Bio-psycho-social assessment

Bio-psycho-social assessment; To learn more about a patient’s physical, emotional, and social health, mental health specialists, medical professionals, and social workers frequently employ a bio-psycho-social assessment, a thorough examination technique. It entails evaluating the biological, psychological, and social elements that affect a patient’s mental health.

Information on the patient’s physical health, including medical history, medication use, and any underlying health conditions, is gathered as part of the assessment’s “Bio” section. This information can shed light on the potential relationship between the patient’s physical and mental health problems.

The “Psycho” component entails examining the patient’s psychological state, including their feelings, behaviors, and past experiences with mental illness. An evaluation of mental health symptoms including anxiety, depression, or trauma is part of this process. This component’s data collection can aid in making a precise diagnosis and choosing the best course of action.

The patient’s social and environmental elements that may be affecting their mental health are the subject of the assessment’s “Social” section. This could entail investigating their connections, housing arrangements, employment, financial condition, and access to amenities like healthcare and social support systems. The social component also sheds light on potential societal and cultural influences on the patient’s mental health.

A Bio-Psycho-Social Assessment is a useful tool for medical and mental health professionals to gain a thorough understanding of a patient’s mental health status and to create a suitable treatment plan.

  1. biopsychosocial assessment,
  2. critical thinking,
  3. risk and resilience,
  4. psychological and social theoretical perspectives
  5. the stages of development in early life.
  • Reflections:
  • Describe a systems perspective and its relevance to developing knowledge of human behavior in the social environment.

By studying the intricate connections and interactions between people and the different systems in which they live, such as family systems, community systems, and societal systems, a systems viewpoint is a means of understanding human behavior. It places emphasis on how these systems are intertwined and dependent upon one another, as well as how they affect people’s behavior.

The systems viewpoint is especially pertinent to social work when learning about how people behave in social settings. This is so that social workers may better understand and address the issues and difficulties that people encounter in the context of their surroundings and social institutions.

The systems perspective acknowledges that people are not autonomous beings but rather are a part of much bigger systems that have an impact on their actions and experiences. A person’s conduct, for instance, could be influenced by the dynamics of their family, their community, or the larger societal setting in which they reside. Social workers can have a deeper knowledge of the elements that influence a person’s behavior and the difficulties they encounter by comprehending these systems and how they interact.

The systems approach is crucial because it acknowledges the mutual dependence of people and their surroundings. In the same way that environments have an impact on people, environments also have an impact on the systems in which people live. This means that social workers can collaborate with people to provide them the tools they need to improve their surroundings, whether that environment is their family, community, or larger society.

The systems approach stresses the interconnection of systems and the reciprocal link between people and their environment, making it a useful foundation for comprehending human behavior in the social context. By adopting this viewpoint, social workers can gain a deeper comprehension of the difficulties people encounter and the elements that influence their behavior. They can then work to empower people to alter their environment for the better.

  • Describe and apply the biopsychosocial approach to assessment.

The biopsychosocial approach to evaluation is a thorough and all-encompassing method of assessing a person’s health and well-being that takes into account the biological, psychological, and social elements that affect their general health. This method acknowledges that people are more than just physical beings and that their environments, social networks, and emotional states all have an impact on their health and general wellbeing.

The following are included in the biopsychosocial approach:

Biological: This part focuses on assessing the person’s physical health, taking into account their medical background, current prescriptions, and any underlying health issues. It could entail taking vital signs, running tests in the lab, or looking over medical records.

Psychological: This part focuses on assessing the person’s mental state, including their attitudes, emotions, and actions. A psychological evaluation of mental health symptoms such anxiety, depression, or trauma may be necessary in this situation. A mental status assessment may also be performed to evaluate memory, cognitive ability, and other mental health factors.

Social: This component focuses on assessing the person’s relationships, living circumstances, employment, and access to resources like healthcare and social support networks. It also considers their environment and social context. This can entail gathering social history or evaluating the person’s network of social supports.

A physician would gather data from each of these areas and utilize it to create a thorough knowledge of the person’s health and well-being in order to apply the biopsychosocial approach to assessment. With this knowledge, they would create a therapy strategy that catered to the person’s biological, psychological, and social requirements.

For instance, a clinician using the biopsychosocial approach to assessment would learn about the patient’s medical history, including any underlying medical conditions or medications that may be contributing to their symptoms. If the patient presented with symptoms of depression, the clinician would also ask about their symptoms. Also, they would assess the patient’s social background, including their relationships and access to support systems, as well as their mental health symptoms. A treatment plan addressing the patient’s biological, psychological, and social requirements would be created by the clinician using this data, and it might involve using medicine, therapy, or social support interventions.

The biopsychosocial approach to assessment, in its whole, acknowledges the interdependence of biological, psychological, and social aspects and is a thorough and complete method of assessing a person’s health and well-being. By using this method, clinicians can create treatment regimens that specifically address the needs of the patient and gain a deeper understanding of the patient’s health and well-being.

  • Describe the major developmental changes that occur during infancy, early and middle childhood.
  • Explain and apply Erikson’s psychosocial stages of development, particularly those pertaining to infants and children.
  • Explain and apply attachment and psychoanalytic theories and ego psychology.


  • Readings:

Berzoff, J. (2011). Why we need a biopsychosocial perspective with vulnerable, oppressed,

​and at-risk clients. Smith College Studies in Social Work, 81(2-3), 132-166.

Gibbons, J. & Grey, M. (2004). Critical thinking is integral to social work practice. Journal of Teaching in Social Work, 24(1/ 2), 1 23(only).

Lesser, J.G., & Pope, D.S. (2011). Chapter 1: An Integrating Framework for Human

Behavior Theory and Social Work Practice. In Human behavior and the social

environment theory & practice (pp. 1-24). Boston, MA: Allyn and Bacon.

Lesson 1 : Biopsychosocial Perspective

  • philosophical, socio-political and theoretical perspectives.
  • These include social systems, person-in-environment, ecological perspective, the goodness of fit, biopsychosocial assessment, strengths, social justice, and globalization.

Lesson 2: Social Environment 1 :

  • the impact of communities and agencies on individuals, children, and families
  • Describe community risk factors and protective factors that may affect child and youth development and well-being.
  • Identify ways in which agencies may increase the likelihood of engaging children and families with complex social and emotional needs.
  • psychodynamic theories.
  • macro perspective to explore the ‘social’ part of the biopsychosocial by looking at bi-psycho-social assessment communities and organizations/agencies and their fit with the needs of children and families.
  • Most people are deeply impacted by the communities in which they live, i.e., by community strengths, resources, composition, location, environment, gaps in service, risk factors,

Lesson 3: Social Environment 2 :

  • focus on pathological outcomes to one of resilience.
  • Compare and contrast risk and protective factors at the individual, family and

community levels and explain how these interact with one another.

  • Identify adaptive systems that support resilience.
  • exposed to traumatic social or family experiences during their childhood.




Lesson 4: Families


  • families function as systems.
  • family factors associated with resilience.
  • Understand genograms and apply them to family relational patterns.
  • family life cycle,Emotion regulation
  • Reflections :
  • Some people believe, “If all families just had a stronger set of values, children would grow up with fewer problems and would be more resilient.”
  • Would you agree with this statement in whole or even in part? Consider why or why not?
  • Think about your own family’s belief systems, communication patterns, and organizational patterns. How might they have shaped your approach to dealing with adversity?


  • Readings:


Morris, AS, Silk, JS, Steinberg, L et al. (2007). The role of the family context in the development of emotion regulation. Social Development, 16(2), 361-388. doi: 10.1111/j.1467-9507.2007.00389.x

Walsh, F. (2003). Family resilience: A framework for clinical practice. Family Process 42(1), 1-18.

Lesson 5: Families and substance abuse:

  • the strength and flexibility of its internal resources.
  • Describe several social and economic stressors and their impact on families.
  • Analyze the possible impact of policy decisions on the family.
  • possible consequences of substance abuse on families and children.
  • ways a family may respond to a child with a disability.


  • Readings:


Gruber, K. J., & Taylor, M. F. (2006). A family perspective for substance abuse: Implications from the literature. Journal of Social Work Practice in the Addictions, 6(1-2), 1-29.


  • challenges are considered normative and transitional as members move from one phase of development to the next. Some are situational but do not rise to the level of crisis/trauma which usually implies a serious threat to life of oneself or someone close.


  • Often, the difference between whether a challenge becomes a crisis/trauma or not has to do with the internal resources of the family as well as the social and economic support available and the political environment within which the family lives. To understand families we must see them as systems which are embedded within and interact with their cultural, socio-economic, and policy/political environments.





The Family in Society


families along the dimensions of socio-economic and cultural variables.

Anderson, R. E., & Stevenson, H. C. (2019). RECASTing racial stress and trauma: Theorizing the healing potential of racial socialization in families. American Psychologist, 74(1), 63-75.

  • Some families will also be affected by positive, progressive changes in society, even when certain social factions are not supportive. For example, it is interesting to note the unfolding changes in attitudes toward LGBT families since the Supreme Court has banned discrimination against same sex marriage.
  • Children of substance-abusing parents experience many adverse effects. Children rely on their parents for protection, nurture, support, guidance, role modeling, moral development, and other necessities of life. However, to a greater or lesser extent, substance-abusing parents are frequently inconsistent, erratic, and unavailable. They may also be emotionally neglectful and/or physically/sexually abusive. ‘There is clear evidence that children of parents who abuse alcohol or other drugs are at measurable risk for developing emotional behavioral and/or social problems’ (Gruber & Taylor, 2006, p.12). Due to the multiple problems the non-substance-using parent is contending with, he/she may be unavailable as a parent too.


  • A family’s culture, values, beliefs, and personal experiences will all affect its functioning, attitudes, and adaptation to a differently abled member. The availability of financial and supportive resources will also have a great influence on adaptation.


Lesson 6: families and loss


  • meaning of “trauma informed care.”
  • Families experience profound loss for any number of reasons including migration, foster care and adoption, military deployment, illness and death, murder, separation, divorce and abandonment, etc.
  • the dynamic relationship between human behavior, research, policy, practice and field.

Cournos, F.(2002). The trauma of profound childhood loss: A personal and professional and professional perspective. Psychiatric Quarterly, 73(2), 145-156. doi: 10.1023/A:1015059812332

  • Loss and related shifts within a family system are usually accompanied by significant stress and, at times, trauma.
  • Two profoundly important social issues which many families have experienced are migration and foster care.
  • Consider the factors : pre-existing family problems and peri-migration traumas, reasons for migrating, who was left behind, differences between the socio-political-economic conditions in the home and host countries, the developmental stage of the family and individual members, the family’s strengths and ways it has coped in the past, members’ expectations and dreams, , supports (resources), and challenges experienced since entering the host country.

Lesson 7’: spirituality and religion:

“cultural humility,” recognition of the limitations of a Western perspective, .

  • how and why the addition of a spiritual dimension to a biopsychosocial assessment would be of value.



  • Recently, it has been suggested that the biopsychosocial perspective should be extended to become a biopsychosocial spiritual assessment. This recommendation has emerged from social work educators, theoreticians and practitioners’ growing awareness of the role of spirituality and religion in many clients’ lives. Integration of these ideas is crucial to a strengths based and holistic assessment. Adding this dimension to our assessment processes may well promote greater understanding of clients’ values and worldviews and help us tune into their ways of making meaning of significant life events. We also need to understand the role of religion/spirituality in the lives of trauma survivors, immigrants, and recovering substance abusers, amongst others, who consider this aspect of themselves and of their family lives, community and culture extremely important


  • spiritual assessment to the biopsychosocial, we’re able to determine (with the client, of course) if and how their presenting problems are affected by their views of what is unknowabl

Lesson 8: Neurobiology, Biology & Mental Health

  • relationship between stress (acute and chronic) and mental and physical health, and examine some of the social forces associated with physical/mental health inequities.
  • lack of access to resources and negative health and mental health outcomes
  • Distinguish between progressive permanent disability, constant or permanent disabilities, and relapsing or episodic syndromes.
  • issues surrounding invisible disabilities.
  • concept of social determinants of health.
  • invisible/hidden disabilities experience






  • Chronic Illness and Disability : historical, medical, economic and the sociopolitical


  • progressive and permanent conditions (diabetes, cancer, rheumatoid arthritis, and HIV/AIDS), constant and permanent disabilities (deafness, blindness and visual impairment), and relapsing or episodic conditions (MS, lupus).


  • physical, emotional and social implications of each illness, the course of the disease presents unique challenges. A family with a child who has a first psychotic break during adolescence, for example, will certainly face a somewhat different experience than a young mother who discovers she has breast cancer or an elderly person who loses their hearing.


  • Medosch has conditions that cause intense fatigue and chronic pain. She took part in a 2014 Stanford Medicine X conference that included discussion of “invisible” illnesses.
  • considere anyone’s complaints re: exhaustion, pain, etc., to be hypochondriacal or thought they were unnecessarily whining and maybe even dismissed their concerns? Happens all the time. Could it happen with clients? Could their complaints be a physical expression of trauma they’ve experienced? A symptom of a disease which is difficult to diagnose? An indication of substance abuse?
  • underlying social conditions : association between health and socioeconomic status, e.g., in life expectancy, overall mortality rates and higher rates of infant and perinatal mortality.
  • Thoits (2010) identifies five major findings from more than forty decades of sociological research on stress:
  1. Stress has a substantial and damaging effect on physical and mental health.
  2. It is primarily through differential exposure to stress that inequalities in physical and mental health are produced in members of targeted groups (people of color, women, people with disability, the poor, etc.).
  3. Discrimination stress is an additional way in which people of color are regularly harmed.
  4. Stressors increase over the lifespan and are passed on from one generation to the next creating an ever-widening equity gap.
  5. High levels of mastery, self-esteem and social support may ameliorate the negative impact of stress on physical and mental health.
  • Readings:

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York, NY: Springer.

Lesson 9: neurobiology

  • neurobiology is relevant to a biopsychosocial perspective.
  • injuries and disabilities related to brain functioning.
  • key periods of sensitivity in brain development.
  • neuroplasticity and early life abuse and neglect and other forms of trauma.
  • neurobiological perspective to a vignette.
  • Preventive Interventions


  • Readings:

Nelson, H.J., Kendall, G.E., & Shields, L. (2014) Neurobiological and biological foundations of children’s

social and emotional development: An integrated literature review. The Journal of School Nursing, 30(4), 240-250. doi: 10.1177/1059840513513157



  • critical periods of brain development, neural plasticity, memory, cognition and the impact of stress and trauma on the brain and behavior are obviously important for social workers to be cognizant of.


  • brain disruption and psychiatric disorders; neurons responsible for alcoholism identified; memory loss in people with psychosis; borderline personality traits being associated (through studies of the brain) with lower empathy; the potential for prevention and treatment of PTSD through blocking memory pathways; and increases in our understanding of the social brain.




Neurobiological Underpinning of Human Development: Neurological and Biological Foundations of Children’s Development

  • neuroanatomy
  1. nurture (experience) and nature (gene expression).
  2. neurobehavioral disorders such as Autism, Attention Deficit Hyperactivity Disorder, Asperger’s Disorder, Dyslexia, and Mood Disorders. The central theme of this chapter is the effects of neurobiology on human behavior.
  • Nelson, Kendall, and Shields (2014)

stress the ways in which “early experience lays the foundation for lifelong behavior, cognition, learning, and physical and mental health”. neural plasticity,’ the developmental periods in which plasticity is most prolific, the significance of attachment relationship(s), and the impact of emotionally loaded events particularly on the amygdala.

  • Gunnar and Fisher (2006)

 ‘profoundly influences brain development, regulates gene expression, and shapes the neural systems that in humans are involved in vulnerability to affective disorders in response to later stressful life events’





Lesson 10: Critical thinking:

  • developmental theories.
  • Erikson’s theory of psychosocial development
  • principles of Critical Race Theory (CRT)
  • Standpoint Theory
  • Anti-Oppressive practice
  • Globalization and child development
  • psychosocial theory ( strengths and limitations)



  • Readings:


Berzoff, J. (2016). Chapter 5: Psychosocial ego development: The theory of Erik Erikson. In J. Berzoff,

L.M. Flanagan & P. Hertz (Eds.), Inside out and outside in: Psychodynamic clinical theory and practice in contemporary multicultural contexts (4th, ed., pp. 100-122). Lantham, MD: Rowman & Littlefield


  • important to recognize their inherent limitations. For example, they are unavoidably developed within a specific social, cultural, and historical context.

“The inherently ideological nature of theories makes it particularly important for us to examine theories systematically through the use of rigorous intellectual analysis, criticism, and evaluation (Robbins et al., 1999, p. 375)’




Psychosocial Ego Development


Erikson (1902-1944 ) :

 developed a psychosocial approach to development of Identity. He was one of the first theoreticians to include the social environment as a major factor in human development, to identify stages of adult development, and the first to focus on health as opposed to pathology. Erikson focused on the ways in which the ego is adaptive to changing needs over the lifespan.

Berzoff (2011) provides an in-depth review of Erikson’s theory of psychosocial development.



  • believing people follow a sequence of predetermined stages of development.
  • biological forces and age-related social or cultural expectations.
  • physical, emotional, and cognitive and demands of the social environment
  • Ego strength eg, balance of trust vs. mistrust.


Freudian notions about the oral stage

mother is of critical psychological importance.




Erikson’s  stages of Psychosocial Ego Development:


  1. Toddlerhood (anal stage)

Autonomy vs. Shame, Doubt (about 1-3 years)

  • self-confidence ,mastery
  • motor skills
  • ashamed and doubt their ability to develop control.
  • ‘stand on one’s own two feet.’


  1. Early Childhood (oedipal/phallic stage)

Initiative vs. Guilt (3-5 years)

  • Young children must develop a growing capacity to plan and initiate actions or they may feel guilt about ever taking initiative.


  1. Middle Childhood (latency)

Industry vs. Inferiority (6-11 years)

  • sense of competence
  • complete tasks
  • feel inferior or incompetent.
  • socially decisive stage – there is danger when the school-aged child begins to feel that the color of his/her skin, parents’ backgrounds, or his clothes – rather than his wishes or his will – decide his worth and, thus, his/her sense of identity.


  1. Adolescence (puberty)

 Identity vs.Identity Confusion (11-20 years)

  • Childhood comes to an end.
  • Physiological revolution
  • develop /confusion sense of identity.
  • Adolescents and peers.


  1. Young Adulthood (genitality)

 Intimacy vs.Isolation (21-40 years)

  • capacity to commit to deep connections
  • sense of isolation.
  • choosing a career,
  • Interpersonal intimacy
  • socializing with the same or opposite sex,
  • capacity to love or mutuality of devotion.


  1. Middle Adulthood

Generativity vs. Self-absorption/Stagnation (late 20s to 50s or 40-65 years)

  • develop self-interest/ feel stagnated.
  • ‘Mature genitality’
  • Stagnation or self-absorption reflects interpersonal impoverishment.





  1. Late Adulthood

Integrity vs. Despair, Disgust (after 50 or over 65 years)

integrity and contentment

accept responsibility

sense of integrity is achieved.

Wisdom .


Strengths of Erikson’s model include:


healthy coping and development

the relationship between the person and the environment.





  • Critical Race Theory and Cultural Sensitivity Dilemma:


colorblind approach affects the society and its people at the micro, meso and macro levels.

socioeconomic status (Gehlert, Sohmer, Sacks, Miniger, McClintock & Olopade, 2008, p. 340*).


  • Readings:


Abrams, L.S., & Moio, J.A. (2009). Critical race theory and the cultural competence dilemma in

social work education. Journal of Social Work Education, 45(2), 245-261.

doi: 10.5175/jswe.2009.200700109




Applying erickson’s theory:

  • been subjected to scientific scrutiny?
  • be harmful to specific groups?
  • assess this theory using a standpoint or critical race perspective?



Lesson 11:  intimacy and attachment theory


  • aspects of infant development from a biopsychosocial perspective.
  • the core resources an infant needs to build a lifelong foundation of health.
  • infant brain develops in the context of the environment and relationships.
  • risks to healthy development in infants.
  • Erikson’s psychosocial stage of trust versus mistrust.
  • the purposes of the attachment bond, different styles of attachment and the way they may manifest at various stages and cultures.



11.1: Infancy & Attachment Theory



  • ecosystems perspective in which behavior and growth are viewed as the outcomes of transactions between innate biological endowments and the family, social and physical environments.
  • biological and social levels . brain development and how ‘volley and return’ builds brain architecture.
  • impact of trauma on infancy and early childhood development.
  • the meso and macro level forces which have a significant bearing on the interaction between innate biological endowments and the social and physical environment.



  • The study of attachment theory gives us the opportunity to zero-in on the interaction between the genetic/biological, social/relational/parenting and the psychological — as the baby’s development occurs within the context of interactions with the most important people in its life.



  • Overview of Infancy Rogers (2019) )
  • infancy stage of human development from an ecosystems perspective in which behavior and growth are viewed as the outcomes of transactions between innate biological endowments and the social and physical environment.
  • biological, cognitive, and psychological development within a sociocultural context. They also discuss the infant’s capabilities at birth, innate motivational and behavioral systems, temperament, culture, and attachment.


  • Impact of Trauma on Infancy and Early Childhood
  • exposed to traumatic events including physical and/or psychological stressors that overwhelm their capacity to cope.
  • risk for negative outcomes now and in the future.


  • All children experience what is considered to be normative stressors. Being fully insulated from such experiences can actually have a deleterious effect on development as such protection may inhibit the development of self-soothing techniques and interfere with the long range objectives of doing well in work and in love. On the other hand, in the absence of sensitive and responsive support, normative fears may persist and lead the way to future mental health problems.


  • recognize that experiencing violence and trauma disrupts normal developmental processes in infants and young children.

Lieberman and Knorr (2007) for a sidebar titled: The Impact of Traumatic Events Depends On as it provides a helpful assessment tool which is broadly applicable.


  • Sidebars 2 and 3 on page 214 provide important information on the Signs and Symptoms from a Traumatic Event and Behaviors Resulting from Traumatic Events respectively.


  • Readings:


Lieberman, A.E., Knorr, K. (2007). The impact of trauma: A developmental framework for infancy and  early childhood. Pediatric Annals, 36(4), 209-215. doi: 10.3928/0090-4481-20070401-10


  • Reflection:

Erikson’s theory of psychosocial development begins with Infancy — known by Freudian theory as the oral stage of psychosexual development. The psychological question is whether or not the baby will develop a basic trust in relationships which, naturally, emerges from experiences with the primary caregiver(s). Often, but not always, the primary caregiver is the mother.


  • Infancy (oral stage) basic trust vs. mistrust (birth to about one year)

The mouth is seen as the center of the child’s biological drives. Erikson’s theory retains all the Freudian notions about the oral stage. It is also seen as the time when the baby develops a sense of basic trust which depends upon the type of parenting received. According to Erikson, the nature of the relationship with the mother is of critical psychological importance. By the end of the first year, the baby’s relationship with the mother is very strong. Erikson believed the infant’s trust in the care received enables the baby to achieve regulation in feeding, sleeping and eliminating. The trust the baby develops in the mother’s love will — later on — allow the mother to go out of sight without the baby experiencing undue anxiety or rage. This stage forms the foundation for a sense of identity and security. Infants must develop trusting relationships with caretakers or they will distrust the world.



  • Attachment Theory Shilkret and Shilkret (2011
  • attachment theory was not developed specifically for the practice of psychotherapy.
  • theory of development.
  • the belief in an unconscious (Freudian topographical theory) and the creation of internal working models of relationships.
  • The notion of internal working models is important in Object Relations Theory (which you may study in another course).
  • Attachment theory is highly influential in many realms of social work practice including trauma and psychopathology, affect regulation, and understanding the process of psychotherapy.
  • Types: secure and insecure attachment styles (including case examples), trauma and attachment, attachment over the lifespan, attachment theory and temperament, and attachment and psychopathology.,culture and attachment



Lesson 12: early childhood and Psychosocial Development,


-Early childhood is an amazing time of growth — physically, neurobiologically, cognitively, linguistically, socially, emotionally, morally and (Freud would say) psychosexually.


  • major developmental changes that occur during early childhood.
  • the child’s emerging sense of self evolves according to Erikson.
  • importance of school readiness, peer relationships and play in early childhood.
  • contextual variables that shape development in early childhood.
  • Analyze the strengths and limitations of central concepts of psychoanalytic theory.
  • advances in biological and behavioral sciences may be integrated into





  • Readings:


Berzoff, J. (2016). Chapter 2: Drive and beyond: Freud’s psychoanalytic concepts. In J. Berzoff, L.M. Flanagan & P. Hertz (Eds.), Inside out and outside in: Psychodynamic clinical theory and practice in contemporary multicultural contexts (4th, ed., pp. 18-49). Lantham, MD: Rowman & Littlefield.


Rogers, A. T. (2019). Chapter 7. Development in Infancy and Early Childhood. In Human Behavior in the Social Environment: Perspectives on Development and the Life Course (5th ed.). New York, NY: Routledge


  • Early Childhood: The Toddler and Early School Years
  • neurological, motor, cognitive, language, and moral development, and the emerging sense of self. Sociocultural development including peer relationships and play, individual differences, culture and the impact of disabilities are discussed.
  • disabilities discussed in this chapter includes Attention Deficit Hyperactivity Disorder and Autism. Contextual variables that shape development such as the childrearing environment, culture, class and parental discipline strategies are summarized as well as a variety of factors that impact on school readiness and later school achievement.
  • early experiences affect the quality of brain architecture via the interactive influences of genes and experiences. Human brain development evolves from the development of sensory pathways to language and on to higher cognitive functions.


  • Psychosocial Ego Development
  • Toddlerhood (anal stage) Autonomy vs. shame, doubt (about 1-3 years)

Toddlers need to develop self-confidence and a sense of mastery over themselves and their world. They need to master the use of newly developed motor skills or they will become ashamed and doubt their ability to develop control. Too much shaming leads to a secret wish to get over. Holding on and letting go can be done with discretion. At this stage, the baby learns to ‘stand on one’s own two feet.’


  • Early Childhood (oedipal/phallic stage) Initiative vs. guilt (3-5 years)

Young children must develop a growing capacity to plan and initiate actions or they may feel guilt about ever taking initiative.



  • Freud’s Psychoanalytic Concepts
  • A Bio-developmental Framework
  • Shonkoff (2010) provides an enhanced model for considering the origins of disparities in learning, behavior, and health. The author asserts that current transactional and ecological models and concepts of risk and protective factors (at multiple levels) have stood the test of time. However, there is a growing body of evidence that “foundations of healthy development and the origins of many impairments can be found among biological ‘memories’ that are created through gene-environment interactions in the early years of life, in some cases beginning as early as the prenatal period” (Shonkoff, p. 359).


  • The Foundations of Healthy Development and Sources of Early Adversity as well as Adult Outcomes in Learning, Behavior and Health , the interaction between genes and environment (whether cumulative or during sensitive periods, how these are expressed through important (e.g., metabolic) biological systems, and their proposed outcomes in adult learning, behavior, and health.


“Early childhood matters because experiences early in life can have a lasting impact on later learning, behavior, and health.”

Lesson 13: middle  childhood and ego psychology theory (6-11/12 years of age)

  • biopsychosocial perspective and to be inclusive of the many important systems which influence middle childhood development including family, school, peers, and community.
  • ego psychological theory (ego/executive functions.)
  • assessment of ego functioning is often part of a biopsychosocial assessment
  • the main components of a comprehensive biopsychosocial assessment of a child between the ages of 6 and 11/12.
  • Synthesize some of the major changes in biological, physical, psychological, cognitive, moral, gender, and racial development in middle
  • Discuss the social, cultural, and economic factors and various contexts that impact development in middle childhood.
  • key concepts associated with ego psychological theory and ego functions.
  • Assess aspects of ego functioning of an individual.
  • Analyze the strengths and limitations of ego psychological theory.
  • the effects of oppressive school environments on child development.


  • Readings:


Schamess, G., & Shilkret, R. (2016). Chapter 4: Ego psychology. In J. Berzoff, L.M. Flanangan & P. Hertz (Eds.), Inside out and outside in: Psychodynamic clinical theory and practice in contemporary multicultural contexts (4th ed., pp. 64-99). Lantham, MD: Rowman & Littlefield





Middle Childhood

An Integrative Model of Child Development

Middle Childhood (latency) Industry vs. inferiority (6-11 years)

School-aged children need to develop a sense of competence to master and complete tasks or they feel inferior or incompetent. This stage is seen as a lull before puberty when earlier drives reemerge in new combinations. This is the time for the child to become the little worker and provider. Development may be disrupted when family life has not prepared the child for school life or when school life fails to sustain the promises of? earlier stages. A socially decisive stage – there is danger when the school-aged child begins to feel that the color of his/her skin, parents’ backgrounds, or his clothes – rather than his wishes or his will – decide his worth and, thus, his/her sense of identity.


Think about an adolescent you know (client, friend, relative, self) who has not successfully transversed this stage of development. Identify as many risk factors as you can (from the various contexts within which this child lives) that contributed to any difficulties during middle childhood. Also identify any protective factors the adolescent had available to them during middle childhood.


  • Reflection:

What do you think are the likely effects on girls of color when confronting hostile school environments? Zero-tolerance policies? The criminalization of young and (frequently) poor Black girls and other girls of color? How does the intersection of race, gender and class operate together to minimize the chances for these girls to successfully navigate through the stage of industry versus inferiority?


  • Ego Psychology
  • Readings:


Schamess, G., & Shilkret, R. (2011). Chapter 4: Ego psychology. In J. Berzoff, L.M. Flanagan & P. Hertz (Eds.), Inside out and outside in: Psychodynamic clinical theory and practice in contemporary multicultural contexts (3rd ed., pp. 62-71). Lantham, MD: Rowman & Littlefield.


  • Effective ego functioning is crucial to perceiving and adapting to reality, to executing sound judgment and to effective decision-making.
  • Ego functions are also strongly related to the development of interpersonal relationships, to regulating impulses, to distinguishing the internal from the external, to delaying gratification, to utilizing a range of defenses and coping mechanisms, and to learning in all its forms.


















Describe and analyze the biological, psychological and social environmental factors that pertain to: adolescence,Early adulthood., middle adulthood.,late adulthood.


  • Readings


Lesser, J. G., & Pope, D. S. (2011). Chapter 12: Adolescence. In Human behavior and the social environment: Theory & practice (p. 308-334). Boston, MA: Allyn & Bacon.


Lesser, J. G., & Pope, D. S. (2011). Chapter 13: Early adulthood. In Human behavior and the social environment: Theory & practice (p. 335-352). Boston, MA: Allyn & Bacon.


Lesser, J. G., & Pope, D. S. (2011). Chapter 14: Middle adulthood. In Human behavior and the social environment: Theory & practice (p. 353-372). Boston, MA: Allyn & Bacon.


Roy, A. (2011). Chapter 15: Diversity in older adulthood. In Joan G. Lesser and Donna S. Pope (Eds), Human behavior and the social environment: Theory & practice (pp. 385-408). Boston, MA: Allyn & Bacon.Recommended Readings



  • Adolescence


  • Biological Development
  • Physiology sets the wheels in motion for adolescence.
  • Puberty (pyscho-sexual development).
  • Physiological changes begin about two years earlier for girls than for boys.


  • Adolescence begins with pubescence and ends with significant physical growth and a shift away from family toward the peer group.
  • Development is quite variable at this stage. Girls are most dramatically affected by where they fall on the developmental spectrum.
  • Inherent dangers include eating disorders, precocious sex, substance abuse, and lowered self-esteem.
  • Bodily and emotional changes are rarely synchronized.
  • Cognitive growth and development of systematic logic involves grasping abstract concepts, but this process is not completed during early adolescence.
  • Moodiness due to physiological (hormonal) changes.
  • Psychosexual Changes & Development
  • The goal of genital phase of psychosexual development is the integration of sexual maturation into the sense of self and the development of the capacity for intimacy in object relations.
  • Object libido is withdrawn from parent and invested in themselves and peers with a narcissistic libido.
  • Psychosocial Developmental Stage: Identity versus Role Confusion.
  • Ethnic and racial identity issues arise.
  • Gender identity confirmation and re-identification.
  • Sexual identity formation.
  • Social Environmental Factors and Influences
  • Consolidation of separation process begun in early adolescence.
  • Teens tend to perceive themselves as adults and are far more focused on the adult world and where to place themselves within that world.
  • Early relationships with parents are left behind to make room for their own present and future.
  • Peer interactions as seen through school and neighborhood channels.
  • Risks of bullying, drug use, gang affiliation, and violence increases but are also dependent on individual, familial and environmental (protective) factors.


  • Early Adulthood


  • Traditional markers in Western middle class society are noted below.
  • Leaving home and becoming responsible for housing.
  • Taking on work and/or educational tasks.
  • Developing significant relationships and one’s own social networks.
  • Becoming a parent, caring for others.
  • Individuation continues and young adults prepare to differentiate emotionally, geographically, and financially from their family of origin.
  • Biological and Psychological Development
  • Physical functioning is typically at its height during early adulthood.
  • Health risks include unprotected sex, STDs or HIV, unplanned pregnancy, substance abuse including alcohol, accidents, and diabetes.
  • Greatest fertility rates during early adulthood.
  • Cognitively, there is an expansion of abstract thinking which enhances problem solving and reflective thought processes. Early adults are able to entertain multiple viewpoints from various perspectives. Cognitive capacities become more flexible.
  • Morally, there is more complex contemplation given to ethical principles and there is a recognition of larger systems and appreciation for community.
  • Psychosocial developmental stage: Intimacy versus Isolation.
  • Intimacy is focused on the ability to form deep interpersonal attachments which require sacrifice and commitment.
  • Intimate relationships require the ability to take care of as well as being taken care of, meeting each other’s needs and accepting each other’s limitations.
  • These intimate relationships include sexual relationships and meaningful relationships with friends, teachers, family members and fellow workers.
  • Without successfully reaching “intimacy,” isolation may result.
  • Attachment Styles in Adulthood
  • Secure
  • Anxious Preoccupied
  • Dismissive-Avoidant
  • Fearful-Avoidant
  • Social Environmental Factors and Influences
  • Mental health issues may surface due to biological and social factors.
  • Suicidality
  • Inequality in mental health
  • Family systems are established and young adults may take on the role of parenting.
  • Risk and protective factors may insulate some adults.


  • Middle Adulthood


  • Biological and Psychological Development
  • Biological changes may occur in sensory and motor functioning.
  • Male and female climacteric occur.
  • Cognitive strengths continue but some decline may be noted in perceptual speed and numerical abilities.
  • Psychosocial developmental stage: Generativity versus Stagnation.
  • A significant way in which creative capacities are applied is in the pursuit of occupational success and economic security.
  • Generativity involves cognitive, emotional and social development and requires the ability to take action and make life decisions based on the needs and interests of others as well as one’s own.
  • Midlife crisis: The awareness of paths that have not been taken may generate regret or pressure to make changes.
  • “Narcissistic” vulnerability is a common feature and it is important to be aware of such threats to one’s sense of self and self-worth.
  • Identity issues may also surface as middle adults grapple with questions of selfhood.
  • Social Environmental Factors and Influences
  • Family systems continue to evolve.
  • Developing adult-to-adult relationships with children.
  • Adjustment to grandchildren and in-laws.
  • Taking care of unfinished business in relation to aging parents and perhaps caring for them.
  • Divorce is common or a restructuring of family.
  • Work-life balance
  • Managing the rigors of work and family responsibilities.



  • Late Adulthood


  • late adulthood has three sub-phases, young (65-74), middle (74-84) and oldest (85+).
  • Biological and Psychological Development
  • There are progressively larger populations of older adults.
  • There are many physiological changes that accompany late adulthood, particularly because it spans such a large time frame.
  • Cognitive issues at various gradations may be experienced by some elders. This is dependent on genetics, and on psychological and social factors.
  • Ageism continues to be experienced by many in different areas of society.
  • Psychosocial developmental stage: Ego integrity versus Despair.
  • The challenge here is to come to terms with the realities of life circumstances and its limitations.
  • False beliefs and ego attachments are loosened.
  • Mental health issues, such as depression and anxiety will continue to challenge some older populations.
  • Suicidality is not uncommon among the elderly and there are increasing issues with the overuse of drugs and alcohol.
  • Social Environmental Factors and Influences
  • Late adulthood continues to be filled with transitional points.
  • Retirement
  • Family Changes
  • Death of spouse/partner
  • Divorce
  • Grandchildren
  • Facilitated Living
  • Death
  • Socioeconomic factors continue to pose issues for some older adults.
  • LGBT older adults face certain challenges that are particular to that population.



Lesson 1: Course Introduction and Refreshers


  • Re-identify the biopsychosocial perspective and describe why it’s important to the evaluative frame.

Describe and apply critical thinking.

Re-identify and explain the major developmental points of middle childhood.


  • Human Behavior in the Social Environment II is centered on the biopsychosocial approach, which presents a multidimensional view of human development and behavior. This perspective views the person in the context of the environment, and takes into consideration the challenges, stressors and life tasks that occur throughout the life cycle. The course stresses the centrality of culture, race, ethnicity, gender and the socioeconomic environment.


  • Using systems theory as a critical theoretical underpinning, HBII takes a non-linear view to development in which there is a continuous reciprocal interchange and mutual impact among different systems (individual, family, group, community).


  • A major focus of the course is on the development of the human biological, psychological and social structures as they occur throughout the lifespan. HBII draws upon the approaches studied in HBI, and continues with the study of adolescence through late adulthood, and it also reviews the processes of grief and loss. The social realities of the urban environment and immigration are emphasized.


  1. Adolescence
  2. Emerging Adulthood
  3. Early Adulthood
  4. Middle Adulthood
  5. Late Adulthood
  6. Chronic Illness and Disability
  7. Grief, Loss and Bereavement







  • Biopsychosocial Perspective


Let’s review a concept that should now be quite familiar to you, that of the biopsychosocial perspective. From a systems point of view, we might say that human behavior is the result of complex interactions of forces that are rooted within the biological, psychological, spiritual, sociological, and the cultural (Lesser & Pope, 2011). Systems theory, as applied to social work, focuses our attention on both the individual and the environment simultaneously (person-in-situation). It helps us identify the different levels at which social work intervention may take place and helps us choose the focal system. In our assessment of an individual and of a situation, we must obtain an understanding of the variables or risk factors that are imposing challenges, but we must also be mindful of the strengths or protective factors that are present at the individual and social levels. We must never be overly invested in identifying the ‘problems’ and their causes while keeping our minds limited about resolutions and resilience (Lesser & Pope, 2011).


Along with the biopsychosocial perspective, you should also be familiar with a systems level perspective, where challenges, risks, and protective factors to individuals and environments are examined on different levels of social work practice: the macro, mezzo, and micro.


In the social ecological model, emphasis is placed on the interdependence of people, services, local neighborhoods and communities within the larger society. It is essential that social workers know about the impact of the environment on the individual’s, family’s or community’s development, behavior, efficacy, and experience.


Middle Childhood


  • let’s review the stage of development that precede adolescence.

middle childhood As you learned in HBI, middle childhood is relatively longer than infancy, toddlerhood or the preschool years; it extends from ages six to approximately 11 or 12. This is a time when children increasingly enter the world outside of the family and are therefore challenged with new types of experiences and issues.


  • Children continue to grow in height –usually two to three inches per year– and they will often gain 3 to 5 pounds of weight per year. We need to be on the lookout for some eating related issues here but I will speak more about this during adolescence. Gross motor skills such as climbing, running, and throwing, and fine motor skills such as hand-eye coordination and writing continue to improve during the middle childhood years.


  • Cognitively, according to Piaget, middle childhood is when concrete operations develop wherein children become able to reverse or undo an action in their mind (Ginsburg & Opper, 1979). They are also able to focus on
  • on more than one aspect of something at a time, and they have the ability to understand that the properties of an object do not change when their appearances alter. Middle childhood is also when children are developing more of their executive functioning skills (i.e., keep track of belongings, complete more homework assignments, complete longer term projects, raise hands before speaking), although complete development does not occur until late adolescence (Kagan, 1984).



  • Adolescence: Biological Development
  • key features of adolescent development.
  • biological changes that accompany puberty.
  • sexual development may impact and/or challenge an adolescent’s sense of self.
  • neurological developments that occur during adolescence.
  • issues related to the development of eating disorders in adolescence.


  • Adolescence is characterized by significant physical changes, sexual maturation, increased cognitive functioning, formative identity development, increased independence, and the possible experimentation with sex and substance use. It is also a time for peer group connections, including the development of close friendships, social circles and various clubs. Generally, the ages that commence and end adolescence vary and are dependent on the individual, biology, and culture. it is noted to start as early as 10 years of age and to end as one approaches their 20th year, marked by college commencement or entry into the workforce.Adolescence is usually separated into three overlapping sub-phases: early, middle, and late. Each phase has its own dominant themes, and we will explore the characteristics that are often found in each.






  • Readings


Berzoff, J. (2011). Psychosocial ego development: The theory of Erik Erikson. In J. Berzoff, L. M.

Flanagan, & P. H. Lanham (Eds.), Inside out and outside in: Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts (3rd ed., pp. 97–117). Lanham, MD: Rowman & Littlefield Publishers, Inc.



ogers, A. T. (2019). Chapter 9. Development in Adolescence. In Human Behavior in the Social Environment: Perspectives on Development and the Life Course (5th ed.). New York, NY: Routledge.


  • The experience of adolescence is contingent on gender, culture, ethnicity, socioeconomic class, and one’s physical and mental health. There is a great deal of variability in each of these areas that will directly affect the way an individual will process the dynamic interplay of adolescence.


  • the biological changes that occur during adolescence. The physical changes observed during adolescence are attributable to puberty, which sets off complex hormonal surges that bring about physical maturation and the development of secondary sexual characteristics. These physical changes often occur rather quickly, which can make teens feel very self-conscious of their bodies. This factor, along with other biological and environmental precursors and circumstances, may lead some adolescents to have some form of body image dissatisfaction. Due to changes in their physical bodies, adolescents also start seeing themselves as sexual beings, which motivates their exploration of their own bodies and the bodies of others.


  • During adolescence, neurological changes in the frontal regions (neocortex) of the brain are enhancing the teen’s ability to think logically and to understand abstract concepts and theories. As noted by Piaget (Ginsburg & Opper, 1979), adolescents are within the formal operational stage of their cognitive development and, as such, are quickly learning how to manipulate ideas with


Puberty and Sexual Maturation in Early Adolescence


  • This particular section, focuses on the biological changes ushered in by puberty.
  • The biological information provided within Chapter 9 of Rogers (2019). Note the physiological changes that adolescents are experiencing in puberty, as this will provide some context to the behaviors and emotions being relayed and observed within the social environment. Also, pay particular attention to how the physiological changes of adolescence are influenced –both negatively and positively– by the adolescent’s social environment (i.e., nutrition, poverty, trauma, etc.).





  • Reflection:


  1. What are some of the pubertal similarities experienced by both males and females?
  2. How may dieting and poor nutrition negatively impact the biological processes that take place during adolescence?
  3. Does the sexual maturation process of one person’s one sex (male/female) seem more complex than the others?
  4. Where have we historically discussed transgender or intersex during adolescence? How has that changed over time?



  • According to Freudian theory, with sexual maturation, Oedipal tensions resurface and must be dealt with and resolved. Within the genital, and final stage of psychosexual development, teens must redirect their sexual interests away from the parent and toward opposite sex partners in the outside world. Thus, according to Freudian theory (and society’s acceptance of its notions),normal psychosexual development includes internalizing the norms and traditions of society, identifying with the same-sex parent and fulfilling sexual gratification through genital-to-genital contact with a member of the opposite sex. Research and society have arguably been slow to include those who don’t fit within a male or female description and as a result, those that may define themselves in other ways, may be left out, invisible, or worse. For the adolescent, trying to understand who they are and how their bodies are changing, not having additional terminology that better explains their bodies is important. Today, there is more research to suggest that sex is a spectrum and that there are other terms, such as transgender or intersex, that prompt the inclusion of those that may not be characterized within the definition of “male” or “female”. While our society continues to move away from this binary characterization of sexual development, it does provide the foundation by which sexuality is historically examined. In order to expand the discussion and offer additional information, you are encouraged to look at GLAAD’s Media Reference Guide that provides a glossary of terms.


