What it is:

Based on data from the federal Current Population Survey, approximately 1 in 5 youth between the ages of 20-24 are not working or in school. Commonly referred to as “NEET” (not in employment, education or training), these are young adults who are unable to effectively “launch” into independent adulthood and acheive markers such as independent living, financial independence, or maintenance of vocational or educational goals. Many of these youth have attempted to engage in work or school multiple times without success. While there are a number of challenges that can interfere with maintaining a job or attending classes, for some the primary challenge is anxiety-related avoidance and mood-dependent behavior. Mood dependant behavior refers to the tendency to act consistently with one’s mood (e.g., stay in bed when sad, avoid social interactions when anxious) and difficulty initiating or sustaining behaviors that are mood incongruent due to this discomfort this causes (e.g., attend work when stressed, attend class when overwhelmed or experiencing depressive symptoms).

 

Typical challenges for the youth include: 

• Frequently starting and stopping employment, education or training programs

• Trouble going to a job, attending class or completing assignments when feeling sad or worried 

• Periods of anxiety and depression

• Difficulty sustaining goal-directed behavior in the face of setbacks or obstacles

• Vacillation between unrealistic hopefulness and avoidant hopelessness around independent living goals

• Intense distress related to job or academic expectations

• Procrastination and numbing behaviors (e.g., gaming, social media, streaming)

• Difficulty engaging in important tasks during periods of low motivation

• Arguments (or unwillingness to discuss) with family members around expectations or capabilities

• Low self-esteem and low belief in their own capability

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These are young adults who may experience periods of strong motivation to engage in age-appropriate activities such as pursuing a degree, vocational training or employment, followed by experience of intense anxiety, depression or shame that lead to avoidance and withdrawal from pursuing their goals.  

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Typical challenges for the caregivers and support systems include: 

• Difficulty communicating effectively with the youth

• Difficulty setting and maintaining expectations or contingencies with their youth

• Difficulty determining how best to support youth mental health concerns

• Difficulty balancing other demands (e.g., career or other sibling needs) with the youths increasing needs or demands

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These caregivers or family systems often struggle to find the balance between holding realistic, age-appropriate expectations and supporting a youth that may have mental health concerns interfering with their ability to reach adulthood milestones. At times, caregivers can swing between strict, rigid, immediate expectations and permissive, avoidant, or fully disconnected approaches to their youth. 

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Associated Concerns: Individuals that struggle with adult transitions often have concerns with anxiety, mood disturbance, perfectionism or shame. They may develop a pattern of oversimplifying the difficulty of “launching” tasks and subsequently avoiding these tasks due to difficult emotions such as shame or anxiety. Caregivers of these youth may struggle with burn-out, as well as their own mental health concerns such as mood disturbance or anxiety that may interact with youth concerns within the family system.

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Evidence-Based Treatments Offered: An initial assessment is important to determine the most likely cause of the youth’s difficulty with adult transitions. The typical recommendation for these concerns is entry to our EMERGE program. Depending on comorbidities or the intensity of concerns, a variety of treatments such as those intended for anxiety, depression, emotional resilience, eating disorders, substance abuse, or autism-spectrum disorder treatments may be appropriate instead of or as an adjunct to the EMERGE program. Treatments such as Cognitive Behavioral Therapy (CBT), the Unified Protocol (UP) , or Dialectical Behavior Therapy (DBT) may be appropriate.

 

Caregivers are most often referred to the caregiver group within our EMERGE program. Depending on the degree of caregiver or family conflict, adjunct treatments such as couples therapy, family therapy, or behavioral parent training may also be recommended. 

Medication may also be helpful.

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