• Lack of Trust
    o Little or no vulnerability
    o Resistant to care-giving
    o Lack of humility
    o Suspicious of others
    o Manipulative
    o Controlling
    o Teen may be victim of abuse or trauma
    o Teen may have been abandoned, had inconsistent care-giving or unstable living environment
• Oppositional
    o Disrespectful towards adults
    o Disregarding of rules and guidelines
    o Contentious
    o Little or no compliance
• Angry
    o Quick tempered
    o Argumentative
    o Easily frustrated
    o Hostile
    o Verbally aggressive
    o Sudden outbursts
    o Rage
    o Teen is perceived as “irritable” or having a “short fuse”
• Low Motivation
    o Poor completion of tasks and expectations
    o Difficult to inspire towards goals or accomplishments
    o Avoidant of personal responsibility
    o Appears lazy
    o Poor commitment
    o Lack of follow through
    o Apathetic
• Self-Harm
    o History of having suicidal thoughts (no active plans)
    o History of self-harming behaviors
    o Extreme dangerous or high-risk behaviors (high speed racing, stunts, etc.)
    o Simple harm (e.g. scratching)
• Academic Struggles
    o Difficulty taking school seriously
    o Avoidant of homework/school work
    o Difficulty paying attention in class
    o Truancy
    o Poor grades
    o Lack of follow through with assignments and projects
    o Teacher conflict
• Lying, Stealing
    o Lack of conscience
    o Dishonest
    o Taking things that are not his/hers
    o Hoarding
    o Frequent lying
    o Deceitful
• Unsuccessful relationships
    o Relationships characterized by manipulation
    o Selfishness
    o Sabotage
    o Keeping others at a distance
    o Victimizing
    o Blaming others
    o Poor empathy
    o Superficial (lack of depth/substance)
• ADHD
    o Attention Deficit/Hyper-activity Disorder
    o Lack of focus
    o Poor attention to detail
    o Easily forgetful
    o Frequent misplacing/losing of things
    o Poor impulse control
    o Struggles with task completion
    o Poor memory
• Selfishness
    o Lack of empathy in relationships with others
    o Grandiose or inflated ego
    o Concrete thinking
    o Lack of flexibility
    o False/distorted sense of self
    o Struggles with being a “team” player
• Adoption Issues
    o Questions or concerns regarding self
    o Identity
    o Family of origin
    o Feelings of abandonment
    o Feels “different” or “disconnected” from family
    o Teen may display attachment disorder symptoms

        (poor interpersonal relationships, lack of trust, and

         many other symptoms listed)
• Low Self-Worth
    o Struggles with identity
    o Filled with shame
    o Can’t find “fit” or “place” in the world
    o Impressionable, easily influenced
    o Shifting value system
    o Low self-awareness
    o “Chameleon”
    o Externally driven
• Depression
    o Deflated mood
    o Flat affect
    o Poor hygiene
    o Negative self-image
    o Irritable
    o Inconsistent moods
    o Lack of interest in activities
• Anxiety
    o Nervous
    o Avoidant of social situations
    o Isolating behavior
    o Fearful of new situations
    o Resistant to change
    o Difficulty with transitions
• Negative Peers
    o Impressionable
    o Persuaded by peers
    o Gravitation and identification with the dark side of life
    o Withdraws or avoids positive social opportunities
    o Increased disrespect
    o “Parrots” (mimics) behavior of friends
• Impulsivity
    o Reactive
    o Spontaneous
    o Poor “cause and effect” thinking
• Gender Identity Issues
    o Questions/concerns surrounding sexuality
    o Questions/concerns surrounding personal gender
    o Social anxiety is prevalent
    o Teen may have sexual trauma or abuse in personal history
• Sexual Promiscuity
    o Experimentation with or exploring sexuality
    o Indiscriminate touch with strangers
    o Histories or struggles with pornography, chat room, or inappropriate web sites
    o Masturbation issues
    o Teen may have sexual trauma or abuse in personal history
• Substance Abuse Issues
    o Experimentation with substances
    o Mild-moderate use
    o Used to cope with core issue and associated feelings (e.g. trauma)
    o Not addicted to substances
 

*The public may contact the Joint Commission’s Office of Quality Monitoring to report any concerns or register complaints about a Joint Commission-accredited health care organization by either calling 1-800-994-6610 or emailing complaint@jointcommission.org.