ASSESSMENT AND TREATMENT FOR BEHAVIOURAL PROBLEMSBehavioural problems can point towards a person who is deeply suffering and often unable to express their feelings.
Self-harm is a term used by professionals to describe how someone hurts or injures themselves. Approximately 10% of young people self-harm. They do this with intention, it does not apply to accidents. Young people who self-harm is overflowing with emotions or full numb. It can indicate that the young person is dealing with problems that seem too big, or that they are unable to handle alone, it can help them feel in control, it can help them feel pain that distracts from the hurt inside. It becomes a means to cope with unpleasant, overwhelming feelings. Telling someone about self-harming behaviours takes courage. It is the first step in getting the help that you need.
Self-harm commonly includes such behaviours as cutting, hitting, biting, burning, hair pulling, skin picking and overdosing.
Self harm always indicates that something is seriously wrong. Self-harm is not always linked to suicidal thoughts or actions; however, it should always be taken seriously. If you are worried about yourself or someone else; please contact your nearest hospital and ask for the on-call psychiatrist.
The Wave treatment programs for self-harm include 24-hour nursing care and 1:1 observation when necessary. Our Consultant psychiatrists, mental health nurses and clinical team are able to provide around the clock care for young adults with a history of self-harm, suicidal thoughts or attempts.
Oppositional Defiant Disorder
Oppositional defiant disorder is a behaviour disorder that involves a persistent pattern of irritability or anger, defiant behaviours, volatility and argumentative communication. Oppositional Defiant disorder may progress to conduct disorder as the transition from teenager to young adult.
Psychotherapy, family therapy and parent education on management techniques are recommended in the treatment of oppositional defiant disorder. You may also be prescribed medication. ODD is often found to be present with other mental health issues; in particular ADHD, Drug and Alcohol misuse, depression/anxiety, trauma and is sometimes combined with learning disabilities. In some cases, residential treatment is recommended as a primary course of treatment. The Wave offers intensive programs in conjunction with family therapy to assist with ODD and Conduct Disorder. Our therapists and residential Psychiatrists will work in partnership with the family to reduce the impact of OOD and CD and prepare for a brighter future.
Anger and Aggression
Aggression in young people can be part of a general agitation or something that is more pronounced. We may see aggression at home, with the young person losing their temper, being agitated, possibly damaging the home or objects within the home and occasionally having violent outbursts. Young people experiencing aggression might have been in trouble at school or find conflict within their peer groups. These problems can escalate quickly. Aggression can be linked to many challenges, and to addiction in particular. Periods of withdrawal or of obsession about the person’s drug of choice can cause high levels of agitation.
This is an experience can be very frightening for families, especially as it often results in exclusion or suspension from school. It’s also worrying when there are siblings around, as they can be affected by the aggressive outbursts. Those with aggressive tendencies can also run into problems with the police or get involved in legal matters. Aggression may also have happened in previous treatment experiences when the person might have lashed out verbally or physically with medical or care staff.
Aggression can be the result of many different mental health concerns, but we commonly see something called Intermittent explosive disorder (IED), which is an oppositional defiant disorder that can lead to violent moods and outbursts. Under the umbrella of personality disorders, such as borderline personality disorder, we often see a low level of continuous rage which can result in outbursts.
Intensive residential treatment can help challenging behaviours
This treatment has to be very respectful of the individual, and must go slowly, working towards providing a safe and secure environment. At The Wave, our philosophy is that all feelings and emotions are welcome in the treatment room – provided that no one’s going to get hurt or hurt themselves. We work in a very safe and structured manner which doesn’t exclude people from treatment but may mean that we need extra support for that individual in order to protect them and protect those around them.
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Conduct Disorder is behaviour which is outside the range of normal teenage/young adult behaviours. It is not rebellion or experimentation. Young people showing signs of conduct disorder will have shown aggression towards people and/or animals. This may include bullying, threatening, physically hurting, stealing or cruel behaviours towards others. They may have deliberately damaged property, including setting fire to or destroying items. They may also steal from others, take or enter property, lie for personal gain or be involved in shoplifting. They may also have been in trouble with legal services or education/social welfare; possibly running away from home or school or violating other major rules. In order to meet the criteria for Conduct Disorder, behaviours will have happened at least 3 times in the past year and at least once in the past six months.
Not all young people who engage in self harming behaviours have suicidal thoughts. It is not always a precursor to suicide attempts. Some young people describe self-harm as a coping mechanism or as a way to deal with overpowering emotions and feelings. Some people who self-harm have thoughts of also ending their life. Self-harm and thoughts of suicide should always be taken seriously. Never ignore suicidal thoughts or behaviours. It is always a medical emergency.
There could be many reasons why a young person acts in a way that is not compatible with a school or work environment. The events could be temporary or if there have been serious rule violations for over a year, including in the most recent six-month period; advice from a specialist young person’s treatment service may be required. A Psychiatrist with a specialist interest in Young people will be able to advise you and recommend treatment options. This may include outpatient therapy and psychiatric appointment, or they may recommend an adolescent treatment provider, with a program similar to those describes at The Wave. Activity based treatment with intensive psychotherapy and education is considered the gold standard in treatment for young people with behavioural problems.
Having more than one mental health and behavioural diagnosis is fairly common in your adults and teenagers. Professionals may call this dual diagnosis. When young people having several symptoms or problems occurring at the same time, life can feel very overwhelming. In some case one set of symptoms or condition may trigger another. For example, in cases of social anxiety or depression; a person may reach out for alcohol or another depressant drug to relieve the symptoms. Overtime the tolerance to the drug of choice may increase, which can see use and consumption increase to dangerous levels; with the potential for addiction following. Mental health like other physical health conditions benefits from early intervention. The more quickly we can get the right level of help to young people the hope we have for the future. At The Wave we advise parents, families and carers to gather medical advice at the earliest opportunity. The Wave works with mental health professionals all over the world to help them to access treatment for young people swiftly.
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You and your loved one don’t need to suffer alone
Behavioural problems can be frightening for family members to witness and cause additional distress to those who are on the receiving end of outbursts or violence. When left unaddressed, they can leave lasting effects on mental and physical health for both the individual and the people around them. If you’d like more information about our program and facilities, or want to tell us more about your family’s needs, please: