Children Health | Children Care

In earlier articles, I explained one basic mental health

category called conduct disorders (C.D.s), the child at

highest risk of extreme violence, and

emphasized how you must work differently with C.D.s

compared to any other kids. Hopefully, I successfully

conveyed how critical it is to thoroughly understand what

makes this kid “tick,” and to work with them differently

than everyone else, or you may find yourself or others

in dangerous situations. In that piece, I devoted

extensive time to teaching you “all” the in’s and out’s

of working with this complex, potentially dangerous youth.

I want to move past the youngster at highest risk of

violence so I can now address the next two groups of

high risk students in this article.(Our web site

has some additional information on conduct disorders

if you need more info on that group now. Visit

http://www.youthchg.com/hottopic.html.)But, remember that

these pointers will be no substitute for

thoroughly updating your skills on such a challenging kid.

Now that you know a bit about C.D.s, the youth at

top risk of violence, let me tell you about the

students who follow next in risk. That is the focus of

this article.

** Youth at 2nd and 3rd Risk of Extreme Violence:

These youth are not nearly at as great a risk as the conduct disorder.

We will cover each of these 2 types of youth separately, but must stress

that the risk for both of these 2 groups drops off dramatically

from that posed by conduct disorders. Remember that when any child

appears to be potentially violent, you take that concern seriously,

regardless of whether the child was on our list. This list is meant only to

guide you when you lack any specific events or circumstances that

show you how to apportion your time, supervision and other resources.

** Thought Disorders: The risk posed by thought disordered

children is probably far less than that of the conduct disordered

youth. Although #2 on this list, it is a rather distant second choice.

Part of the explanation is that there are probably a lot more

conduct disordered kids than thought disordered ones. The other

reason that explains the somewhat distant #2 status is that the

thought disordered child may be well-intentioned, kind, and loving

at times. The conduct disorder child really never is able to care

about anyone else. Another reason to explain the distant #2 status is

that often the thought disordered child will act in rather than act out.

They often will pose a harm to self rather than others.

Unless you work in a treatment setting, just a very small fraction of

the children you work with, may have what mental health professionals

call a thought disorder. While the thinking of the conduct disorder is

clear and lucid, that assumption is not always true for the

thought-disordered child. The child who has been diagnosed with this

type of problem by a mental health worker, has very serious problems

with their thinking. The child may hear voices or see visions that no one

else can, for example. The child may believe demons or devils are

governing them. If the voices, for instance, tell the child to hurt

someone, then the child may feel compelled to do it. This is where

potential danger could lie.

The thrust of working with a diagnosed thought disorder is often

on proper medication, although focusing on skill building and structure

are also very important. Perhaps the single most important concern

will be that the child takes any prescribed medication regularly and

properly, because when properly medicated, this child may

function almost normally in many ways. When not correctly medicated,

this child is at the mercy of any demons, visions, voices or upsetting

thoughts that pop into their head.

** Severely Agitated, Depressed Kids: The occurrence of extreme

violence by severely depressed, agitated children probably also

greatly lags behind the risk posed by conduct disorders. This term

refers to a child who has experienced extremely severe problems

with depression, and also struggles mightily at least once with

agitation. Many kids, especially teens, struggle with depression,

but this group endures some of the most prolonged, profound,

deep depression; this should not be confused with typical

adolescent ups and downs. When the severely depressed and

agitated child also abuses substances, the problem can be

magnified greatly depending on the interplay of the substance

and the existing emotional concerns. Crisis, sudden changes and

the usual adolescent successes and failures can quickly

de-stabilize this child who is already seriously struggling;

these events can have the effect of the straw that broke the

camel’s back.

Any emotion that a child has trouble managing may get acted out

or acted in. Depression is generally acted in. Many view it as

anger turned inward: the child withdraws, reduces their activities,

may eat less, etc. But, depression can also be acted out. Feeling

cornered, unable to endure any more pain, some children will act

out, sometimes lashing out in very severe ways. All things in nature

strive to come to a conclusion. Storms eventually dissipate, the

rain ultimately gives way to sun, and even the snow will eventually

end. Humans, as part of nature, also tend to move towards resolution.

For some children, extreme violence can be the flash point that

offers that resolution. When there appears to be no hope, perhaps

the child believes that there is nothing left to lose. Depression can be

tough on adults, but couple the depression with a child’s lack of time

concept, lack of perspective, their impulsiveness, immaturity, and

resistance to understanding the link of actions to final outcomes,

extreme violence can be grabbed as perhaps a solution. If this

vulnerable child becomes involved with a conduct disordered

peer, you can see how under certain circumstances, that could

become a deadly combination as the depressed, agitated child may

join in the acting-out.

To help this child, alleviating some of the torment will be critical.

Help to manage anger in socially acceptable ways, tempering the

depression, and alleviating some of the agitation can keep this

child from remaining at the level of extreme discomfort they

currently experience. If this child receives useful aid to vent

the agitation and give some light to the depression, any risk of

extreme violence can be significantly impacted. Of the three

risk categories, this group’s concerns are potentially the most

amenable to intervention by you, and is of the three, the

most hopeful diagnosis. You can have much lasting impact

on this child.

**Appraising the Risk: Now you can look at your class or group

and not just wonder where the where the potential, serious

danger would come from. Now that you have more refined

guesses about which youth potentially pose potential danger,

here is a way to better rank that risk in your mind. A juvenile

court judge in Springfield, Oregon, said after the shooting

there, that so many kids are like “little match sticks waiting

to be lit.” To adapt that image a bit, here is how you can

apply that thinking to the three at-risk groups listed here.

You can imagine that the conduct disorder is already lit;

a flame is burning. Whether that flame becomes smaller,

flares larger, or creates an inferno, is anyone’s guess, but

the flame is burning always, the potential for disaster is

always there.

The thought-disordered child may be like a pilot light,

a tiny flame that is always lit, but is fairly unlikely to

inexplicably get massively bigger or out of control. Properly

shepherded and assisted, this light may stay forever just a

benign flicker. Unshepherded or inadequately assisted,

however, this flame can get bigger, even flare out of

control.

The extremely agitated depressed child may be the

unlit match stick that the judge visualized. Outside

factors will likely come into play to incite any flare-up.

Outside forces could include peer pressure, crises, substance

abuse, family woes, or just mounting problems that fuel the

agitation and create a profound, all-encompassing sense of

desperation that leads the child to “spontaneously” combust.

Like the thought-disordered child, the severely agitated

depressed youth can often be so readily aided if the

community can identify them, then consistently care and

effectively intervene.

** In Summary: If you work with kids, but you are not

a mental health professional, maybe it’s time to at least

learn some of the basics about children’s mental health.

And, no matter what your role with children, please

consider it your obligation to train your kids to be peaceful.

That may be the most important contribution you could

make in a world that so thoroughly ensures that every

child knows so much about extreme violence, and so little

about anything peaceful.

Hopefully, you now have more mental health basics for working

with juveniles who pose extreme classroom management problems.

Remember, if you wish to get more thorough information, click

over to our site for free magazines, strategies, articles and

much more– all designed to assist educators to better manage

and instruct problem and difficult students.

By: Ruth Wells

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