This paper describes the problems faced by severely troubled children and youth and outlines key elements of effective programs for treating these youth.
Severely troubled youths are defined as “those who have an emotional disturbance that significantly disrupts their everyday life at home, school, or in the community for an extended time (a year or more).” More often than not, severely troubled youth face multiple problems, such as substance abuse, delinquent behavior, and learning difficulties. Research has demonstrated the need to approach each problem in combination, rather than treating them separately. The normal behavior of rebellious teenagers is contrasted to that of severely troubled youths. Three reasons are identified for focusing on severely troubled youths: (1) if left untreated, severely troubled youths become severely troubled adults; (2) a heavy toll is paid by the youth and society if the problems are not addressed; and (3) effective and timely intervention efforts have been met with success in treating severely troubled youths. Although it is difficult to estimate the number of severely troubled youth in society, school records in Saint Paul, MN, suggest a 20 percent increase over the past 5 years in children receiving special education for emotional-behavioral disorders. The causes of emotional disturbance in youth are considered, as are the protective factors that reduce the risk for some youths, including meaningful involvement in school and community life. The key features of successful programs for severely troubled youths are outlined. Often a single approach is not enough to address severe difficulties and even the most successful programs are not effective in every case. Communities are urged to discuss how a community effort can head off serious difficulties for at-risk youth.