  • The hormonal surges that accompany puberty bring forth physiological changes that incite a sexual maturation effect that has psychological implications. Teens may start to acknowledge themselves as sexual beings and, as such, become progressively interested in experiencing sexual activity with others.


  • With the advent of sexual activity comes the concern of contracting sexually transmitted diseases and infections, and of becoming pregnant. STDs often have no obvious sign or physical symptoms, so regular screenings are critical.


  • Reflection: Discuss how a trans-identified teen may be emotionally/psychologically affected by the biological changes brought on by puberty that may not necessarily affect a teen who is cisgender (or cis)?

Body Image and Eating Disorders

Body image disturbance is a complex phenomenon, whose origins are rooted in various biological and social factors. Due to the physiological changes that adolescents experience, and the social pressures of peer acceptance, teens may be particularly susceptible to experiencing body image issues as they try to both conform and construct their identities to socially accepted norms. Research has noted that body image dissatisfaction may be a precursor to the development of disordered eating patterns, such as anorexia nervosa and bulimia nervosa (Lowe et al., 2006; Stice et al., 1999).


  • Reflection:
  • Case: A 15-year-old student tells you that they are feeling ugly and overweight compared to their peers.
  • Using Markey (2010) and your own knowledge about body image dissatisfaction, how would you describe and attribute the student’s her present feelings to your clinical supervisor? As you consider the student’s situation, keep in mind their present stage of biological development and sociocultural context.

According to the information given, it’s conceivable that the 15-year-old pupil is unhappy with their figure. Teenagers frequently feel body image dissatisfaction, which is a negative assessment of one’s physique or certain body parts. According to Markey’s (2010) model of how body image develops, there are a number of personal, societal, and environmental elements that might contribute to body dissatisfaction. Here is a possible explanation for the student’s feelings and how several elements could be used to explain them:

Factors specific to the student: The student may be experiencing physical changes typical of adolescence, such as weight gain or changes in body composition. Feelings of uncertainty and self-consciousness might result from these changes. Also, the student might be feeling inadequate since they are comparing their body to the bodies of their peers. The student’s discontent with their bodies may be influenced by these individual circumstances.

Social factors: The student can be absorbing media messages or social cues that suggest thinness and particular physical characteristics are desirable. This can give the pupil the impression that their body doesn’t live up to these expectations. Also, the student might be getting criticism from friends or family members that only serves to reinforce their unfavorable perception of their bodies. These social variables can be making the student’s discontent with their bodies worse.

Environmental factors: The student can reside in a setting that is unfriendly to a healthy diet and regular exercise. For instance, kids might not have access to wholesome diets or secure exercise facilities. This can be a factor in the student’s weight increase and unfavorable self-perception.

Ultimately, a mix of personal, societal, and environmental variables may be responsible for the student’s poor body image. It would be crucial for you, as their clinical supervisor, to carry out a thorough evaluation in order to identify the factors influencing their poor body image. The sociocultural environment of the student should also be taken into account because various groups may have different cultural views of what constitutes a beautiful body and an attractive face. To help the student reframe unfavorable views about their bodies, cognitive-behavioral therapy may be used as a treatment intervention, along with working with the student to establish appropriate diet and exercise routines.

The Adolescent Brain  Jean Piaget in Ann Arbor


  • Understanding the developmental processes that occur within different substructures of the brain can have bearing on the way that teens are treated in different areas of the social environment.
  • The Steinberg (2012) article will provide a general overview of some changes that occur in the adolescent brain, while also noting how the knowledge of such scientific developments are informing public policy and other initiatives.
  • Jean Piaget (1986-1980). According to Piaget, by the time individuals reach adolescence, they should have passed three stages of cognitive development: the sensorimotor, preoperational, and concrete operational. Arriving at the formal operational stage, most adolescents, depending on their genetics, environment and interests, would progressively develop the ability to reason and verbally state a hypothesis, as well as deduce the consequences that hypotheses imply (Austrian, 2008).
  • As they continue to mature, adolescents start to draw logical conclusions, become more flexible with their thinking, exchange information in broad circumstances, and allow their thinking to become adaptive to various issues that arise (Austrian, 2008).


  • Theories applied :


  1. Piaget stages of cognitive development.
  2. Kohlberg’s stages of moral development


  • Piaget was a strong influence to the work of Lawrence Kohlberg (1927-1986), a psychologist whose research included the stages of moral development. Kohlberg’s formulations of moral development were based on the analysis of 72 boys who were upper-middle to lower socioeconomically, and ranging in ages, 10 through 16 (Cincotta, 2008). From childhood, the stages are separated into three main phases: pre-conventional morality, conventional morality and post-conventional morality. View the stages of moral development below and note the parameters set for adolescents (conventional morality).






  • Reflections:


Based on Piaget’s Stages of Cognitive Development and Kohlberg’s Stages of Moral Development, consider the questions below:


  • What are your thoughts about these theories? In particular, what may be some of the limitations of stage-based theories of development? For example, consider their limitations in regard to age/time, race, gender, sexual identity, socioeconomic status, etc. Theories can also lead to assumptions and they may reinforce ideas about certain populations. How might these theories lead to “otherness” categorizations?


  • Steinberg (2012) It also will help in concretizing the understanding that the biological changes accompanying adolescence don’t occur in isolation, but rather have an interactive effect with the environment. From an ecological perspective, when we examine any biological factor, we must also consider the effects it may have on the meso and macro levels.


  • how might you explain to concerned parents and board members the risk-taking behaviors that teens engage in?


  • Readings:


Steinberg, L. (2012). Should the science of adolescent brain development inform public policy?

Issues in Science and Technology, 28(3), 67-78.


Friedman, R. A. (2014, June 28). Why teenagers act crazy. The New York Times. Retrieved from


High levels of moral reasoning correspond with increased gray matter in brain. (2015, June 3). Retrieved December 16, 2015, from


The teen brain: Still under construction. (2011). National Institute of Mental Health. Retrieved from



 Adolescence: Psychological Development


  • An adolescent’s psychological development encompasses a multitude of variables. One that is of particular importance is identity.
  • cohesive identity will provide the internalized structure for understanding the self in relation to the world and to remaining true to one’s own beliefs and value systems.
  • dimensions that comprise identity formation. We will concentrate our time on exploring the constructs of race, ethnicity, gender and sexuality.




  • key features of adolescent psychological development.
  • the factors that comprise an adolescent’s identity construction.
  • Name and describe
  • social elements that challenge an adolescent’s identity



  • Chapter 3, Rogers (2019) notes the contributions of Erik Erikson to the importance we place onidentity development. In his eight psychosocial stages of development, Erikson named the crisis that pertains to adolescence as that of Identity versus Role Confusion. Here, the challenge of the adolescent is to construct a sense of self within the social group, as opposed to becoming very confused about themselves and their purpose.


  • Theory:


Sue and Sue (2003) created the group level tripartite model personality identity development noted below. What are some of your thoughts as you examine each level?


Identity is all about context and so we must examine its development in relation to the social discourse and social situation in which it is being constructed. You will note that many if not all theoretical models reviewed within Lesser and Pope (2011) are formulated as stages. This may not always be the case, as we will read in the next section.


  1. Ethnic and Racial Identity


  • signficant stress and confusion for the individual. Others who are more racially ambiguous may have have more of a choice to construct their own ethnic/racial identity, within limits. Regardless, the social pressure to “choose only one race” remains a feature of American society and presents unique challenges for the development of racial identity for this heterogeneous group.


  • Rogers (2019) provided you with the basic tenets of various identity constructs. Most were based on traditional stage conceptualizations. However, as we have learned, issues as complex as identity development don’t neatly conform to a set formula. Yi and Shorter-Gooden expand our understanding of ethnic identity formation by proposing a constructivist narrative approach. Ethnic identity is observed as being more fluid and multidimensional in context, influenced by the interactions one has with friends, family and social institutions and parties. This isn’t as uniform and linear as stage models have often depicted.


  • Yi and Shorter-Gooden (1999) use the term ethnic identity broadly enough to encompass racial identity too. As such, according to an internal quotation that Yi and Shorter-Gooden (1999) utilize, ethnic identity is “an enduring fundamental aspect of the self that includes a sense of membership in an ethnic group and the attitudes and feelings associated with that membership” (Phinney, 1996, p. 22).




  • Reading:


Gibbons, J., & Gray, M. (2004). Critical thinking as integral to social work practice. Journal of

Qin, D.B. (2009). Being “good” or being “popular”: Gender and ethnic identity negotiations of Chinese immigrant adolescents. Journal of Adolescent Research, 24(1), 37-66. doi: 10.1177/0743558411402335


Russell, S. T., & Fish, J. N. (2016). Mental health in lesbian, gay, bisexual, and transgender (LGBT) youth. Annual Review of Clinical Psychology, 12(1), 465-487. doi:10.1146/annurev-clinpsy-021815-093153


Tummala-Nara, P., & Sathasivam-Rueckert, N. (2015). The experience of ethnic and racial group membership among immigrant-origin adolescents. Journal of Adolescent Research, 1-44. doi: 10.1177/0743558415592178


Yi, K., & Shorter-Gooden, K. (1999). Ethnic identity formation: From stage theory to a constructivist narrative model. Psychotherapy: Theory, Research, Practice, Training, 36 (1), 16-26. doi:10.1037/h0087723





  1. Gender Identity


  • In her book The Second Sex (1973), Simone de Beauvoir, suggests that gender is in fact constructed and evolves due to appropriations made by the individual within the context of cultural compulsions. Developing one’s own gender identity or subscribing to the gender prescriptions encoded by culture and society can be challenging, particularly for those who are gender variant. There are many adolescents who struggle with gender identity issues and who must navigate very tough situations in order to gain individual and public acceptance.
  • The articles for this section were selected because they discuss important issues that we must keep in mind since we are a profession that works with a wide and diverse population. As noted within the Social Worker’s Code of Ethics (National Association of Social Workers, 2008):
  • Value: Dignity and Worth of the Person
  • Ethical Principle: Social workers respect the inherent dignity and worth of the person.



  • challenges confronted by trans-identified adolescents and how those experiences affect their quality of life. According to the NY Times (Hartocollis, 2014), due to the wider acceptance of transgender identity, the number of teens obtaining reassignment surgery has steadily increased. Yet, even with growing acceptance, there continue to be appalling acts of violence perpetrated against trans people, most especially against Black and Latinx individuals (Hartocollis, 2014). The Human Rights Campaign (Baum et al., n.d.) noted that at least 29 transgender-identified individuals were murdered in 2017, the highest number recorded.


  • What are some of the challenges that the teens depicted and experience in their daily lives that are a direct result of their gender identity? What are their coping mechanisms?

Because of their gender identification, teens who identify as transgender or gender non-conforming frequently experience particular difficulties in their daily lives. Here are some instances of the difficulties people might have and some coping techniques they might employ:

Bullying and harassment: Teens who identify as transgender or who identify as gender non-conforming are more likely to experience bullying and harassment at school and elsewhere. They might experience physical assault, verbal abuse, and social marginalization. To cope, people may turn to friends or allies for assistance, look for welcoming places to go, or speak up for themselves by denouncing bullying and harassment.

Discrimination: Teens who identify as transgender or gender non-conforming may encounter prejudice in a range of settings, including housing, work, and medical treatment. Their well-being and mental health may be impacted by this discrimination. Finding jobs or housing providers who are open and tolerant, as well as advocating for themselves by informing others about the problems faced by transgender and gender non-conforming people, are some examples of coping techniques.

Teens who identify as transgender or gender nonconforming may encounter rejection from their families if they don’t accept or understand them. Feelings of loneliness and isolation may result from this. Finding supportive adult mentors or role models, engaging with transgender and gender non-conforming communities, and asking chosen family or friends for assistance are all examples of coping techniques.

Gender dysphoria: When a person’s gender identification differs from the sex they were assigned at birth, they may experience anguish or discomfort known as gender dysphoria. In addition to engaging in self-care activities like exercise or artistic endeavors, coping techniques may involve obtaining gender-affirming medical treatments like hormone therapy or gender-affirming surgery, as well as getting help from mental health specialists.

In general, bullying and harassment, discrimination, familial rejection, and gender dysphoria are just a few of the difficulties that transgender and gender non-conforming youth endure because of their gender identity. Finding safe environments where one feels accepted, speaking out against stigma and discrimination, and seeking help from friends, allies, and mental health experts are all examples of coping techniques. It is crucial that parents, caregivers, and mental health professionals are aware of these difficulties and are able to offer the right tools and assistance to aid transgender and gender non-conforming youth in overcoming them.

  1. Sexual Identity


As teens establish themselves as sexual beings amongst their peers, they must also come to terms with their sexual preferences and orientation.

Rogers (2019), sexual orientation encompasses sexual behavior but it also concerns itself with the adolescents’ awareness of the objects of their desires, to whom they are attracted, and what they wish to do with them.

Sexual orientations are commonly defined as heterosexual, bisexual, gay, or lesbian. Individuals that identify as trans may have a sexual orientation that is heterosexual, bisexual, gay, or lesbian; most trans people identify as heterosexual (Bohan, 1996; Green 2004).

There has been a lot written on what makes a person gay. Responses are rooted in many different areas of interest: genetics, gender, evolution, the environment (i.e, within the womb during gestation), and familial circumstances, to name a few. Neil Swidey of the Boston Globe provided some updates to the questions in a 2015 article, which you may choose to read here.

Swidey, N. (2015, August 23). What makes people gay? (An update). The Boston Globe. Retrieved from



  • Homelessness: impacts a disproportionate number of lesbian, gay, bisexual, transgender, and queer/questioning youth in the United States1. In a recent national report, those youth and young adults who identify as LGBTQ are over 100% more likely to experience homelessness than their straight and cisgender peers.2


  • Some youth (minors) who identify as LGBT may be forced by their parents or caregivers to attend reparative (conversion) therapy, a pseudoscientific treatment modality whose main objective is to change the homosexual orientation of a person to heterosexual. Both medical and mental health communities have condemned the practice of conversion therapy due to the serious effects it has on the patient.


  • Consider the influences that family has on LGB identity and how rejection may affect identity formation. Consider how symbolic interaction theory and the role that family may play in administering social support to teens who are expressing their sexual identity. Also interesting to note are the various theoretical models of sexual identity development that are discussed.


