Resilient Factors In The Life Of Pauline example essay topic

(1) The following study discusses the risk & resilient factors in the life of Pauline, a 16 year old NZ European / Maori teenager. These factors involve her family life and its importance to her: the value of education and the consequences of leaving school without qualifications; how activities such as church participation can be helpful and the problems involved with having nothing to do; the effects of substance abuse; early sexual involvement and its risks; the risk of suicide, suicide attempts & ideation. The likely impacts of all of these factors on her current & future health status will be considered. Key words or concepts: resilience or protective factors: is factors that buffer young people from risks & promote positive youth development. Risk behaviour's: dangerous behaviour that involves a threat to health & well being adolescence: the developmental period between childhood and adulthood mentor: someone whom the young person can trust connectedness: feeling cared for, close to and enjoying either family, school or an adult mentor. The study will follow the format using the HEADS framework.

This was devised in 1972 by Eric Cohen, a Specialist in adolescent medicine in Los Angeles. It is a method used to interview & assess young people & is an acronym for the following; - (H) home environment (E) education & employment (A) activities & interests (D) drugs (S) sexuality (S) suicide (2) Home Pauline has a number of risk and protective factors happening for her in her home situation. Until the age of three years she was the focus of her own two parents. At the age of sixteen she is positioned between her Father's new family of a partner & three very young children (who Pauline lives with) and her Mother, partner and their two young children. She has expressed dissatisfaction regarding her irregular contact with her Mother who lives in another town. Early attachment in childhood sets the stage for acting out behaviour's in adolescence (Brennan 1993).

Pauline clearly felt nobody cared for her, that her Father was more interested in her stepmother and children, she felt this so strongly it led her to running away from home. She was at risk as she became involved with criminal activity & subsequently Youth Justice. The measure would have been the attachment she experienced as a small child. Pauline expresses that there is a lot of arguing with her Dad & Stepmother.

This provides risk for her as serious conflict between caregivers and children can put them at the risk of the problem behaviour's (Channing Bete Company 2004). The separation of a child's parents can put him / her at risk especially if there are a lot of changes or that the child does not have a good relationship with at least one parent (Burt 2002). It has been indicated in a study that girls in two parent families are less likely to act out risky behaviour's than those in single parent families. (M.D. Resnick et al 1993). Children or adolescents who are well reasonably well adjusted after divorce nearly always come from an environment where there is a firm, responsive, nurturing, supportive adult (Henderson 2002).

Pauline's recent history is shows this sort of environment has not been there for her. A factor that protects an adolescent is having an adult in her life she can trust and with whom she can confide. The presence of an adult Mentor in an adolescents life helps reduce the participation in risk taking behaviour's. (Beier et al 2000). Pauline reports having a close relationship with her Aunty Sarah who lives down the road with her Nan. She is able to confide with Aunty Sarah and feels close to her.

This is a significant protective factor for Pauline. (3) Having parents of different ethnic origins can be a source of conflict for a young person. Pauline's Mother is and her Father is Maori. It is an important foundation for Maori to acknowledge their as this is where much of their identity & support comes from. (Adolescent Health Group Research Group 2003). One of the contributing risks to health is reduced support (M. Durie 2001).

Pauline is aware of her i wi links and does see her extended family at times. This factor will act in her best interests The government is recognising that Maori identity and access to cultural, social & physical resources is a health issue that they set down a strong foundation for health and legislation has been passed to assist in the respect for people's needs in these areas (M. Durie 2001). Pauline's home life has been impacting significantly on her health & causing her to enter into risk taking behaviour's, but protective factors such as her extended family contacts are having a positive influence. Education / Employment It can be assumed that Pauline left secondary school at the age of fifteen or even younger. However Pauline is attending an Alternative Education School which she says she quite likes & attends regularly.

These schools are for students who have had behaviour al problems such as repeated expulsions, pregnancy, child care responsibilities and who are not allowed to attend regular secondary schools. The young people who attend New Zealand Alternative Education schools have significantly more health issues than those at main stream schools (S. Denny et al 2004). Her enjoyment and attendance are indicative of positive things happening for Pauline and she has stated she wants to stay there as long as she can, until she finds a job. An emotional shift of dependence from her home life (which is stressful for her) to an extra familial one is helping her (E. Werner 1993).

A large part of this is to do with her (4) relationship with her tutor with whom she gets on well. Pauline has an aunt & a tutor, two adults in her life she has a good relationship with. Results of the NZ study showed that Alternative Education students largely felt they were a part of the school and people at the school really cared about them. A significant protective factor for Pauline is her teacher getting to know her well. This tends not to happen in secondary schools unless a student is seen as having problems but in the AE schools the 'Teacher got to know you' (S. Denny et al 2004). Feeling connected to school can be more protective than any other factor including family protectiveness (A.E. Bonny et al 2000).

