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Section 5
Child Adjustment Problems

Question 5 | Test | Table of Contents

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In the last section, we discussed the double dose resulting in decreased empathy, hyper-vigilance, and fear of retaliation that children both receiving and witnessing abuse can experience.

In this section, we will discuss Adjustment Disorder that can arise from children who have witnessed domestic abuse. Are you currently treating a child experiencing Adjustment Disorder?

Marcy, a 52 year old woman, had adopted Robbie, a 13-year old boy. Robbie's mother had been killed in a beating by her husband. Before being adopted by Marcy and her husband, Robbie had once been handcuffed to his bed for a day by his father after he had missed the school bus. As you know, Adjustment Disorder is a condition from which many children in abusive homes suffer. These children often become unable to form loving and intimate relationships and show almost no affection toward people. Let's look at Robbie's behaviors.

♦ Robbie's Behaviors:
1. Destructiveness: Robbie had set fires and once threatened to kill his sister's pet rabbit with a butcher knife.
2. Chronic Lying: In a session with Robbie, I noticed that he avoided eye contact for most of the session and that he lied about nearly every question I asked him. As with many children suffering from Adjustment Disorder, I found that Robbie had difficulties developing a conscience, thus making it very easy to lie and be distrustful of others.
3. Unusual Social Behavior: In addition to exhibiting destructiveness and chronic lying, Robbie also had unusual social behaviors. For example, if a classmate told him to run head first into a wall, he would do it repeatedly to the point of drawing blood on his forehead, just to gain attention. He only stopped when a teacher would intervene. He was an excellent artist but would only draw violent scenes.

Robbie also exhibited abnormal speech patterns. By this, I mean as soon as Robbie entered my office, he started with a stream of nonsensical questions and incessant chatter.

With children such as Robbie who are suffering from Adjustment Disorder, I often found, like you, that the home environment is usually the biggest factor in the child's recovery. Marcy, Robbie's adoptive mother, reviewed basic parenting techniques like defining expectations, being fair, expressing love, and allowing emotions. I felt Robbie hid his true emotions from others and himself by destructiveness, lying, unusually social behavior to gain attention, and incessant chatter.

♦ Advantages of Using Lists and Unfinished Sentences
I found the Unfinished Sentence in conjunction with making Lists helped to facilitate discussion concerning Robbie's true feelings.

The advantage of an Unfinished Sentence is that Robbie could write about the first thing that popped into his head without worrying about where he was headed with the topic. I supplied the beginning of sentences such as: "One thing I would change about my relationship with my adoptive family is……" or "I show my anger at my family member by….." This helped Robbie to be more open and honest with me in our sessions and gave me more of an insight into who Robbie was and what he needed help with.

In conjunction with the Unfinished Sentences, I used Lists to help my clients organize his thoughts and feelings about a large or unclear issue. Robbie was so overwhelmed with feelings of anger and frustration about the abuse he endured before joining his adoptive family that he could not organize or resolve the issue. Examples of Robbie's topics for List-Making included "family members with whom I feel angry," "Things I do when I'm angry," and "My problem solving techniques." Lists created a sense of order for Robbie in which he could see the meaning of his experience more clearly.

In this section, we discussed the three Adjustment Disorder Behaviors of Destructiveness, Chronic Lying, and Unusual Social Behavior, that many children in violent families suffer from. We have also provided you with two techniques of unfinished sentences and list-making to treat children with Adjustment Disorder such as Robbie. Would it be beneficial to consider using the Unfinished Sentence or List-Maing in the the next session you have with your Robbie? If so, you might consider replaying this section just prior to your session as a reminder about these techniques.

In the next section, we will discuss the Yo-Yo Syndrome children can experience when moving from home to home to escape danger.
Reviewed 2023

Peer-Reviewed Journal Article References:
Jouriles, E. N., McFarlane, J., Vu, N. L., Maddoux, J., Rosenfield, D., Symes, L., Fredland, N., & Paulson, R. (2018). Mothers’ posttraumatic stress and child adjustment problems in families seeking services for intimate partner violence. Journal of Consulting and Clinical Psychology, 86(7), 604–614.

Owen, A. E., Thompson, M. P., & Kaslow, N. J. (2006). The mediating role of parenting stress in the relation between intimate partner violence and child adjustment. Journal of Family Psychology, 20(3), 505–513. 

Piotrowski, C. C. (2011). Patterns of adjustment among siblings exposed to intimate partner violence. Journal of Family Psychology, 25(1), 19–28.

 Thomas, K. A., Mederos, F., & Rodriguez, G. (2019). “It shakes you for the rest of your life”: Low-income fathers’ understanding of domestic violence and its impact on children. Psychology of Violence, 9(5), 564–573.

Tibubos, A. N., Schermelleh-Engel, K., & Rohrmann, S. (2020). Short form of the State-Trait Anger Expression Inventory-2. European Journal of Health Psychology, 27(2), 55–65.

QUESTION 5
What are two techniques used to treat children with Adjustment Disorder to facilitate the exploration of feelings and organize or resolve issues? To select and enter your answer go to Test.

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