5 teenagers think so little of themselves that life does not seem worth living. In spite of these powerful feelings, depression may not be obvious to other people.

Sexual Problems

• The dramatic physical changes of adolescence can be very worrying to some teenagers, especially to those who are shy and who don't like to ask questions. At the other end of the scale, some express their concern with excessive bragging about sexual ability and experiences.
• More than half of young people in the UK will have had their first experience of sex before the age of 16 and so the risk of pregnancy is a significant part of adolescent life.
• The age of consent for both heterosexual and homosexual intercourse is 16 in England, Scotland and Wales, 17 in N. Ireland. It is illegal to have sex if either partner is under this age, even if they give consent.
• Those who start having sex early are at greater risk of early pregnancy and health problems. Sexually transmitted diseases are common, and HIV infection and AIDS are becoming more common.
• Crushes on someone of the same sex are common in adolescence. Some young people go on to be gay.
• Some young people (and their parents) will not be sure whether they are gay or straight.
• Sensitive support, clear guidance and accurate information about these different aspects of sex are essential - from parents, schools, GPs, and family planning clinics.
• Most adolescents choose their partners quite carefully. Sleeping around and risky unprotected intercourse are often signs of underlying emotional problems. They may also be the signs of a risk-taking lifestyle - adolescents who take risks in one way tend to take risks in other ways as well.
• Recent research suggests that girls who are close to their parents are less likely to become pregnant in their teenage years.
• Teenagers can get confidential advice on contraception from their GP, who does not have to inform their parents. Emergency contraception from pharmacies is only available to those aged 16 or over.

Parental shock

It can be surprisingly upsetting when your child has their first serious relationship, or you find out that they have started to have sex. For the first time in your life together, you are not the most important person to them. The sense of shock will pass, but you may need a while to adjust to the new state of affairs.

Behaviour problems

• Teenagers and their parents complain about each other's behaviour. Parents often feel they have lost any sort of control or influence over their child. Adolescents want their parents to be clear and consistent about rules and boundaries, but at the same time may resent any restrictions on their growing freedom and ability to decide for themselves.
• If disagreements are common and normal, when should you worry? Experience suggests that children are at greater risk of getting into trouble if their parents don't know where they are. So, try to make sure that you know where they are going and what they are up to. If you really don't know, you need to find out.

School problems

Refusal to go to school can be due to:

• difficulties in separating from parents
• being perfectionist, and becoming depressed because they can't do as well as they would want to
• disturbed family life, with early separation from or death of parent.
• an established pattern which may have started at primary school. These children often have physical symptoms, such as headache or stomach-ache.

Those who go to school, but then play truant, are usually unhappy at home and frustrated at school. They prefer to spend their days with others who feel the same way.

Emotional problems will often affect school work - worrying about yourself or about what is going on at home makes it difficult to concentrate. Pressure to do well and to pass exams may come from parents or teachers, but adolescents usually want to do well and will push themselves. Excessive nagging can be counter-productive. Exams are important, but they should not be allowed to dominate life or to cause unhappiness.

Bullying can cause all of the above. Around 1 in 10 secondary school children is bullied at some point; about 1 in 20 is bullied every week. Short children are more likely to be bullied. If you are worried that this is happening, talk to the school to make sure that they enforce their bullying policy.

Trouble with the law

Most young people do not break the law, but those who do are usually boys. When they do, it usually only happens once.

If a parent doesn't feel that breaking the law is particularly important, it is more likely that their children will offend.

Unhappiness or distress can also lead to behaviour that will get them into trouble with the police. It is always worth asking about their feelings if an adolescent is repeatedly getting into trouble.

Eating problems

Weight can be a real problem. If an adolescent is overweight and is criticised or made fun of, they are more likely to dislike themselves and to become depressed. This can lead to inactivity and comfort eating, which worsens the weight problem - dieting can actually aggravate the situation. It is more important to ensure that they feel happy with themselves, fat or thin.

Many adolescents diet. Fortunately, few will develop serious eating disorders - only around 1 in 100 teenagers develop anorexia, 1 in 50 have bulimia. However, these are more likely to occur in those who take up serious dieting, think very little of themselves, are under stress and who has been over-weight as a child.

