Attention Magazine April 2018

A GROWING NUMBER OF YOUNG ADULTS continue to live at home with their parents, appearing to others to be unmotivated to lead more independent, self-sufficient lives. They often feel stuck and unable to move forward, even when provided access to different supports. Their parents are also often at a loss about how best to help.

These young adults suffer from what some refer to as failure to launch (FTL). While not an official diagnosis, their struggles are real, and frequently the source of significant anxiety, depression, and despair. There is, however, a light at the end of the tunnel. Some mental health experts now feel there are specific tools that families can be provided with that help these young adults learn to be more independent. Among these experts is Yale Child Study Center Associate Professor Eli Lebowitz, PhD.

Alleviating shame

According to Lebowitz, the term failure to launch has been a source of shame and embarrassment to many young adults who experience difficulty separating from their parents. Lebowitz helps these young adults and their parents see their situation as a process, not a failure. It’s an important first step in helping to legitimize rather than further stigmatize the family’s turmoil and emotional pain. Another important step is helping parents escape the “accommodation trap.”

Escaping the accommodation trap

While FTL young adults are not linked to one diagnostic classification, many experience a great deal of anxiety about leading more independent lives. To alleviate their anxiety, parents can find themselves engaging in “accommodating behaviors,” or behaviors that acquiesce to their adult child’s fears and perceived needs.

Accommodating behaviors can include things like doing their adult child’s laundry, providing a weekly stipend, cooking all of their adult child’s meals, driving them to appointments and events, acting as go-between between the adult child and the outside world, and so on.

On the one hand, accommodating behaviors can help alleviate fear of, or resistance to, engaging in independent actions the real world requires. The downside is that they also prevent the adult child from engaging in experiences that can help develop real-world independent living skills, as well the skills adults need to cope with stressful experiences outside the home. It’s what Lebowitz refers to as an “accommodation trap.”

To escape the trap, he provides parents with tools to help them safely, gradually, and empathically reduce their accommodating behaviors. The focus is on safely changing the parents’ behavior, not the adult child’s behavior. According to Lebowitz, it’s a systemic approach to helping the entire family. From a systemic perspective, any change in one part of a system can change the entire system. Parents likely have already tried to change their adult child’s behavior. But it probably didn’t help. What they can control, however, is their own behavior. Actions speak louder than words, says Lebowitz.

Parents are coached on how to communicate the message behind less accommodating behaviors: “I know you’re capable of doing more of these things on your own. I care about you and want to support you. As your parent, I believe that allowing you to do more of these things on your own is helping you, not hurting you.” Lebowitz often has parents communicate these messages in writing to their adult child, to insure the adult child understands the true motivation behind the behavioral changes, and to reduce arguments that can easily escalate under stressful conditions.

Finding support

Lebowitz’s treatment approach also encourages parents to reach out to their circle of support for help. Sometimes, there can be another trusted individual close to the family, someone the adult child or their parents will listen to, and whose help they will accept. According to Lebowitz, keeping the problem a secret will usually only further increase the family’s sense of shame and embarrassment. Gaining support from trusted individuals can help family members gain strength and stability as the family system begins to change.

No doubt, breaking the accommodation trap and helping highly dependent young adults move forward can be easier said than done. But it in a recent study involving twenty-seven parents of FTL young adults, Lebowitz found significant improvement following the completion of treatment.

Lebowitz’s work is actually an extension of the successful practices he developed to help parents of highly anxious children lead less anxious, more successful lives. Th e practices are drawn from his SPACE Program (Supporting Parenting for Anxious Childhood Emotions), a unique parent-based intervention that provides parents with specific tools to help reduce their child’s anxiety related symptoms (forthcoming in the June 2018 Attention).

The FTL young adults are not required to be involved in the treatment process. In some instances, they may refuse to participate. However, as long as they’re fully aware of the changes to come, Lebowitz finds that treatment can still proceed, and successful changes in the family system can still be made.

To learn more about Lebowitz’s work with parents and young adults, listen to the podcast, “Failure to Launch”: Shaping Intervention for Highly Dependent Adult Children: JAACAP February 2016, available through PodFanatic (www.podfanatic.com). He also devoted a chapter describing his work in his 2013 book, Treating Childhood and Adolescent Anxiety: A Guide for Caregivers (Wiley, 2013), which he coauthored with Haim Omer, PhD. Th e book also includes a detailed manual of the SPACE Program. Lebowitz is scheduled to speak about both the SPACE Program and his work with parents and their FTL adult children at the 2018 Annual International Conference on ADHD in St. Louis, Missouri.

A clinical and consulting psychologist, Mark Katz, PhD, is the director of Learning Development Services, an educational, psychological, and neuropsychological center in San Diego, California. As a contributing editor to Attention magazine, he writes the Promising Practices column and serves on the editorial advisory board. He is also a former member of CHADD’s professional advisory board and a recipient of the CHADD Hall of Fame Award.