  • Reflection: How will the trajectories of sexual identity development differ between those teens that identify as heterosexual and those that identify as LGB?

Those who identify as heterosexual and those who identify as lesbian, gay, or bisexual may experience different sexual identity development trajectories, according to research (LGB). The following are some significant variations:

Age of onset: According to research, LGB people may first become attracted to and question their sexuality earlier than their heterosexual peers. While heterosexual adolescents may not question their sexual orientation until later in life, LGB youth may start to do so during puberty.

Timeframe: LGB people may need more time than heterosexual people to accept their sexual orientation. According to research, LGB youth come out on average later and may take longer to embrace and fully incorporate their sexual orientation into their identity.

Identity development phases: Many LGB people go through certain sexual identity development phases that are distinct from those that heterosexual people go through. These phases may contain a variety of feelings, such as perplexity, anxiety, and self-doubt, and might include denial, exploration, acceptance, and integration.

Minority stress: Due to their sexual orientation, LGB people may feel minority stress. The trajectory of sexual identity development may be impacted by this stress, which can result from experiences of prejudice, rejection, and stigma.

Teens who identify as heterosexual and those who identify as LGB may progress along different paths in terms of their sexual identity development. LGB youth may begin to question and feel sexual attraction sooner, take longer to accept their sexual orientation, go through certain stages of identity formation, and deal with minority stress, all of which can have an effect on their trajectory. It’s critical for parents, caregivers, and mental health professionals to be aware of these variations and to offer the proper resources and support to LGB adolescents as they negotiate the difficulties of developing their sexual identities.





Adolescence –Development in the Social Environment (1/2)


  • the important mezzo and macro systems that interact with adolescents and distinguish the similarities and differences.
  • the risks and protective factors that adolescents may encounter within family systems.
  • the risks and protective factors that adolescents may encounter within peer groups.


  • As adolescents continue to develop and start taking steps toward understanding their own sense of self, they begin the separation process from their families of origin. This separation is not so much physical as it is emotional. The redefinition of self is not based on parental identities, as it was in childhood. Rather, the definition encompasses the social world. Teens begin to more fully engage with peers and also expand their affiliation with school and community channels. As they interact, integrate and assimilate into different spheres of the environment, they may experience certain challenges. When examining eachsome of these situations, consider the effect it may have on the adolescent as well asbut also on the other entities within the social environment. For example, when discussing teen drug use, think of its implications from the societal perspective, but also critically examine the consequences that behavior may have on family units, on school and medical systems, and on communities.


  • The ecological model is yet another way to understand the multi-textual frames by which social workers can assess the relationship between the individual and the environment.



Family Matters


  • Family, especially parents, parental figures, and caregivers have a particularly strong reaction to adolescent development. Some may fear it due to the challenges it ushers into the family unit. They may experience vulnerability due to the infiltration of other social systems (peers, gangs, etc). Parents and caregivers will observe their adolescent undergo a series of social milestones where they will explore sex, independence, drinking and maybe even drug use. There is also the inevitable process of letting go that parents must manage. Families must tackle the challenging aspect of developing the ability to provide control and order, while also relinquishing some power to the adolescent. The change in the status quo may even instigate a mourning process for the parent in the loss of the child they once knew. Additionally, there will definitely be disequilibrium due to the challenges confronted, but homeostasis should be reestablished in time.


  • Due to the amazing changes in their physical bodies, adolescents start seeing themselves as sexual beings and they take initial steps to separate themselves from parents and caregivers. According to Blos (1967), there is a second individuation whereby the adolescent separates from the primary love objects in order to become a participating member of society. Consequently, there is a greater tendency toward self-absorption and, paradoxically, toward having more peer interactions. Lyons-Ruth (1991) appropriately noted that good and healthy development requires a degree of individuation but it also must constitute attachment, rather than full separation. The push toward greater independence is in keeping with the adolescent’s need for establishing a self-identity. The loosening of their dependence on parents helps the early teen to step out of childhood. Some teens may move from total reliance on parents to more of a reliance on peers and environmental supports external to the family, including community centers, schools, sports leagues, and religious organizations.


  • the important role that families play in fostering resilience in teens that navigate some very challenging social circumstances, including racism, poverty, poor school performance, and stigmas related to physical and personal characteristics. Resilience is a term that you encountered earlier in the Human Behavior sequence. It refers to a strengths component that plays an important part in explaining how many people get through challenging times. According to Masten (2001), resilience can be described as a “good outcomes in spite of serious threats to adaptation or development” (p. 228).


  • Constructionists state that resilience is the result of “negotiations between individuals and their environments to maintain a self-definition as healthy” (Ungar, 2004, p. 24). Teens want to develop more independence and are looking to create their own self-identity. Often they will negotiate terms with their parents as it pertains to supervision, and they will be the gatekeepers to the amount of interactions that are done in conjunction with adults (Ungar, 2004). That being said, studies have noted that teens continue to need family support. If there is poor parenting, there is a greater likelihood of having a child that has poor mental health and behavior (Gerard & Buehler, 1999). Consequently, familial resources in the form of contact and control, unconditional acceptance, consistent emotional support, and attention and hope are often necessary and expected (Lefkowitz, 1986; Werner & Smith, 1992). The diagram below( Eastman k corona demonstrates the importance that family interactions have on adolescent behavioral outcomes.


  • Reflection:

Think about your own family and your relationships during adolescence. How would you characterize those relationships? What were the risk factors that you faced in your life? Was your family instructive in providing you the necessary resources to help you cultivate resilience? Think about the challenges that teens in foster care face within the system and as they age out of foster care. What are some protective factors that can minimize the potential for negative impact?



Peer Interactions and Associated Risks


  • Peer relationships are of paramount importance in adolescence, as identity constructs are influenced by the exploration and experimentation that adolescents partake in with others. Teens will increase their interactions with peers and with other groups and organizations in an attempt to find similarities and commonalities. Peer support has been correlated with successful academic outcomes, increased motivation, and better mental wellbeing (Brittian & Gray, 2014; Maurizi et al., 2013).



  • In attempting to expand their external support system, some adolescents may turn to gangs. St. Cyr and Decker (2003) have noted that there were some overlapping factors that may lead a teen to become a gang member: (1) family troubles, (2) gang presence within the neighborhood or community, and (3) a family member’s connection to a gang. Research has noted that gang members have delinquency and drug use rates at a much higher level than teens not involved in gangs (Thornberry et al., 1993).


  • Within adolescence, comparisons are made between the self and others in terms of appearance, bodily changes, athletic and intellectual abilities, popularity, social influence, and a multitude of other variables. As comparisons are made, inevitably vulnerabilities are noted and very often expose the individual to marginalization or bullying. Bullying has been defined as “negative actions, physical or verbal, that have hostile intent, are repeated over time, and involve a power differential between the bully and the victim” (Pepler et al, 2006, p. 376; Olweus, 1993).





Bullying and Suicide: Risk Factors


  1. Emotional distress
  2. Family conflict
  3. History of depression or other mental illness
  4. Alcohol or drug abuse
  5. Stressful life event or loss
  6. Easy access to lethal methods
  7. Lack of access to resources/support
  8. Relationship problems


Adolescence –Development in the Social Environment (2/2)

  • the adolescent:
  1. social environment,
  2. family and peer interactions.
  • the risk and protective factors to adolescents related to school systems, communities and neighborhoods.
  • issues of engagement/participation, violence, alcohol and drug use, college enrollment and employment.
  • the risks and protective factors that adolescents may encounter within school systems, neighborhoods, and communities.
  • issues related to adolescent college enrollment and employment.


  • Readings:


Brittian, A.S., & Gray, D.L. (2014). African American student’s perceptions of differential treatment in learning environments: Examining the moderating role of peer support, connection to heritage, and discrimination efficacy. Journal of Education, 194(1), 1-9.


Button, D.M., O’Connell, D.J., & Gealt, R. (2012). Sexual minority youth victimization and

social support: The intersection of sexuality, gender, race, and victimization. Journal of Homosexuality, 59(1), 18-43. doi:10.1080/00918369.2011.614903


Hawkins, J.D., & Weis, J.G. (1985).The social development model: An integrated approach to delinquency prevention. Journal of Primary Prevention, 6(2), 73-97. doi:10.1007/bf01325432


Jain, S., Buka, S. L., Subramanian, S. V., & Molnar, B. E. (2012). Protective factors for youth exposed to violence: Role of developmental assets in building emotional resilience. Youth Violence and Juvenile Justice, 10(1), 107–129. doi: 10.1177/1541204011424735


Lindstrom Johnson, S., Jones, V., & Cheng, T. (2014). Promoting successful transition to adulthood for urban youths: Are risk behaviors associated with career readiness? Social Work Research, 38(3), 144–153. doi:



Schools and Neighborhoods Fostering Belonging


  • Schools, neighborhoods and communities can be great resources to adolescents in a variety of ways. They can provide teens with protective factors, including positive peer interactions, mentors, and in improving skills and learning, all of which can build pride, esteem and cultural capital. However, schools and neighborhoods can also bring negative consequences, increasing risks to teens when those environments are poorly managed, constructed and when they contain negative elements.


  • Adolescents spend a large portion of their day in school engaged in learning based activities. Schools are also the environment that may affect adolescents’ development on many other levels (i.e., physical, psychological, social, and in terms of safety) (Marin & Brown, 2008). Schools can affect a student’s mental health through academic and social stressors; they are also the environment where mental health issues may first be diagnosed and treated (Marin & Brown, 2008). Students may receive direct physical care through a school’s healthcare services but their safety may be compromised if the school’s security is vulnerable to violence and gang related activities.

Schools can provide the teen with a sense of belonging and acceptance. Peers, teachers and administrators may make the teen feel valued and they may be a source of encouragement through this particularly challenging developmental process. Numerous studies have noted the positive correlation between school belonging and educational achievement, motivation and the internalization of academic values (Maurizi et al. 2013). In fact, receiving support from teachers is extremely important to adapting to a learning environment (Brittian & Gray, 2014). Involvement in afterschool programs also fosters psychological well being and stronger academic success (Maurizi et al, 2013). In stark contrast, when an adolescent does not receive peer and teacher support and when the school environment does not foster a sense of belonging, there is a lower level of academic achievement and the teen is more prone to feeling depressed and lonely (Brittian & Gray, 2014; Marin & Brown, 2008).


  • Neighborhoods and communities will also deeply affect adolescent development but the extent of the interaction and effect has not been studied as much as within school systems. Despite this limitation, however, research has noted that involvement in neighborhood organizations and activities will motivate adolescents to achieve greater academic success, particularly those that live in poor areas (Quane & Rankin, 2006). Teens who engage in civic activities are also less likely to become pregnant and to use and abuse drugs (Zaff & Michelsen, 2002). Additionally, when they engage in community activities, including the YMCA, Boys or Girl Scouts, religious youth groups, and organized sports teams, they are more likely to have better grades, an increased esteem and be more likely to be civic minded regarding volunteerism and work.



  • Social ecological model > Bronfenberrer


  • the risk and protective factors associated with both schools and neighborhoods. The risk and resilience factors discussed within the articles provide a very good foundation for the next few sections. Themes continue to reverberate throughout the complex layers of the social environment. Within Maurizi et al. (2013), read the introduction and the discussion sections carefully and note how neighborhood and school belonging have a particular effect on Latino youth. When reading Brittian and Gray, (2014), note the importance that a connection to ethnic identity plays on educational outcomes, most especially in situations where racism continues to be a pervasive challenge. Recall the points made about race and ethnic identity within Lesson 3 as you review the introduction of the article and the discussion sections.


Violence and Victimization


violence here as any harmful behavior such as bullying, hitting, robbery, and assault.


Stoddard, S. A., Whiteside, L., Zimmerman, M. A., Cunningham, R. M., Chermack, S. T., & Walton, M. A. (2013). The relationship between cumulative risk and promotive factors and violent behavior among urban adolescents. American Journal of Community Psychology, 51(1-2), 57–65.


Sexual Victimization


Rape – Forced sexual intercourse including both psychological coercion as well as physical force. Forced sexual intercourse means penetration by the offender(s). Includes attempted rapes, male as well as female victims, and both heterosexual and homosexual rape. Attempted rape includes verbal threats of rape.


Sexual assault – A wide range of victimizations, separate from rape or attempted rape. These crimes include attacks or attempted attacks generally involving unwanted sexual contact between victim and offender. Sexual assaults may or may not involve force and include such things as grabbing or fondling. It also includes verbal threats.



  • Youth who experience a trauma related to abuse, rape, sexual assault, violence and the urban environment (e.g., gang activity, poverty, drug use, etc.), are at a greater risk to experience mental health difficulties (McKay, Lynn & Bannon, 2005), due to the effects that such experiences have on brain activity.


  • Victims of trauma are more likely to suffer from depression, post-traumatic stress disorder, alcohol and drug abuse, and be prone to suicidal ideations (RAINN, Cniro et al, 2005; D’Augelli, Grossman, et al., 2006. McKay et al., 2005).


  • Note each section of the brain to obtain an understanding of its functionality and the role it plays in PTSD.





Alcohol and Drug Use


  • Due to the biological, cognitive and social changes that occur, it is almost expected that adolescence be a time for experimentation and exploration.
  • Peer pressures and just the nature of increased socialization exposes teens to various situations where the opportunities to drink alcohol and use drugs present themselves.
  • teens are at a significantly higher risk of developing an addiction compared to adults. The National Institute on Drug Use (Robertson, David, & Rao, 2003) provides a list of risk and protective factors that pertain to drug abuse.


  • Readings:


Robertson, E. B., David, S. L., & Rao, S. A. (2003). Preventing drug use among children and adolescents: A research-based guide for parents, educators, and community leaders (No. 2). Bethesda, MD: U.S Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse. Retrieved from !



Adapted from National Institute on Drug Abuse. (2014). Drugs, brains, and behavior: The science of addiction. Retrieved from


Underage drinking. (2015, November 12). Retrieved December 21, 2015, from


Salas-Wright, C. P., Vaughn, M. G., Schwartz, S. J., & Cordova, D. (2015). An “‘immigrant paradox’” for adolescent externalizing behavior? Evidence from a national sample. Social Psychiatry and Psychiatric Epidemiology, 1–11.



  • Note how these risks and protective points are similar to those that were discussed when reviewing violence and victimization. Also, notice how the domains relate directly to the social environment that you have been studying.


Preparing for Adulthood


  • A number of adolescents are participating in the work force before and after school, during school vacations and on weekends. As teens continue to construct and progressively develop their identities, they should become more aware of the interests, which may subsequently lead them to pursuing a particular vocation or career. Career readiness, the skills and knowledge to achieve an understanding of one’s future work plans (Johnson et al., 2014), is hinged on some of the social environmental factors we have reviewed. Parental guidance and monitoring, school academic resources, and community channels all play a significant role in getting an adolescent ready to move on to the next step of development, emerging adulthood.