Drugs, solvents and alcohol

• Many teenagers experiment with alcohol and illegal drugs. Around 1 in 3 15- year-olds in England has used drugs at some time.
• Regular use of drugs or alcohol is much less common. Less than 1 in 100 of 11-12-year-olds are regular users, but this increases to 1 in 6 of 15-year-olds.
• Although cannabis has been widely felt to be relatively harmless, there is now good evidence that it can make mental health problems worse in adolescence, and can double the risk of developing schizophrenia.
• Despite publicity about other drugs, alcohol is the most common drug to cause problems for adolescents.
• You should consider the possibility of drug or alcohol use when you notice sudden or dramatic changes in behaviour.
• Find out about any drugs your children may be using - see the telephone and web resources at the end of the leaflet.

What if they ask about the drugs you used to use in your younger days?

Honesty is generally the best policy, although it is probably worth stressing the differences in drugs available now. For example, much of the cannabis available today is many times stronger than was available 20 years ago, and we now know a lot more about its risks to both physical and mental health.

Abuse

• Physical, emotional and sexual abuse may occur in adolescence and may cause many of the problems mentioned above.
• Children or teenagers who are being abused can find someone to talk to at ChildLine.
• Families with these problems need expert advice and should seek help. The list of organisations at the end of this leaflet may be able to point you in the right direction.

Mental illness

Much less often, changes in behaviour and mood can mark the beginning of more serious psychiatric disorders. Although uncommon, bipolar disorder (manic depression) and schizophrenia may emerge for the first time during adolescence.

Extreme withdrawal may indicate schizophrenia, though there are usually other explanations for such behaviour. Parents who are concerned about these possibilities should ask to see their GP.

Adolescence has had a bad press. However, recent studies have shown that most teenagers actually like their parents and feel that they get on well with them. It is a time when the process of growing up can help people to make positive changes, and to put the problems of the past behind them.

It is not just a difficult stage, although it can feel very much like it at times. The anxiety experienced by parents is more than matched by the periods of uncertainty, turmoil and unhappiness experienced by the adolescent.

Difficult times come and go, but most adolescents don't develop serious problems. It's worth remembering this when things are difficult.

Parents may sometimes start to feel that they have failed. However, whatever may be said in the heat of the moment, they play a crucial part in their children's lives. Helping your children grow through adolescence can be profoundly satisfying.

Don't be jealous

The good times and opportunities that adolescent children have may well make you feel very middle-aged. Their physical strength is increasing at a time that yours may well be waning. Jealousy can be the hidden fuel for all sorts of arguments and trouble.

Make your home a safe base

Adolescent children are exploring life, but need a base to come back to. Home should be somewhere they feel safe to come back to, where they will be protected, cared for and taken seriously.

Mutual support

Parents need to:

• agree between themselves about their basic values and rules
• support each other in applying them.

It's difficult for a teenager to respect parents who are always at each other's throats or undermining each other. A common trap is for one parent to ally themselves with their child against the other parent. This usually leads to constant trouble.

Easy Listening

Adults need to be a source of advice, sympathy and comfort. A teenager needs to know that his or her parents will not automatically jump down their throat with a judgement, a criticism or routine advice. Listening comes first

Rules

However fast they may be growing up, you are your children's providers and it is reasonable that you should decide what the ground rules are. Whilst adolescents may protest, sensible rules can be the basis for security and agreement. They must be:

• clear, so everybody knows where they stand
• where possible, they should be agreed with the children
• consistent, so everyone sticks to them
• reasonable
• less restrictive as children become more responsible.

You can't (and shouldn't) have rules for everything. While some issues will not be negotiable, there should be room for bargaining on others.

Sanctions, such as grounding or loss of pocket money, will only work if they are established in advance. Don't threaten these if you are not willing to carry them out.

Rewards for behaving well are just as important - probably more important, in fact.