When there is an adult mentor on the scene and there is a strong positive relationship with the adolescent there is often a decrease in the participation of high risk behaviour's (S. Beier et al 2000). In the Kauai Longitudinal study it was evident amongst the participants that a favourite teacher became a role model for them as well as a friend & confidant (E. Werner 1993). New Zealand schools are places these days where health requirements can be met emotionally and physically with the medical and counselling resources available, also where achievements can be made both in the classroom, in sports and the arts. The outcome of this can be good as far as helping Pauline adapt to adult life (Adolescent Research Group 2003). If she leaves school too early the cost for her could be poorer paid employment, less options in life and less work satisfaction. These factors can lead onto depression, substance abuse and criminal activity.

(Burt 2002) (These factors have / are already happening in Pauline's life & she has stated she wants to leave them behind). For Pauline apart from acquiring the skills required for adult life at her Alternative Education programme she is also feeling cared for and this is a crucial requirement for any young person especially if the care needs are not being met at home. (C.A. McNeely et al 2002). Her Alternative Education school is a significant positive factor in building resilience in her life and assist in having positive effects on her health status. (5) Activities Activities such as sports, the arts and hobbies if loved can be another resilient factor in a young person's life. If young people are not unusually talented and their families are not intact, but they love hobbies & interests they find solace. (E. Werner 1993). Pauline enjoys hanging out with her friends but she states that she doesn't have much to do except watching videos and hanging about the town centre.

There is concern in this age in which we live that there is too much time taken up watching TV as it produces inactivity which contributes to such problems as obesity and being unfit. These health concerns lead to diseases such as diabetes and heart disease. (Adolescent Health Research Group 2003). To expand on this The Whakatau Mauri Foundations for Health expresses concern that physical inactivity can lead to depression and inability to cope, a decrease in cognitive functioning and lower self est eem (M. Durie 2001).

However, Pauline has recently been attending a church and reports this to be a positive change in her life. High risk behaviour's are less likely to be engaged in if there is an affiliation to a religious institution. Findings suggest that connectedness with these institutions enables positive peer and adult relationships & social experiences (M.D. Resnick et al 1993). Church historically is an institution which promotes community, can attract a variety of age groups, encourages leadership, fun activities and provides a framework of belief, faith, hope, values and purpose. (E. Werner 1993).

If Pauline is reporting positively regarding her recent church attendance it is quite likely that she is responding to what the church stands for (as mentioned above). Church and having faith can also be helpful particularly later on in adulthood to be able to put past pain and experience into some sort of positive life meaning context instead of the memories always being a negative factor (E. Werner 1993). Hopefully Pauline's attendance will be long term, if so benefits explained should impact on the different risk areas of her life therefore effecting good health outcomes. (6) Drugs Research has identified alcohol and other drug use as one of five adolescent problem behaviour's that lead to risk (Channing Bete Co 2004). Pauline uses marijuana several times a week, she binge drinks alcohol most weekends and some week nights. She also smokes cigarettes habitually.

It is probable that she started this substance use as early as fifteen years when she was living on the streets. This puts her at greater risk of having drug problems than if she starting using at a later age for example nineteen. (Channing Bete 2004). Studies such as one by the Institute of Psychiatry in London of 759 people born in Dunedin New Zealand are showing that teenage use of marijuana increases the risk of psychosis or schizophrenia in later life. (K. Atkinson 2005). Apart from the threat to Pauline's mental health, damage can occur to all her body systems if there is prolonged use of the drug. Its addictive nature is worse than alcohol as its elimination from the body can take up to three days (M. K Schuchard?

1992). Also studies have suggested that 'marijuana is three to seven times more addictive than alcohol and that levels of compulsive daily use escalate with rising potency, easier availability and social acceptability' (M.K. Schuchard? 1992 p 5). A concern for Pauline is that she uses the substance several times a week.

