Adolescence is a time when youth make decisions, both good and bad, that have consequences for the rest of their lives. Some of these decisions put them at risk of lifelong health problems, injury, or death. The Institute of Medicine held three public workshops between 2008 and 2009 to provide a venue for researchers, health care providers, and community leaders to discuss strategies to improve adolescent health.

This informative and useful volume provides a substantial contribution to the understanding of adolescent risk behavior. The book combines theoretical analysis and the findings of a broad-based research project, with accessible presentation throughout.

Adolescence is a developmental period of accelerating physical, psychological, social! cultural, and cognitive development, often characterized by confronting and surmounting a myriad of challenges and establishing a sense of self-identity and autonomy. It is also, unfortunately, a period fraught with many threats to the health and well-being of adoles cents and with substantial consequent impairment and disability. Many of the adverse health consequences experienced by adolescents are, to a large extent, the result of their risk behaviors. Many adolescents today, and perhaps an increasing number in the future, are at risk for death, disease, and other adverse health outcomes that are not primarily biomedical in origin. In general, there has been a marked change in the causes of morbidity and mortality among adolescents. Previously, infectious diseases accounted for a dispro portionate share of adolescent morbidity and mortality. At present, however, the over whelming toll of adolescent morbidity and mortality is the result of lifestyle practices.

Adolescents obviously do not always act in ways that serve their own best interests, even as defined by them. Sometimes their perception of their own risks, even of survival to adulthood, is larger than the reality; in other cases, they underestimate the risks of particular actions or behaviors. It is possible, indeed likely, that some adolescents engage in risky behaviors because of a perception of invulnerabilityâ€"the current conventional wisdom of adults' views of adolescent behavior. Others, however, take risks because they feel vulnerable to a point approaching hopelessness. In either case, these perceptions can prompt adolescents to make poor decisions that can put them at risk and leave them vulnerable to physical or psychological harm that may have a negative impact on their long-term health and viability. A small planning group was formed to develop a workshop on reconceptualizing adolescent risk and vulnerability. With funding from Carnegie Corporation of New York, the Workshop on Adolescent Risk and Vulnerability: Setting Priorities took place on March 13, 2001, in Washington, DC. The workshop's goal was to put into perspective the total burden of vulnerability that adolescents face, taking advantage of the growing societal concern for adolescents, the need to set priorities for meeting adolescents' needs, and the opportunity to apply decision-making perspectives to this critical area. This report summarizes the workshop.

Rich with illustrative case material, this book guides mental health professionals to break the cycle of at-risk behavior by engaging adolescents and their families in home, school, and community contexts. The authors explore the multigenerational patterns that shape the lives of poor and ethnic minority adolescents and present innovative strategies for intervening beyond the walls of the agency or clinic. Grounded in research, the book shows how to implement both home-based family therapy and school-based achievement mentoring to provide a comprehensive web of support. Building on the earlier Reaching Out in Family Therapy, this book reflects the ongoing development of the authors' multisystems approach and many other important changes in the field; the majority of the content is completely new. It is an indispensable resource for beginning and experienced professionals or text for courses on adolescent intervention or adolescent mental health.

Adolescents are more likely than any other age groups to engage in behaviors that contribute to injuries, violence, unintended pregnancies, sexually transmitted diseases, and reckless alcohol, tobacco, and drug use. At-risk adolescents may also exhibit signs of moodiness, aggression, and even self-injury, and these behaviors often cause parents, teachers, and clinicians to become extremely frustrated. Adolescents themselves may even believe that change is impossible. Drawing on proven-effective dialectical behavior therapy (DBT), Dialectical Behavior Therapy for At-Risk Adolescents is the first reader-friendly and easily accessible DBT book specifically targeted to mental health professionals treating adolescents who may be dangerous to themselves or others. If you work with adolescents who exhibit at-risk behavior, you know how important it is to take immediate action. However, you may also have trouble “breaking through” the barrier that these young people can build around themselves. This book can help. The DBT skills outlined in this book are evidence-based, and have been clinically proven to help build emotion regulation skills, which are useful for all age groups, though perhaps especially for the millions of at-risk adolescents experiencing depression, anxiety, anger, and the myriad behaviors that can result from these emotions. This book also includes practical handouts and exercises that can be used in individual therapy sessions, skills training groups, school settings, and when working with parents and caregivers. Adolescents stand at the precipice of the future, and the decisions they make now can have life-long impacts. By showing them how to manage their emotions and deal with the stresses that are common in day-to-day life, you are arming them with the tools they will need to succeed and thrive.

This report constitutes one of the first activities of the Forum on Adolescence, a cross-cutting activity of the Institute of Medicine and the National Research Council of the National Academies. Established under the auspices of the Board on Children, Youth, and Families, the forum's overaching mission is to synthesize, analyze, and evaluate scientific research on critical national issues that relate to youth and their families, as well as to disseminate research and its policy and programmatic implications. The goals of the forum are to: (1) review and establish the science base on adolescent health and development and make efforts to foster this development; (2) identify new directions and support for research in this area, approaching research as a resource to be developed cumulatively over time; (3) showcase new research, programs, and policies that have demonstrated promise in improving the health and well-being of adolescents; (4) convene and foster collaborations among individuals who represent diverse viewpoints and backgrounds, with a view to enhancing the quality of leadership in this area; and (5) disseminate research on adolescence and its policy implications to a wide array of audiences, from the scientific community to the lay public.