Involve your children in making family rules - like all of us, they are more likely to stick to rules if they can see some logic to them and have helped to make them. If a teenager is reluctant to discuss rules for him or herself, they may still do this if they can see that it might be helpful for younger brothers or sisters. If they don't want to get involved, they will just have to put up with the rules you decide on.

Parents should pick their battles. A lot of things adolescents do are irritating (as you probably irritate them), but not all are worth an argument. It's usually better to spend time on praising good decisions or behaviour. Most annoying habits will burn themselves out once parents stop reacting to them.

Don't use corporal (physical) punishment

Although it is now viewed as unhelpful, many people still occasionally smack younger children. If you do this with adolescent children:

• You create the impression that violence is an acceptable way to solve difficulties. This means that they are more likely to grow up to use violence as adults.
• You can get stuck in a cycle of violence - you hit them, they hit you back (because they are now big enough), you hit them again and so on.

Set the example

Although they are becoming more independent, your children will still learn a lot about how to behave from you. If you don't want them to swear, don't swear yourself. If you don't want them to get drunk, don't get drunk yourself. If you don't want them to be violent, don't use violence yourself. If you want them to be kind and generous to other people ….. try to be like this yourself. “Do as I say, not as I do” just won't work.

Gratitude

Don't worry if your children aren't as grateful as you would like. It's great if they are, but they may not be until they have children of their own and realise how demanding it can be.

Sometimes, all of this may not be enough and you (or your child) may be unable to cope. Worries about the physical changes of adolescence - are they too early, too late or ever going to happen - or about relationships can be discussed with your GP.

If there is violence in your family - parents hitting one another, children hitting each other, parents hitting children or children hitting parents - ask for help.

When problems arise at school, obviously teachers may be a useful source of information. The teacher may suggest that an educational psychologist becomes involved. Psychologists can find out if there are any particular problems with learning, but can also offer counselling if relationships are the issue.

Adolescents who experience turmoil or distress for more than a few months - persistent depression, anxiety, serious eating disorders or difficult behaviour - generally require outside help. Counselling agencies may be suitable if things have not gone too far. They exist for young people and for parents and some contact addresses are listed below.

However, specialist help may be needed from the Child and Adolescent Mental Health Services (see our factsheet ‘Who’s who in CAMHS). They mainly offer out-patient treatment and can be contacted through your GP.

As they grow older, your children will want more privacy. Adolescents may, quite naturally, wish to see the doctor on their own. The law allows them to agree their own treatment from the age of 16, or younger under certain circumstances.

Brook - Provides a free and confidential sexual, health advice and contraception by young people up to the age of 25. Helpline: 0808 802 1234.

ChildLine - Provides a free and confidential service for children. Helpline 0800 1111.

Kidscape - Provides advice, run training course and produce helpful booklets and information about bullying.

Family Lives - Parentline offers help and advice to parents bringing up children and teenagers: 0808 800 2222.

Talk to Frank - Free confidential drugs information and advice line. Tel: 0800 776600.

Young Minds - Free advice and support for parents worried about their children’s behaviour, emotional problems and mental health. Parents Helpline: 0808 802 5544.

Your Teenager - Website which focuses on how to handle teenage behaviour and build a positive parent/teem relationship.

Recommended reading

The Young Mind: an essential guide to mental health for young adults, parents and teachers. Edited by Bailey, S. and Shooter, M. (2009). ). This is an accessible, user-friendly handbook produced by the Royal College of Psychiatrists

• Gutman Leslie Morrison; et al (2010); Change in wellbeing from childhood to adolescence: risk and resilience. Department for Children, Schools and Families, Great Britain.
• Rutter, M. & Taylor, E. (eds) (2008) 'Rutter’s Child and Adolescent Psychiatry' (5th edn). London: Blackwell Publishing.

Revised by the Royal College of Psychiatrists’ Child and Family Public Engagement Editorial Board (CAFPEB).

 With grateful thanks to Professor Richard Williams,  Dr Professor Ann Le Couteur,  Dr Virginia Davies, Dr Vasu Balaguru, and Thomas Kennedy.

This resource reflects the best possible evidence at the time of writing.

© Royal College of Psychiatrists March 2017

Due for review March 2020