Psychosocial Development
An adolescent has four tasks to accomplish to become a well-adjusted adult. These tasks are categorized as: 1) independence, 2) body image, 3) peer relations, and 4) identity.
Adolescence is divided into three periods; early (ages 12-14), middle (ages 15-17) and late (ages 18-21). Some teens will develop faster in one task than others. Some go through the stages smoothly while others do so with lots of turmoil. Of course, no one goes through adolescence exactly as the model may suggest.
The tasks of adolescence
1. Independence
Middle adolescents are often hostile towards parents and authority figures. Some openly rebel while others assert their independence secretively when not under adult supervision. Adults, including physicians, find that many decisions teens make are disturbing and the adults feel frustrated at their lack of control over the teen. Because of their rebellious nature and risk behaviors, middle adolescents are the group that society "loves to hate." By late adolescence, most families are comfortable with the youth's individuality and decision making skills. The teen, gaining confidence with the change in stature, increasingly turns to the parents for advice and guidance in decision-making, though this doesn't mean they always do what the parent wants. The parent-adolescent interaction is more on an adult-adult level. The physician should take into account this move toward independence and help parents appropriately give the teen responsibility for medical care. For instance, an early adolescent may need to be reminded to take his daily medication while a middle adolescent should not. By late adolescence, the patient should be encouraged to make his own appointments, monitor medication needs and get prescriptions filled. Failing to recognize this move towards independence makes the physician prone to appearing as an "agent of the parent" and may make it more difficult to gain the confidence of the teen. |
2. Body Image
Middle adolescents are more at ease with the changes and want to make the most of their "new" body. Clothing, jewelry and makeup become big with this group. Taking care of issues such as acne or unwanted hair (e.g., eyebrows) becomes paramount. Weightlifting and dieting become important as well. With the gain in confidence comes increased interest in the opposite sex. This is often the onset of dating and the development of skills and behaviors related to sexual relationships. By late adolescence, teens are comfortable with the changes in their body. Pelvic exams or hernia checks are not as stressful. Many adolescents are now ready to deal with issues such as birth control. Sexual relationships become less exploring and exploitative and more loving and sharing. |
3. Peer Relations
Middle adolescents may share intense personal relationships with the group. As teens become more comfortable with their own decision making and independence, peer groups hold less sway. By late adolescence, peer groups do not demand the same level of conformity. It is all right to attend a party and not drink when others are drinking. Individuality is more acceptable. Often times, late adolescents will grieve over the fact that their relationships with friends are not as close and have become less intense. A useful strategy for providers is to ask about the risk behaviors of the teen's friends, since teens are often more comfortable sharing information about friends than about themselves. This enables the physician to explore the adolescent's feelings and knowledge of risk behaviors. |
4. Identity
The values and morals of the early adolescent are those of the parents. As they attempt to pull away from the family and move closer to peers, teens' values mirror those of their friends. Usually by the end of adolescence, the teens' morals and values come back in line with those of their family.
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