Working with young adults in the transition to adulthood

Course overview

A workshop by Andrea Landini, MD and Patricia M. Crittenden, PhD

The transition to adulthood is one of the most consequential maturational shifts in the life span. It includes biological and social changes. Biologically, sexual maturity, changes in the limbic structures that affect emotion and risk-taking, and maturation of the pre-frontal cortex that permits reflective, integrative thought powerfully change risks and opportunities for young people. 

Socially, young people are transitioning from their childhood family to both larger community contexts and more private intimate relationships. Managing sexual maturity, finding a romantic partner, becoming economically independent, leaving one’s childhood home, and establishing a new family require new and complex mental processes. 

For endangered young people, there is a risk of catapulting from adolescence to adulthood too quickly, with consequences that can shape lives for decades to come. The most concerning risks are injuries, severe mental illness (personality disorders and psychosis), addiction, isolation, criminality, and, for early parents, child protection. In all of these, gender plays a greater role than at any other point in life.

To manage successfully, vulnerable young adults must undertake massive reorganization of their childhood protective attachment strategies. This encompasses conscious recognition of their own strategies, understanding of the strategies’ adaptiveness for specific threats, inclusion of sexuality in the reorganized strategies, and a unique self-definition that can underlay choosing a romantic partner and career.

The Dynamic-Maturational Model of Attachment and Adaptation (DMM) addresses the brain and body changes that occur in the transition to adulthood and how these are incorporated into reorganizing childhood self-protective attachment strategies. This includes managing sexual desire, tendencies toward risk-taking, and learning to use new cortical integrative capacity to process information about danger and safety. For vulnerable young adults, this decade is their best opportunity to free themselves of the limitations of their childhood. The alternatives, continuing to use childhood strategies or reorganizing to more extreme strategies, risk maladaptation in adult situations.

In spite of the importance of this developmental period, few services are designed for emerging adults and the unique aspects of their development are rarely taught in professional training programmes. The most challenged young people are those who are so precisely attuned to past dangers that they find it difficult to manage the opportunities that the transition to adulthood provides. For them to change, they must feel safe and supported. Because at risk adolescents rarely have that advantage, service providers need to create and deliver new forms of service that can maximize this window for developmental change.

In this workshop, we will describe several developmental pathways through the transition to adulthood. Constructs from the DMM about arousal regulation and cortical planning will be used to generate ideas for intervention. Group work on cases will highlight the special needs of vulnerable young adults and ways to address those needs through service structures.

1. To know how to assess strategic self-protective organizations in adolescents, and how these organisations are integrated with sexuality

2. To be aware of how arousal regulation motivates normative and at risk behaviour in adolescents

3. To recognize the different opportunities for treatment and prevention that are relevant to different developmental pathways in the transition to adulthood

Andrea Landini, MD is a Child and Adolescent Psychiatrist, specializing in cognitive-constructivist and family psychotherapy. He is the Director of the Family Relations Institute in Reggio-Emilia, Italy and Miami, USA. His clinical practice includes psychotherapy with adolescents and families and supervision of professional staff caring for out-of-home youth. For two decades, he has taught the DMM, published research on attachment, and collaborated with Dr. Crittenden in the development of the Dynamic-Maturational Model (DMM) of Attachment and Adaptation. He co-authored Assessing Adult Attachment and Attachment and Family Therapy.

Patricia M. Crittenden, PhD, has degrees in special education (M. Ed.), developmental psychopathology (Ph.D.), and sexual abuse (post-doc). She trained with Mary Ainsworth, John Bowlby, ultimately developing the Dynamic-Maturational Model (DMM) of Attachment and Adaptation. She has published empirical research, treatment guidelines, and several books, including Raising Parents: Attachment, Parenting, and Child Safety. She developed a life-span set of DMM assessments of attachment, including the Transition to Adulthood Attachment Interview (TAAI).

With a special contribution from Udita Iyengar, PhD, visiting lecturer at Roehampton University and project manager for research on Looked After Children at the Institute of Psychiatry, Psychology and Neuroscience, King’s College, London.

This course will take place on Monday 16 December from 9am - 12pm
Certificate of attendance
The Tavistock Centre, London
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