BrainSTARS: Adolescent Self-Regulation Jeanne E. Dise-Lewis, PhD, Margaret Lohr Calvery, PhD, and Hal C. Lewis, PhD, BrainSTARS

Despite their age, adolescents with self-regulation difficulties require the amount of supervision and structure typically provided for younger children.

Use everyday activities:

• Use videos, daily situations, and real life experiences to illustrate other’s points of view. Engage in discussions in which you and your adolescent each “take a side,” and then switch sides. Avoid topics that are likely to start a fight.
• Find ways to talk about what is really going on at school and with friends. Discussions need to be non-judgmental.
• Make a habit of starting off a conversation on a positive or neutral topic. Do not let yourself get immediately pulled in to controversy or negativism.  Schedule a daily time for discussion about problems and review of household rules and expectations. Avoid these topics during other conversations.
• Set a curfew for your adolescent and expect him to call you if plans change. Reinforce your expectations by making the privilege of going out contingent on his follow through.

Change the environment:

• Use and enforce clear rules and consequences for inappropriate verbal behavior, drug use, and alcohol use. Do not accept these activities as part of “a phase.” Instead, address and deal with them directly.
• Provide clear and concrete information about the ramifications of sexual activity. Teach your teenager how to deal with social situations that may lead to sexual activity. Identify specific situations (for example, he is at a large party or an unsupervised get-together, and alcohol and drugs are being used) and plan a course of action. Support your adolescent in developing a detailed and realistic plan of escape from such situations. Discourage unrealistic solutions (for example, “I’ll just be cool”).
• Acquire detailed knowledge about your adolescent’s peer group. Ask directly about what goes on at the parties he attends, and reward him for telling you the truth, even if it is upsetting. Encourage your teen to invite friends to get together at your house. Limit interaction with peers who are involved with drugs, alcohol, or other dangerous activities.

Teach new skills:

• An adolescent who has poor self-regulation abilities should be involved in individual therapy with a therapist knowledgeable in working with both adolescents and brain injury. Therapy should include a family component to help guide discussions about appropriate limits, expectations, and punishments, and to brainstorm ideas for appropriate family activities.
• In order to avoid poor choices, your adolescent must be involved in other structured activities that fill time and provide opportunities to meet well-behaved peers. Examples include volunteer work, jobs, community recreation activities, hobby-related courses, and community service. 
• Verbal abuse may be a symptom of difficulty with expressive language. If your adolescent has this problem, teach him how to appropriately express himself in language and behavior, by discussing acceptable alternatives and modeling them yourself. Participation in a social skills group may be necessary to offer your teenager a reasonable forum for problem-solving better behavior in a group of his peers.
• Adolescents with judgement difficulties experience widespread interpersonal and social failure. Teachers and parents must persist in their efforts to create opportunities for success and improved self-esteem.

See other BrainSTARS articles.

From BrainSTARS, Brain Injury: Strategies for Teams And Re-education for Students, © 2002 Jeanne Dise-Lewis, PhD. Used with permission. The manual is available in English and Spanish. For more information or to order copies, call 720.777.5470 or chris.moores@childrenscolorado.org. A short video on how to use the BrainSTARS manual is available at www.youtube.com/BrainSTARSprogram.

Jeanne Dise-Lewis, PhD is a child clinical psychologist, director of the Psychology Program for the Department of Rehabilitation Medicine at The Children’s Hospital, and Professor of Psychiatry and Rehabilitation Medicine at the University of Colorado Anschutz Medical Campus. Dr. Dise-Lewis is a Magna cum Laude graduate of St. Joseph’s University in Philadelphia, the University of Pennsylvania (MS in Human Learning and Development), and the University of Denver (PhD in Child Clinical Psychology). A member of the faculty of the University of Colorado Health Sciences Center since 1984, Dr. Dise-Lewis has extensive experience in working with children and families of individuals who have acquired brain injuries. For the past 23 years, she has been the director of the Rehabilitation Psychology Services at The Children’s Hospital, creating several innovative programs of services for children who have medical needs and their families. She has developed workshops and presented papers nationwide in the area of pediatric traumatic brain injury.  She has been the principle investigator of three federal grants and has developed the BrainSTARS Manual, along with other innovative consultation programs regarding acquired brain injuries in children and adolescents. She is the PI of a grant funded by the Centers for Disease Control and Prevention titled “An Investigation of Outcomes associated with Pediatric Traumatic Brain Injury” and currently is the co-director of a Personnel Preparation grant funded by the US Department of Education, “Preparing School Psychologists to Meet the Needs of Students who have Acquired Brain Injury.” 

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