  • Factors of risk and resilience stemming from various sectors of the social environment will impact a teen’s ability to engage in the notion of work and the idea of having a future, possibly pursuing a post-secondary education or in a skills/vocational training program.



Emerging Adulthood


  • the characteristics of emerging adulthood.
  • the differences between emerging adulthood and late adolescence.
  • factors that have led to the disenfranchisement of youth in the US.
  • the differences in identity formation in emerging adulthood.
  • Emerging adulthood is a transitional point between adolescence and early adulthood. As such, it absolves the individual from having to fully participate in normative operations and expectations that usually accompany adult development.



  • This time of development is characterized as a period for exploration and experimentation with different roles, occupational intents, educational pursuits, religious beliefs and relationships. Individuals place more focus on these aspects of their lives than they did in adolescence but there is still no full commitment undertaken. Emerging adulthood theory recognizes that the socialization experienced within family, peer groups, school and community,


Between Independence and Dependence



  • Experts have noted that socioeconomic factors, delayed marriage plans and the pursuit of education have led more youth to make the decision to live at home. There are some mutual benefits that parents and their kids get from living together. Besides the economic and emotional perks grown kids get from living at home longer, parents also benefit by having fewer depressive symptoms since they feel a part of their grown children’s lives (Byers et al., 2008; LeMoyne & Buchanan, 2011). According to a poll conducted by Clark University in 2013, 61% of parents said that they received little to no social support from their grown children (Arnett, 2015).


  • Sociocultural assessments and articles centered on education have noted that parental involvement is crossing serious lines for youth within the emerging adulthood stage of development, very much to their detriment. Helicopter parenting, the term given to caregivers who are crossing boundaries by becoming too involved in their grown children’s lives, is limiting the opportunities for youth to become self-reliant adults. The behaviors associated with being a helicopter parent are being especially noted within colleges and universities. Parents are waking their grown children up, transporting them, speaking to professors for them, reminding them of deadlines, completing application forms, and speaking with college administrators. A 2014 study from the University of Colorado (Barker et al., 2014) has determined that when parents provided children with a highly structured childhood, they developed less executive functioning skills (Barker et al., 2014). It was also noted that these students were more anxious, prone to depression and more rigid in their thinking (LeMoyne & Buchanan, 2011).


  • Reflection:

What are some of the cultural and political values/issues connected with the concept of “helicopter parenting”? Why might some believe there is a connection between helicopter parenting and white privilege? What are your thoughts?


Work and Relationships


  • Within the interactive play of dependence and independence that unfolds between parents/caregivers and their kids, many young people between the ages of 18 and 25 are taking steps to explore work and other relationships.
  • youth will explore different paths of employment in order to better understand which course is the one to settle on for the future. Consequently, unlike previous generations, the intention is not just to find a steady job to add to their stability. Rather, the task is centered on finding a job that will be the basis for their professional identity (Mayseless & Keren, 2013). Additionally, they will seek to explore the career that will be guiding them into adulthood and providing them with a meaningful life. Mayseless and Keren (2013) delve into the construction of a meaningful life and why it’s thought to be a major developmental task for youth.
  • using work venues as a way of tapping into their identities and quest for a meaningful life, youth are also engaging in various relationships in an attempt to understand more of what they like, physically and emotionally (Mayseless & Keren, 2014). Emphasis is placed on the casual, although this period may be interspersed with committed relationships or no relationships at all. There isn’t one linear approach, as relational situations are often complex and dependent on a few variables. As was noted in Munson et al. (2013), not all youth follow this progression of romantic exploration. For some, depending on their personality, environmental circumstances and culture, this period can be one in which they participate in a milestone of adulthood by getting married or having a child.


  • Maysless and Keren (2014) will also discuss romance in emerging adulthood, and the way it may add and, at times, subtract from the quest to construct a life that one is happy in pursuing. (Please note that romantic love and the forms it takes will be discussed in greater detail in the next lesson on Early Adulthood.)


  • Due to the relational experiments that emerging adults often participate in, they are at higher risk of contracting sexually transmitted diseases, including HIV, and of having an unwanted pregnancy.




The Disenfranchisement of Youth


  • time to experiment with work interests in order to gain a better perspective on one’s self and professional identities.
  • Lewis and Burd-Sharps (2015), youth disconnection continues to be both insidious and pervasive. The report assesses the current situation and presents the various socio-demographic variables as pertain to respective regions of the United States.


  • Readings:


Gross, A. (2015, June 11). How America’s cities “disconnect” youth. The Atlantic. Retrieved from


Measure of America of the Social Science Research Council. (n.d.). Youth disconnection in New York city. Retrieved from


Early Adulthood – Biological and Psychological Development


  • biological changes that accompany early adulthood development.
  • the Eriksonian psychosocial stage that pertains to early adulthood development.
  • attachment theory as it pertains to adulthood.
  • biological and psychological issues that may present challenges in early adulthood.


  • Readings:


Berzoff, J. (2011). Psychosocial ego development: The theory of Erik Erikson. In J. Berzoff, Flanagan, L., & Hertz, P. (Eds.), Inside out and outside in: Psychodynamic clinical theory and practice in contemporary multi-cultural contexts. (pp. 97-117). Northvale, NJ: Jason Aronson.



Rogers, A.T. (2019). Chapter 10. Development in Early Adulthood. In Human Behavior in the Social Environment: Perspectives on Development and the Life Course ( 5th ed.). New York, NY: Routledge.




  • Traditional markers in Western industrialized, middle class societies may include:


  • Financial independence and authority in decision making. Although, as we noted in emerging adulthood, a certain level of financial independence may not always signify adulthood.
  • Taking on work and graduate-related educational endeavors. Here, too, as was reviewed in emerging adulthood, there may still be a reliance on parental/caregiver’s care.
  • Developing a significant relationship and subsequently getting married (or formalizing the relationship).
  • Piaget : cognitive development, adulthood is a continuation of the intellectual progression that was started during adolescence (Austrian, 2008; Ginsburg & Opper, 1979). In the Formal Operational stage, individuals expand, refine and challenge existing belief systems. There is an expansion of abstract thinking which enhances problem solving and reflective thought processes.
  • Early adulthood is also marked with an increase in the person’s executive functions, which include coping, adaptation, self-assurance, and self-control.
  • Morally, early adulthood brings greater independence in decision making. There is an ability to contemplate more complex ethical principles. This is also a time when individuals start to develop a moral conscience. They move from seeking social approval through conformity to redefining and revising values and selecting behaviors that match those values. They start to give more to larger systems and they have more appreciation for community. Young adults also gain more understanding that social roles are relativistic, instead of rigid and prescribed.



Health and General Wellness


  • increased socialization and physical intimacy, health risks include STDs and HIV. Since the greatest fertility rates occur during early adulthood, there are also risks of unplanned pregnancies. Using early adulthood as the entryway into adulthood generally, there are some interesting statistics that should be noted regarding physiology and mental health.


  • Other common types of adult disabilities included those related to vision and self care, independent living, and memory. Interestingly, but not terribly surprising if you recall our discussion of risk factors within the social environment, individuals with lower levels of education and income, and unemployment tended to report more disabilities (Geggel, 2015). When examining ethnic and racial lines, it was shown that non-Hispanic black adults and Hispanics report more disabilities.



Kumanyika, S. K. (2019). A Framework for Increasing Equity Impact in Obesity Prevention. American Journal of Public Health, 109(10), 1350–1357.



  • Of course, health issues are not always the result of an individual’s investment in certain behaviors. It may also be directly related to the factors endemic to society or the family of origin. For example, stress can place an incredible amount of demand on the body. There are many types of stress, for example,stress may be rooted to the environment, socioeconomic class, family life, and acculturation, to name just a few.


Types of Stress:

  • Acute stress, the most common form of stress, is short-term and stems from the demands and pressures of the recent past and anticipated demands and pressures of the near future (APA, 2011).
  • Chronic stress, a long term form of stress, derives from unending feelings of despair/hopelessness, as a result of factors such as poverty, family dysfunction, feelings of helplessness and/or traumatic early childhood experience (APA, 2011). Chronic stressors associated with health disparities include perceived discrimination, neighborhood stress, daily stress, family stress, acculturative stress, environmental stress and maternal stress (Djuric et al, 2010; NIH, 2011).



  • Long-term activation of the stress-response system can disrupt almost all of the body’s processes and increase the risk for numerous health problems (Mayo Clinic Organization, 2011; NIH, 2011).

Allostatic load is the cumulative biological burden exacted on the body through daily adaptation to physical and emotional stress. It is considered to be a risk factor for several diseases — coronary vascular disease, obesity, diabetes, depression, cognitive impairment and both inflammatory and autoimmune disorders (Djuric et al, 2010).

Stress may prematurely age the immune system and could enhance the risk of illness as well as age-related diseases (Djuric et al, 2010; Geronimus et al, 2010).



Attachment ( attachment theory Bowlby and Mary Ainsworth)


  • attachment theory, originated by the seminal work of John Bowlby and Mary Ainsworth, is no longer connected solely to infancy. Rather, the theoretical constructs of attachment are being applied throughout the life developmental process. Bowlby believed that human beings must maintain some form of bond with others in order to create stability and security in their own lives (Bowlby, 1980; Sable 2008). The attachments that we form early in life become the working models by which we create parts of our adult personality and adult relationships (Bowlby 1969, Sable 2008). The forming of a bond or attachment is the means by which to create health and wellbeing.


  • Attachments in adult relationships are quite complex and multidimensional and consequently, it may be difficult to correlate them directly to attachment concepts (Sable, 2008). The convoy model has been used to account for various degrees of relationships in adulthood, with a perspective given to the individual in relation to the other within the environment (Antonucci et al., 2004).


  • Hazan and Shaver (1987), configurations of adult attachment styles within the context of intimate relationships have been formulated. Research on attachment has also attempted to create a linear progression of attachment styles from childhood through adulthood. Although the descriptors of the attachment styles are quite standard, the names of each may change depending on the author. The chart below presents two ways in which the descriptors may vary so that you may gain familiarity with the differences.


  • Readings:


Antonucci, T., Akiyama, H., & Takahashi, K. (2004). Attachment and close relationships across the life span. Attachment & Human Development, 6(4), 353–370.



Intimacy and Commitment


The need for both attachment and intimacy are significantly amplified in early adulthood as individuals move toward creating deeper and more committed relationships. The establishment of a couplehood through traditional channels of marriage or cohabitation publicly acknowledges the fact that individuals are committing to one another. Mate selection may be based on romantic reasons or that the individual represents certain ideals. Other factors for choosing a particular person may be proximity, congruence in values, desire for monogamy, and compatibility (Carter & McGoldrick, 1989).






Early Adulthood – Development in the Social Environment


  • the social environmental issues that impact early adulthood.
  • significant events/milestones that occur during early adulthood.
  • the changes that may take place in the family system.


  • Adults within the early stage of development continue to experience many of the social and cultural conditions discussed in emerging adulthood. That is, much of their attention is spent developing relationships on the various plains of intimacy. There is an increase in socialization through work and other channels, but young adults also start to engage in more committed long-term relationships. As was noted in the previous section on young adulthood, attachment is formed in terms of intimate or romantic relationships. Some may choose to marry and cohabitate, while others may opt for another pathway to intimacy.


  • Rogers (2019) notes that early adulthood is also marked by the testing out independence, completing educational goals, acquisition of employment that can support themselves, and perhaps moving into a space of their own or with similar phases roommates.


  • Rogers (2019) acknowledges that tasks or roles traditionally thought to be done in young adulthood have been taking place slightly later. As a result, a new life stage, emerging adulthood, has been conceptualized (Arnett, 2000). This life period is categorized as the development phase between adolescence and mid-twenties although this distinction is only made for those living in industrialized countries. The emerging adulthood phase was meant to help explain the time shift in the adult roles previously accomplished in younger adults. Other tenets of this newly defined age category include delayed childbearing and marriage, more frequent job changes, and an increase in risky behaviors.


Establishing a Family and Parenting



  • Meyer (1990) noted that a unit is considered a family when two or more people are joined together by bonds of sharing and intimacy. The family is an intimate environment, a constellation in which people live, and hopefully, thrive. According to Carter and McGoldrick (2005), a family unit may include extended kin, the community and cultural groups. Their definition of family certainly broadens the scope of the familial construction and it speaks to the diversity within the United States. Currently, American families are more “ethnically, racially, religiously and stylistically diverse than half a generation ago” (Angier, 2013).


It is important to note here that the above language may highlight how heterosexual, white, privilege, is used as the exemplar from which divergent models are compared. More contemporary examples include families of choice, which, while it is individualistic in what it encompasses, generally means a compilation of people that are chosen to be one’s family. See here for an article



  • The definition of family should be kept flexible and broad for the sake of our clients, so that we may better comprehend their narratives and accommodate the work needed in reaching their goalss. Families differ from other systems in an important manner – in other systems members may leave and be replaced at one time or another, but in families – the main component is the value of the relationship. Therefore, when one person leaves, they cannot be replaced (Carter & McGoldrick, 2005).


  • Along with establishing a family, many individuals in early adulthood also endeavor to have children. They may be single parents or share the responsibility with one or more people. Adapting to new roles as parents means a certain loss of freedom and the acquisition of new responsibilities. The new parents’ childhood experiences, as well as structural and socioeconomic variables, will strongly influence the family’s structure and the dynamic interplay between parent and child. Cultural values significantly affect how children are socialized, the values they acquire, and the behaviors they learn. For example, parents from ethnic minority groups expound goals that are more directed toward interdependence and family cohesion, instead of the individualism that is the preferential mode of behavior expounded by the European American parents (Suizzo, 2007).


  • Today’s families are also diverse in their constitution. Thirty-four percent of children today are living with an unmarried parent, which is a huge shift in the family structural unit considering that the same number for 1960 and 1980 were 9 percent and 19 percent, respectively (Livingston, 2014).



Mental Health


  • Mental illness is defined here as

(1) a mental, behavioral, or emotional disorder (excluding developmental and substance use disorders); (2) Diagnosable currently or within the past year; and

(3) Of sufficient duration to meet diagnostic criteria specified within the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

  • Individuals with a serious mental illness (SMI), have a mental disorder that seriously impairs their functional abilities and it interferes with or limits one or more major life activities. Although the statistics being cited are rendered for all adults, it is pertinent that the information be reviewed here in early adulthood since that is the developmental time frame when many mental illnesses manifest.


  • Long term socioeconomic disadvantages, economic stress, and lack of net worth (wealth) have been attributed to increases in mental health issues and stability (Mossakowski, 2008). poverty and mental health problems in children and subsequent health issues in adulthood (McDonough & Berglund, 2003; Mossokowski, 2008).