A small proportion of those who use high doses of a drug like marijuana can eventually lead them onto clinical dependence & harm (Y. Bonobo et al 2005). While under the influence of alcohol and marijuana Pauline is at risk of not being in control and can be at risk of such things as rape, accidents, drug spiking in drinks and traffic accidents as these substances reduce the ability to judge and communicate in threatening situations. (N. Rappaport et al 2004). Outcomes, can change someone like Pauline's health forever, as the adolescent is often not cognitively equipped to foresee them (K.J. Elliott et al 1999). Nicotine addiction is a health concern and a high proportion of Maori women smoke (nearly 60% of Maori women aged between 15 & 44 years smoke) (M. Durie 2001). The results of long term, frequent cigarette smoking is the risk of lung cancer, heart disease, diabetes, plus a myriad of other diseases of which Pauline could run the risk of (7) contracting (M. Rutter 1993). The three substances alcohol, tobacco and marijuana play a large part in Pauline's life.

Unless she understands the risks involved and 'puts the bad stuff behind her' as she has expressed, her health outlook is at risk of what is described above. Sexuality Pauline is living at home with her eighteen year old boyfriend of eight months. He works as a panel beater. They are sexually active & use condoms most of the time.

Pauline is at risk of being pregnant as condom use needs to happen all of the time. That Pauline is involved at her age with Jack has both resilient and risk factors. If Jack is special to her, gives her support, makes her feel loved, needed & valued then her self esteem can be elevated (E. Werner 1993). However, with the risk of pregnancy at such a young age, comes the high possibility of wanting to keep the baby and facing the many adjustment problems associated such as low income, pressure on the parents therefore probable discord, inability to attend Alternative Education and therefore the consequences of lack of achievement and low self esteem (D. L Bennett). The teenage birth rate in 1997 was five times higher for Maori than European / Pakeha.

Maori who became pregnant were much less likely to have an abortion. If Pauline were to have a child as a teenager he / she is likely to be disadvantaged with poorer health & education, more prone to abuse and the cycle of disadvantage has a high chance of continuing into the next generation. (N. Dickson et al 2000). Protective factors in the sexuality area would hopefully help Pauline such as her Alternative Education programme where she would hopefully be receiving sex education plus her two adult mentors and the church, encouraging her to make good choices and helping her to understand why the choices are beneficial to her. (8) Suicide A change in parents, a lack of maternal care and protection, unsatisfying parental attachment and low achievement in school qualifications, are some of the factors that contribute to risks in suicide attempts and suicide ideation (D.M. Fergusson 2003). l Pauline has experienced a these factors in her life. There is a strong relationship between substance abuse and suicidal ideation (S.G. Forman et al 1998). It is relatively common for young people to experience suicide ideation and carry out suicide attempts.

As has been outlined, Pauline has many risk factors in her life which would impact on her susceptibility (D.M. Fergusson 2003). In New Zealand, suicide thoughts are common among teenagers and more common in females. It was reported in a survey that amongst fifteen year old students 33.9% of female students thought about killing themselves (Adolescent Health Research Group 2003). Pauline made one suicide attempt while she was on the streets by cutting her wrists, unfortunately she has a constant reminder of her attempt due to the scars, which cannot be helpful to her self esteem. Emotional well being is an important protective factor for adolescent girls (I.W. Borowsky et al 2001). Pauline says her mood is about 'five out of ten' where ten is really good and naught is really bad.

Her score is not very impressive but she does state things are getting better and that she 'wants to put the bad stuff in her life behind her' (including removing the tattoo she has). Pauline does show good cognitive processing (a protective factor) as she seems to want to be able to learn from situations, this is evident when she makes a comment such as 'not ever wanting to go back to the streets as she doesn't want to live like that anymore. ' Also it has been noted her one reported attempt was while she was on the streets, a time when she was in a particularly bad space. Pauline has a balance of risk and protective factors happening for her with regard to suicide. If the protective factors she is beginning to build into her life remain and continue to grow the equilibrium between them & the risks has the chance of becoming more stable and will impact positively on her health. (9) Summary This study indicates risk factors for Pauline including an unhappy home situation with her Dad's new family where she has felt nobody really cared whether she was there or not, her unsatisfying relationship with her Mother, her alcohol binging, cigarette smoking & marijuana use, her limited activities, dropping out of school at a young age, early sexual involvement and low mood.

Protective factors bringing some resilience to her life include adult trust with her Aunt Sarah and Tutor, awareness of her i wi links and contact, her enjoyment and regular attendance to at Alternative Education and her goal of wanting to stay there until she gets a job, recent enjoyable church involvement, her ability to learn from situations and wanting to make positive changes in her life. The likely outcomes for Pauline's health are hopeful but the significant concerns that could tip the equilibrium are firstly the early onset in her life of a relationship with Jack and their sporadic condom use, as a probable outcome for Pauline is pregnancy and wanting to keep the baby, and secondly her alcohol, marijuana and nicotine use and the level of addiction that may have built up..