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William (not his real name) is a high school student. He suffers from medically diagnosed depression and anxiety disorders which often become hurdles for him in completing school work. He is constantly at risk for dropping out of school because of his poor self-esteem. Whether because of the depression or because of other undiagnosed mental illnesses, William expresses paranoid thoughts about students he doesn’t know laughing at him because “they know all about me”; or teachers plotting to make him fail classes. At home, William displays irritability associated with depression, frequently arguing with and defying his guardian who has become exhausted from the confrontation. William probably lacks the social skills to hold a regular job; it’s hard to tell right now because his anxiety has overwhelmed his desire to actually make a job application.
The backstory is this: William was likely born with some level of substances in his body according to relatives. His parents had substance use disorders. His mother suffers from her own mental illnesses and has never been able to care for him. He probably has a developmental disability but has never been tested because his caregivers didn’t have insurance or had other needs they focused their attention on. The Community Action Team at Apalachee Center in Tallahassee focuses on difficult adolescent clients like William with circumstances that make it hard for them to meet the norms of society. CAT clients typically have not achieved success with less-intensive mental health treatments and have multiple contacts with law enforcement and the child welfare system. The CAT purpose can be summed up succinctly: Prevent adolescents from entering psychiatric hospitals, the child welfare system and the justice system, while keeping them in school. The CAT concept is a multi-disciplinary approach that makes a range of services available to the client’s family including nursing, peer mentorship, social services management, medication and psychotherapy. The concept has proven itself through years of pilot projects, which is why the state of Florida expanded teams to every county in 2018. Back to William. In collaboration with all the people that care about his future, we are working to minimize his mental disorders, instill daily living skills, prepare him for work, and get him to graduation so he can live a full and purposeful life.
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Attachment in psychological and therapy terms is simply the bond of one person to another, typically a child to a caregiver. We often think of attachment as the bond between an infant and a mother; early attachment is very important to the subsequent development of relationships and social development later in life. However attachment is important at any phase of life, and ruptured attachments can affect how people cope with relationships as teens and adults. For example attachment problems can arise in teens who experience the death of a parent or caregiver. Without repair of that attachment injury, the teen may become more reluctant or avoidant of forming close relationships as a defense mechanism against further disruptions. Attachment problems can be treated in mental health counseling through attachment based treatments.
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AuthorTerance is a mental health therapist focusing on children and families. Archives
March 2025
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