  • the link between childhood issues that have followed into adulthood has been all the more validated. Research has noted that adverse childhood experiences are directly correlated to poor health and life satisfaction in adulthood, including an increase of symptoms related to depression and anxiety. Additionally, Grollman (2014) explains the effects that societal discrimination has on mental and physical health.





Middle Adulthood – Biological and Psychological Development


  • the physiological changes that accompany middle adulthood.
  • the emotional issues that may arise due to the physiological changes that take place during middle adulthood.
  • explain the Eriksonian psychosocial stage that pertains to middle adulthood development.
  • Reflect on the meaning of midlife crisis.


  • Readings:


Rogers, A. T. (2019). Chapter 11. Development in Middle Adulthood. In Human Behavior in the Social Environment: Perspectives on Development and the Life Course (5th ed.). New York, NY: Routledge.


Torges, C.M., Stewart, A.J., & Duncan, L.E. (2008). Achieving ego integrity: Personality development in late midlife. Journal of Research in Personality, 42(4), 1004-1019. doi:10.1016/j.jrp.2008.02.006


  • people show a period of industriousness in their 30s, followed by a series of adjustments and readjustments between their late 30s and 40s, and responsibility and stability in their 50s and 60s (Lesser & Pope, 2011).


  • During midlife there is a general trend toward increased competence which is very much affected by the availability of resources. Individuals’ experiences are dependent on social and structural opportunities, as well as cultural and familial influences.


  • Many factors drive outcomes in midlife including: personality, health, family, as well as other social, economic, situational, cultural, and biological variables. Additionally, an individual’s own ego strengths will determine whether midlife is a time of real and perceived deterioration, or of increasing confidence and adjustment.


  • Rogers (2019), life events during middle age may stress an individual’s sense of self and self-esteem. Identities as a spouse or parent shift as partner relationships change and divorce occurs, or offspring leave the home thereby ending the period of everyday parenting responsibilities. “Narcissistic” injury may be particularly experienced when bodily changes lessen feelings of cisgender women or cisgender men, health, and physical strength.


  • Depression may be the result of shame, self-consciousness, a loss of confidence, and feelings of rejection (Goldstein, 2005). Similarly, cisgender men may experience climacteric, described as a change in life, where they are in a stage of reevaluation whether it be in their careers, familial relationships, and other areas of life (Rogers, 2019).


  • Cognitively, middle adulthood continues to be a time when there is peak strength in postformal thought, and overall development seems to be multidirectional.


A dapted from Santrock, J. W. (2008). Life-span development (14th edition). McGraw-Hill Education LLC.



The Aging Process


As was noted in the Introduction, middle adulthood usually is accompanied by various changes to the physical body. Please view the following video to learn more about the different systems of the body that may be affected by the aging process.

Even with some of the losses experienced in the normal aging process, the typical middle aged American is likely to be in good health. As we have noted in earlier discussions, however, health is dependent on genetic predispositions and is also based on one’s experience within the social environment in relation to factors such as gender, race, socioeconomics, and sexuality. Some factors experienced much earlier in life may also come to the fore in middle age and in later adulthood. For example, Raphael (2011) poignantly writes about the biological and health consequences endured by individuals in later life due to living in poverty during childhood.



The Wide Gap Between Generativity and Stagnation


  • the stage of Erikson’s psychosocial theory pertinent to middle adults.
  • the midlife crisis that can very much be related to Erikson’s discourse on stagnation.
  • the re-evaluatory process accompanying midlife may in fact bring forth changes in identity, particularly as it relates to sexuality.


  • generativity has been defined differently for male identified than for female identified. Males were thought to be generative in matters of work and females in matters related to the household. These limited perspectives have changed considerably in the last few decades, as exemplified by the manner in which creative capacities are applied in the pursuit of generativity in occupational success and economic security.


  • Generativity involves cognitive, emotional and social development and requires the ability to take action and make life decisions based on the needs and interests of others as well as oneself. In family matters, to be generative with raising children must include providing guidance based on one’s maturity and desire to nurture. Not having children does not preclude being generative, and having children in and of itself does not mean being generative. On the other hand, “stagnation” is often evident in people who have difficulties in the roles of parent or worker. Torges et al. (2008) describe how the generativity one has at midlife is helpful to achieving the ego integrity sought in later adulthood.







The Midlife Crisis


  • psychological tasks include accepting the end period of one’s life,
  • reviewing and evaluating the past,
  • deciding what to keep of the past and what to reject
  • considering possibilities for the future
  • Losses may significantly challenge important values, self-esteem, security and safety.


  • There have been various theoretical perspectives offering diverging views on the “midlife crisis”. At the same time, Levinson’s Theory of Adult Development would suggest that a midlife crisis is more a reflection of the “normal tasks” of adult development rather than negative responses to aging (Rogers, 2019).


In middle age, certain illusions about life may be challenged.

For example, individuals may for the first time perceive and assess the limitations of their age and their choices in a life partner. The prospect of never finding a mate, or the right partner may be felt more acutely.


  • the illness and death of parents necessitate changes in their own self-concept, a reworking of relationships and a possible revisit of earlier developmental issues.
  • The awareness of paths that have not been taken may generate regret or pressure to make changes.
  • Opportunities for career development and satisfaction may diminish.
  • Latent conflicts may come to the fore as challenges and other stressors present themselves.
  • Depending on the individual’s particular situation, illness and even death may loom, which exposes one to certain vulnerabilities and threatens any sense of immortality.


  • Abraham Maslow’s (1908-1970)

The crisis that is said to occur at midlife may in fact be a cultural phenomenon that is based on socioeconomic status and on Western value systems. It is nonetheless interesting to also assess this distinctive period from the perspective of Abraham Maslow’s (1908-1970) hierarchy of needs. It would seem that individuals experiencing a reassessment of their life, may be in the self-actualization stage that Maslow discusses in his theory.




Identity Revisited


  • Midlife is not necessarily a time of crisis, nor is it only a time of loss and decline. It may also be a time of achieving goals, sustaining satisfying relationships, finding a sense of safety, security and well being, freedom, stability and personal power. All of this depends upon the larger sociocultural context and values system, the individual’s particular circumstance leading up to midlife, and the current situation that one is attempting to grapple with in order to gain a better understanding of self.
  • One of the most fundamental tasks of adult life involves maintaining self-esteem and identity in the face of biological, psychological, and social stressors and losses that occur as we grow older. There is an existential quality to identity re-evaluation, as has been noted in Erikson and all the midlife undercurrents of “crisis.”


  • There is also something quite real and concrete in the identity redesign

Middle adulthood is a period when people make life altering decisions, and seek solutions to issues or problems that have been weighing on their minds for years.





  • When faced with imbalance –like disruptions or crises– systems tend to regulate cohesion in response to the stressors. As with other systems, families attempt to maintain or preserve balance. For example, a reevaluation of one’s life at midlife, or the death of a close family member will cause a disruption in the family system. Homeostasis is maintained in the family unit by some kind of intervention. When there is a death in the family, another family member stepping in to take over the role of the deceased can restore equilibrium.


Salvador Minuchin (b. 1921) is a physician who has worked extensively in developing structural family therapy. Minuchin (1974) noted that mechanisms will always work to re-establish order within family units when deviations bring them beyond the systems’ normal threshold tolerance.



  • Ahrons (2016) outlines the five transitional stages that constitutes the divorce developmental process. Though the stages are presented sequentially, some may happen simultaneously. Working with divorce requires a complex multilevel approach. We often need to be aware of our own biases and stereotypes and correct them by gaining knowledge of the emotional, legal and economic factors that characterize a divorce process.

Individual cognition: the decision

Family metacognition: the announcement

Systematic separation: dismantling the nuclear family

Systematic reorganization: the binuclear family

Family redefinition: the aftermath



  • Divorce presents dual tasks of managing physical and emotional separateness while maintaining ongoing familial connections. These processes of separateness and connectedness are particularly significant to family life and to the parent-child relationship. Lives need to be restructured so children can continue their relationships with both parents. There are many factors that contribute to the healthy adjustment of children, including meeting their basic economic and psychological needs and continuing to foster warm and loving relationships via the divorcing parents and other family members (Ahron, 2016).


  • One of the primary tasks of clinicians who work with divorced or divorcing parents is to facilitate the interpersonal and intrapsychic reconstruction and redefinition of the parent-to-child relationship and parent-to-parent relationship. The modified and redefined family system will present itself in the context of the social environment and will therefore interact with other family systems, peers, schools, community and society at large.




Work-Life Balance


  • As was previously noted, families work on a system of checks and balances. Rules and common operatives help to maintain equilibrium and allow the family unit to prosper and grow. Some of the consequences of disruptions in the family system are the result of external and structural forces such as a gender-based division of labor, an oppressive labor market that perpetuates gender and racial economic inequities, a dual welfare system, and insidious and systemic sexism in society (Bianchi & Milkie, 2010; Jang & Zippany, 2011).
  • These factors that infiltrate our lives both inside and outside the home, make finding equanimity and balance all the more important, while continuing to advocate for policies that reduce workforce equities.
  • Work-life balance is defined broadly as the satisfaction obtained with the “integration of personal time, family care and work with a minimum of role conflict” (Jang & Zippay, 2011, p. 84). Work-life balance issues affect many people from different strata of the social and economic spheres. However, the factors of work-life balance remain particularly important for single parents, individuals with disabilities and chronic health problems, low income families, racial minorities, and those individuals that care for multiple children and elders (Jung & Zippay, 2011).
  • Overall, the roles of parents/caregivers within families have really seen a change over the last few decades. Identified males are spending more time at home and engaging in home related activities and identified females are working more outside of the household.


Immigrants and Midlife



Late Adulthood – Biological and Psychological Development


  • the physiological changes that accompany late adulthood.
  • factors that contribute to HIV infections in older adults.
  • explain the Eriksonian psychosocial stage that pertains to late adulthood development.
  • the mental health issues that are prevalent in late adulthood.


  • Readings:


Chopik, W.J., Edelstein, R.S., & Fraley, R.C. (2013). From the cradle to the grave: Age differences in attachment from early adulthood to old age. Journal of Personality, 81(2), 171-183. doi: 10.1111/j.1467-6494.2012.00793.x


Erickson, K. I., Gildengers, A. G., & Butters, M. A. (2013). Physical activity and brain plasticity in late adulthood. Dialogues of Clinical Neuroscience, 15(1), 99-108.



Ferrer, I., Grenier, A., Brotman, S., & Koehn, S. (2017). Understanding the experiences of racialized older people through an intersectional life course perspective. Journal of Aging Studies, 41, 10-17. doi:10.1016/j.jaging.2017.02.001


Greenlee, K. & Hyde, P.S. (2014). Suicide and depression in older adults: Greater awareness can prevent tragedy. Journal of the American Society of Aging, 38(3), 23- 26


Rogers, A. T. (2019). Chapter 12. Development in Late Adulthood. In Human Behavior in the Social Environment: Perspectives on Development and the Life Course (5th ed.). New York, NY: Routledge.



  • There is also an increasing feminization of older adults throughout the world as women live longer than men, especially within the older than 80 age group (Murray et al., 2006).. Current life expectancy is 81.1 years for women and 76.1 years for men. The CDC and the Prevention’s National Center for Health Statistics reported that the US life expectancy age has decreased somewhat in the last few years due to increased deaths caused by opioid use and suicide.





  • Ageism, like racism and sexism, is a form of prejudice, which oppresses and limits those that are the object of oppression. The very act of holding ageist views shapes the perceptions of people, both young and old (Laws, 1995, p. 113). Ageism is manifested in a wide range of phenomena, on both individual and institutional levels stereotypes and myths, outright disdain and dislike, simple subtle avoidance of contact, and discriminatory practices in housing, employment, and services of all kinds (Butler, 1989). By the time younger individuals become elderly they have spent upwards of 50 years expressing and internalizing negative stereotypes of aging. Therefore, it isn’t surprising that older adults and younger age groups may have the same notion or hold the same stereotype of the aged.


Some myths about aging (Kelchner, 1999):


  1. Biological myths address the physical changes associated with the aging process. These include illness, unattractiveness, exertion, sleep, and sexuality. There is a belief that all older people are alike and will go through the same process.
  2. Psychological myths include rigidity, tranquility, unresponsiveness, senility, diminished intelligence, memory issues, lack of problem solving, diminished sexual interest, and dependency.
  3. Social functioning myths include withdrawal, isolation, alienation, stress, retirement, and the increase in leisure time.


  • Ageism is communicated through verbal and behavioral actions in many areas of society. Ageism is also structurally insidious on the macro level and it works its way to the mezzo and micro levels:
  • Policies
  • Services
  • Workplace
  • Organizations
  • Print and Electronic Media (representation/under-representation)
  • Schools
  • Neighborhoods
  • Families


  • Older adults grow to believe that they are not physically functional and may become more sedentary.The lack of thought-provoking activities given to late adults may produce cognitive stagnation.Chronic exposure to stereotypes related to limitations in physical activity may cause some older individuals to lose motivation to engage in forms of exercise. Physical activity (i.e., 30 to 60 minutes of moderate exercise) is very important for older adults. Older adults who have more positive outlook on the aging process will take better care of their health and may engage in more physical activity.



Body and Mind – Changing Perspectives


Cognitive Changes


  • Vivian Clayton, a neuropsychologist in California defined wisdom as containing three components: cognition, reflection and compassion. Unfortunately processing speed and the ability to recall information declines as one ages. Yet, quality of life in older adulthood is more strongly linked to clarity in thinking than it is to the speed at which information is processed. Additionally, older people have more information stored than young people, so it may in fact take longer to process (Korkki, 2014). Professor Ursula Staudinger of Columbia University discusses that true personal wisdom involves five elements: personal insight, demonstrating your personal growth, being self aware of your own life experiences, being aware of and understanding of priorities and values, and having a knowledge of life’s ambiguities (Korkki, 2014).


  • The initial stage of cognitive dysfunction is called age-associated memory impairment (AAMI). It is followed by even greater memory loss which is diagnosed as mild cognitive impairment (MCI) which may progress to dementia (e.g., increasing forgetfulness and disorientation). AAMI and MCI are limited to memory loss alone, whereas dementia results in the disruption of daily living and an inability to function normally.


  • Risks for cognitive decline and dementia include genetic factors such as being female, medical conditions including heart disease and diabetes, lifestyle choices such as smoking, or substance abuse. However, as noted within Erickson et al. (2013) cognitive strengths may be maintained by taking steps toward physical activity. Additionally, older adults should do as much as possible to work with modifiable risk factors such as (a better) diet, smoking (cessation), (increased) education, obesity and hypertension.


