Amongst other Developmental Considerations, there are Neurodevelopmental challenges faced by the young person: these include freshly enhanced cognitive complexities, that in turn face the young person with integrating a far more complicated set of thoughts about her own and others' feelings and motivations.

Brain changes in the adolescent - TED talk by Professor Sarah-Jayne Blakemore (UCL)

Brain changes:

The outpouring of gonadal hormones in early and middle adolescence is implicated in the major changes that occur in brain development at this stage of life. the changes in the adolescent brain are more dramatic than any since the earliest stages of childhood. During this phase, the previous efflorescence (branching and re-branching) of neurones, with the formation of huge numbers of synapses (chemical 'bridges' carrying nerve impulses between neurones), that dominates the antenatal period and the earliest years of life, effectively goes into reverse. The dominant process at this stage in life is then Synaptic Pruning, and this occurs in relation to use-dependent iterative processes, so that unused neural pathways are actively shed, whilst pathways with heavy traffic are reinforced. Put crudely, then, the adolescent development of the brain refines capacities so as to preserve those that are socially adaptive and advantageous, and losing those that are less relevant.

In effect, although some degree of 'plasticity' remains throughout life (we can to some extent relearn skills that have been lost after a stroke), the adolescent years are when the major brain architecture is laid down and finessed into its mature form, one that will have to carry that individual through adult life. An analogy that can be helpful to explain this uses the image of a nation's public transport system: this is the period when the brain's main motorway or railway systems are laid down. It is largely because of the sensitive nature of these changes, and the implications associated with getting a poorly adaptive "transport system" at the other end of adolescence, that early and intensive intervention in adolescence is justified.

Three 'functional nodes' have been proposed, which have more or less identifiable neural structures, and whichfucntion together to help to govern social interaction. These have been called the "Social Information Processing Network" (Nelson et al, Psychological Medicine, 2005). The first node (Detection) appears to fucntion by comparing incoming socially relevant information to pre-ordained (learned/remembered) 'social scripts'; it alerts the system if this information appears to err from these scripts. The second node (Affective) attaches an emotional reaction (generally fight/flight) to such instances. In the adolescent, crucially, the neurodevelopment of the third functional node normally lags about two years behind the development of the first two nodes described - this is the Cognitive Regulatory Node, and is a frontal function, which operates by inhibitting the impulsive affect-driven responses to such situations by applying higher order analysis to the situation, taking context into account, etc (Mentalization, in short).

Effects

As a result, there is a developmental hypersensitivity to mental states, which may overwhelm the adolescent's capacity to cope with thoughts and feelings except through action on his body or the world.

Although such adolescents may seem able to talk about feelings quite fluently, more abstract psychological ideas create great strain on the adolescent's system. This can lead to an apparently dramatic breakdown in Mentalization, withdrawal from the young person's SocialEcology and the intensification of Anxiety and enactments (Acting Out). The extent to which this leads to long-term difficulty depends not only on the inherent strength of the YP's psychic structures, but also on capacity of the environment to support his weakened mentalizing function.

Naturally, this is further complicated by the fact that the YP may undermine the capacity of institutions to support him. An important principle, in integrating the different therapeutic interventions, is to create such support as strongly as possible, by reinforcing the understanding (and thus the effectiveness of the support) available in the YP's social environment.