  • cognitive impairment, it is important to not overlook the fact that older adults with cognitive dysfunctions are often the target of abuse. Elder abuse has seen a spike in several parts of the world in recent years. Learn more about the factors associated with this form of behavior that targets a vulnerable population.



Physiological Changes and Concerns


  • that the physical and cognitive changes described in most studies are not necessarily inevitable but are profoundly influenced by extrinsic factors such as socioeconomic status, trauma, nutrition, access to quality health care, exercise, medications, and the presence or absence of satisfying relationships. Sexual potency begins to decline early in the developmental process (approximately in the 20s through early 30s), but without disease and certain mental health diagnoses, sexual desire and capacity continue into late adulthood.
  • chronic illness and death can be delayed through lifestyle changes including improvements in one’s diet, social activities, smoking, alcohol and drug cessation, and regular health screenings. Successful aging has been defined as “minimal debility past the age of 65 or so, with little or no serious chronic diagnoses, depression, cognitive decline or physical infirmities that would prevent someone from living independently” (Reynolds, 2014). Various forms of exercise are consistently noted as being beneficial to providing successful aging, particularly when activities were started earlier in adulthood (Reynolds, 2015).


Sink, K. M., Espeland, M. A., Castro, C. M., Church, T., Cohen, R., Dodson, J. A., … Williamson, J. D. (2015). Effect of a 24-month physical activity intervention vs health education on cognitive outcomes in sedentary older adults. The Journal of the American Medical Association, 314(8), 781–790.


Psychological Well-being


  • One obtains integrity by identifying with all humanity and coming to learn that everyone is interconnected. Additionally, psychosocial development in late adulthood asks that individuals make peace with the temporal existence of life. They are challenged to come to terms with the realities of life’s circumstances and its limitations. In so reflecting, they will come to develop feelings of wholeness and meaningfulness about their life. False beliefs and ego attachments are loosened. Self-integration may also lead to despair when one is dominated by feelings of regret and notions that they’ve wasted their lives (Marcia, 2014). The older adult is unable to let go of the feeling that they would do it all again if they had a chance.


  • A number of longitudinal studies have indicated that happiness in later adulthood is marked by diminished trauma and of loving connections in early life (Stossel, 2013).



Chopik, W.J., Edelstein, R.S., & Fraley, R.C. (2013). From the cradle to the grave: Age differences in attachment from early adulthood to old age. Journal of Personality, 81(2), 171-183. doi: 10.1111/j.1467-6494.2012.00793.x



  • For some older adults, depression and suicidal thoughts may be triggered by external events, including a disabling illness, a death of a spouse or loved one, retirement, and moving out of one’s home to a living assisted community (NAMI, 2009). Some of the suicides committed by older adults could have been prevented since many of them reached out for help before taking steps toward more tragic consequences: 20% see a doctor the day they die, 40% the week they die, and 70% the month they die (NAMI, 2009).


  • The increased use by this population may be attributed to the fact that Baby Boomers, the cohort born between 1946 and 1964, have a more relaxed viewpoint of drug use and may in fact have experimented with different drugs in their youth (McGarvey, 2015). Additionally, nursing home and long-term health care facilities are also prescribing, many times unnecessarily, medications that patients may become addicted to.



  • Readings:


Marica, J.E. (2014). From industry to integrity. Identity: An International Journal of Theory and Research, 14, 165-176. doi: 10.1080/15283488.2014.924413


National Alliance on Mental Illness (2009). Depression in Older Persons: Fact Sheet. Retrieved from:


Late Adulthood – Development in the Social Environment


  • the social environmental issues that impact late adulthood.
  • the factors that are challenging to LGBTolder adults.
  • issues that affect family systems in late adulthood.


  • Readings:


Ferrer, I., Grenier, A., Brotman, S., & Koehn, S. (2017). Understanding the experiences of racialized older people through an intersectional life course perspective. Journal of Aging Studies, 41, 10-17


Williams, M. N. (2011). The changing roles of grandparents raising grandchildren. Journal of Human Behavior in the Social Environment, 21(8), 948–962. doi: 10.1080/10911359.2011.588535



  • Late adulthood is certainly a time for social role transitions and of experiencing multiple life events. Some significant transitional life events that cause the most stress cluster in late adulthood and include retirement, death of a spouse or partner, institutionalization, and coming to terms with one’s own health and eventual death.


  • The retirement age has increased only slightly in the last 10 years to the age of 64 for male identified and 62 for female identified (Center for Retirement Research, March 2015). There are those seniors who continue to work out of choice and those who must for financial reasons. In early 2014, the Bureau of Labor Statistics projected that by 2022, 31.9% of people ages 65 to 74 will continue to be working.


  • Robert Atchley (2000) developed six descriptive phases of retirement that provide some understanding of the transitional process experienced by the individual. The stages are classified as remote, near honeymoon, disenchantment, reorientation, stability and termination.


  • Emotional and social intimacy may occur at any age if the opportunity to form new relationships is present. Our abilities to relate to and bond with one another are the most fundamental attributes of human beings. Valued friendships provide people with self-affirmation, feedback and shared meaning. Dependable and somewhat predictable friendships help produce a sense of security. Connections and interactions with close others will likely promote health and shape daily behavior choices (Martire & Franks, 2014).



Family in Later Life


increased longevity the post retirement period lengthens. For many people, the significance of the marital or partner relationship increases in late adulthood.

Relationships with children and grandchildren are also significant in late adulthood. Grandparents may take on roles that are influential, supportive, passive, authority-oriented, or detached. Surprisingly, multigenerational families are more common in recent years resulting in more interactions and exchanges across generations. These intergenerational exchanges are not unidirectional in that, although children often care for their agingparents, healthy older adultsalso provide significant assistance to their adult children



LGBT Elders


Challenges that LGBT elders encounter stem from three areas:


Access to services;

Lack of recognition from their families of origin; and

Nursing homes, where there are still issues related to homophobia. A study found that transgender elders, have a particularly difficult time in nursing homes due to discrimination and facilities being deficient in understanding the needs of trans clients (Perry, 2015).

Espinoza (2014), reports on some interesting findings of a survey study conducted of older LGBT people. Some of its key findings have been listed below.



Socioeconomics and Older Adulthood


In general, poverty rates increase with age across the late adult years. According to the Department of Health and Human Services, in 2016 there were over 4.6 million adults 65 and over who were living below the poverty level. See pages 9 and 10 of the 2017 Profile of Older Americans report for other statistical information related to the financial stability of older adults in the US.






Chronic Illness and Disability


  • what constitutes chronic illness and disability.
  • how chronic illness affects individuals along the stages of development.
  • the challenges that family systems face when addressing chronic illness.
  • the issues that surround chronic illness in the current medical/political climate.


  • Readings:


Corrigan, P.W., Druss, B.G., & Perlick, D.A. (2014).The impact of mental illness stigma on seeking and participating in mental health care.Psychological Science in the Public Interest, 15(2), 37-70.

doi: 10.1177/1529100614531398


Rolland, J.S. (1999). Chronic illness and the family life cycle. In B. Carter & M. McGoldrick (Eds.), The expanded family life cycle: Individual, family and social perspectives (pp. 492-511). Boston: Allyn and Bacon. doi: 10.1111/j.1365-2648.1996.tb00052.x




  • Increase Risk Factors – Excess body weight, tobacco use, high risk activities or behaviors, chronic conditions such as, diabetes, high blood pressure, back pain, anxiety or depression, frequent alcohol consumption or substance abuse.


  • Decreased and Protective Factors – Maintaining a healthy body weight, no tobacco use, healthy diet and sleep habits, regular exercise, moderate to no alcohol consumption, avoidance of high risk behaviors including substance abuse, maintaining a healthy stress level, and effective treatment of chronic health conditions.



The Caregivers


There are many U.S. adults who are providing assistance to chronically ill and disabled individuals and their demographics are varied.



Caregiving activities may vary but often include providing assistance with daily living activities, bathing, hygiene, food preparation and feeding, and dressing. Caregivers also provide help with medication dispensation, medical visits and interpretation, advocacy, and the logistics of navigating a complex healthcare system (Almgren & Diwon, 2008).



Barrett, L. (2013, November). Caregivers: Life changes and coping strategies. Retrieved December 23, 2015, from




Intellectual and Developmental Disabilities


  • According to the American Association of Intellectual and Developmental Disabilities and ARC, intellectual disability is characterized as having below average cognitive ability and three other distinctive features:


Intelligent Quotient (IQ) is between 70-75 or below;

There is significant limitation to adaptive behaviors associated with daily living related tasks (eating, socializing, hygiene); and

The onset occurs before the age of 18.”

An estimated 4.6 million Americans have an intellectual or developmental disability. Sometimes intellectual disability is also referred to as developmental disability, which is a broader term that encompasses other disorders that occur before the age of 18 (e.g., autism spectrum disorders, fetal alcohol syndrome etc.) (See ARC website for citations).


  • Children with learning disabilities must be given special attention. Social workers must do their best to protect children with learning disabilities from being sexually exploited. Smeaton (2015) outlines a few steps that social workers can follow in addressing such situations. Emphasis is placed on knowing that children with learning disabilities are just as or more than vulnerable as other young people, which makes it all the more imperative that safety measures be a part of every child’s care plan. Social workers must build a strong relationship with children to facilitate disclosure and then respond to each child’s communication and learning abilities. They must also be aware of how the child’s behavior can in fact reflect the nature of the sexual exploitation.


The Role of Spirituality in Chronic Illness


Nichols and Hunt (2011) explain that chronic illness doesn’t only affect the physical body of the individual but it can also have a detrimental effect on the person’s mental and spiritual well-being. Importantly, they provide clinicians with several suggestions as to how they may address the matter of spirituality with clients and ways in which counseling can be used to assist clients/patients in connecting to their spiritual beliefs as a conduit for comfort in coping with chronic illness.



Grief, Loss and Bereavement


  • Grief, loss, and bereavement will be examined through various theoretical lenses, particularly assessing the effect it has on individuals at different stages of life’s developmental process. Additionally, focus will be placed on the way that death and mourning are explained and attended to through faith, spirituality, and social network systems.


  • factors related to grief, loss, and bereavement.
  • how society and culture (macro/mezzo levels) play a role in the ways that loss and grief are experienced and processed.



  • Readings:


Baker, J. E. (2001). Mourning and the transformation of object relations. Psychoanalytic Psychology, 18(1), 55-73. doi: 10.1037//0736-9735.18.1.55.


Berzoff, J. (2011). The transformative nature of grief and bereavement. Clinical Social Work Journal, 39, 262-269. doi: 10.1007/s10615-011-0317-6


Brubaker, J.R., Hayes, G.R., & Dourish, P. (2013). Beyond the grave: Facebook as a site for the expansion of death and mourning. Information Society, 29(3), 153-163. doi: 10.1080/01972243.2013.777300


Damianakis, T., & Marziali, E. (2012). Older adults’ response to the loss of a spouse: The function of spirituality in understanding the grieving process. Aging & Mental Health, 16(1), 57-66. doi: 10.1080/13607863.2011.609531


Gerbino, S., & Raymer, M. (2011). Holding on and letting go: The red thread and adult bereavement. In T. Altilio & S. Otis-Green (Eds.).In Oxford textbook of palliative social work (pp. 219-327).New York, NY: Oxford University Press.


Kresitensen, P., Weisaeth, L., Heir, T. (2014). Bereavement and mental health after sudden and violent losses: A review. Psychiatry: Interpersonal and Biological Processes, 75(1), 76-97.


Long, S. O., & Buehring, S. (2014). Searching for life in death: Celebratory mortuary ritual in the context of the US interfaith families. Mortality, 19(1), 80-100. doi: 10.1080/13576275.2013.870985


Quinn-Lee, L. (2014). School social work with grieving children. Children & Schools, 36(2), 93-103. doi: 10.1093/cs/cdu005



Understanding Death and Mourning


  • As individuals progress through the life cycle, they tend to experience substantial losses. Loss can be associated with both negative (e.g., death of a loved one, declining physical health, financial insecurity), and positive (e.g., graduation, marriage) life events and circumstances. Losses can also usher in a variety of emotions, which may be directly related to the experienced change (e.g., retirement, relocation). Every loss causes a degree of disruption; the intensity is very much connected to the type and the meaning associated with the loss. Each kind of loss requires the individual to adapt to the new situation. It will challenge one’s ability to cope and it will also test one’s resilience.


  • Death and discussions of it often cause individuals in our society to experience anxiety. Death anxiety is a term used to describe the fear one has when thinking of one’s own death and the death of others. However, in not speaking about it, individuals are denied ways to develop coping skills about this particular phase of life. In the video clip featuring Dr. BJ Miller (below), he addresses the ways in which he’s faced his own death, while still taking valiant steps in living. His presentation is significant, particularly because he discusses death from both an individualistic and systems perspective.




A Study of Grief



  • Different stage-related models were developed to explain the emotional states and the notable sequences and patterns experienced by individuals when undergoing the mourning process. Elisabeth Kübler-Ross developed a five stage model to indicate the emotional responses that individuals experience when dealing with the death of a loved one. Her stages are identified in the diagram below.


Kübler-Ross, E. (2014). On death & dying: What the dying have to teach doctors, nurses, clergy & their own families. New York:



  • Damianakis and Marziali (2012) explore how grief is manifested in older adults who have experienced the loss of a spouse. They note and examine how spirituality plays a part in helping individuals readjust following the death of a loved one. Since social work and other clinical practices are progressively recognizing spirituality as an important resource for many of our clients, Damianakis and Marziali’s study is particularly noteworthy.


  • It is important to understand the consequences of loss and its accompanying bereavement for individuals. In particular, note how death is managed by the very young. Longitudinal and qualitative studies conducted with children experiencing loss note that it was very important for children to maintain some connection and attachment to the deceased person. Often it was done through dreams, waking dreams, by maintaining a personal object that had belonged to the deceased, by maintaining a personal interaction with the deceased in communicating thoughts and feelings, and by internalizing some of the goals of the deceased and working toward them (Silverman & Worden, 1992; Klass, Silverman, & Nickman, 1996).


  • Quinn-Lee (2014) explores some of these factors when examining the grieving process of children within the school setting. The age of the child will often dictate how death is confronted and in the manner in which grief is manifested. Since social workers may work with children, the article provides some important information on how to effectively recognize and help children who are experiencing loss. Social workers may also utilize the information to assist parents and caretakers who are tending to a grieving child.


The Mourning Process – From the Internal to the External


  • During times of crisis, particularly when there is loss and grief, people often turn to organized religion or other assemblies of faith to obtain support and guidance. They also use faith and religion as a means to celebrate the life of the person who died.


  • According to a 2015 Pew Research Center report, the number of US adults who do not identify with a particular religious group has increased. As the charts below indicate, those who identify as Christian still hold a majority in America but other religious identities and affliations are gaining traction.