Hi, I’m Leslie Kolb. I earned my MSW at UCLA and have gained over twelve years of experience working in behavioral health with adults of all ages across all levels of care, from residential to outpatient. Over the years, I have specialized in the assessment and diagnosis of severe mental illness and have taken on clinical leadership roles to drive and shape treatment success for individuals with high-acuity diagnoses. I am trained in DBT and CBT, and often pair those modalities with a mix of Motivational Interviewing and psychodynamic therapy to best fit each member’s needs. I am thrilled to have the opportunity at Amae Health to continue helping members develop the skills and abilities they need to engage more fully in their lives. Outside of my time at Amae, I love spending time with my family, listening to podcasts, and when I get the chance, trying out new restaurants all around LA.
Academic Background
MSW, Social Welfare – UCLA
Professional Certifications
Licensed Clinical Social Worker
LCSW
Recognitions and Scholarly Work
Memberships and Affiliations
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What Is Adjustment Disorder with Disturbance of Conduct?
By
Leslie Kolb
|
June 3, 2025
When life throws challenges our way, we all react differently. Some of us might feel sad or worried, while others may show their stress through changes in behavior. Adjustment disorder is a condition that happens when someone has trouble coping with a stressful life event. When this struggle shows up mainly as problematic behaviors rather than just feelings, doctors call it adjustment disorder with disturbance of conduct.
This article will help you understand this condition, how to recognize it, and what help is available. Amae Health has been working with patients nationwide for many years, and we know better than anyone how to convey information in simple, understandable language.
Understanding Adjustment Disorder
Adjustment disorder is a mental health condition that develops when someone has difficulty coping with a stressful event or life change. These difficulties start within three months of the stressful event and don't last longer than six months after the stress has ended.
How strongly it affects your life makes this condition different from everyday stress. The emotional or behavioral symptoms are more severe than expected and can seriously impact your daily activities, work, relationships, or school performance.
There are several types of adjustment disorders, depending on the main symptoms:
- With a depressed mood (mainly feeling sad)
- With anxiety (mainly feeling nervous)
- With mixed anxiety and depression (both feelings together)
- With disturbance of conduct (mainly behavioral problems)
- With mixed disturbance of emotions and conduct (both feelings and behaviors)
What Does "Disturbance of Conduct" Mean?
When doctors talk about adjustment disorder with disturbance of conduct, they're referring to a specific way that stress shows up in a person's behavior. Unlike other types of adjustment disorder, where feelings like sadness or worry are the main symptoms, this subtype is recognized by changes in how someone acts.
"Conduct" in this context means behavior that affects others or breaks social rules. A disturbance of conduct involves acting out in ways that might violate the rights of others or go against major age-appropriate social norms or rules.
It doesn't mean the person is "bad" or deliberately causing problems. These behaviors are symptoms of difficulty adjusting to stress, just as fever is a symptom of infection, not a sick person's choice.
Common Signs and Symptoms
Key Behavioral Signs
People with adjustment disorder with disturbance of conduct typically show changes in their behavior rather than just in their mood. These changes usually start within three months of a stressful event.
Common behavioral signs include:
- Acting aggressively toward people, animals, or property
- Breaking rules at home, school, or work that they used to follow
- Arguing more frequently with family members, teachers, or supervisors
- Skipping school or work
- Ignoring previously respected boundaries
- Taking risks they wouldn't normally take
- Stealing or damaging property
- Having sudden outbursts of anger that seem out of proportion
- Deliberately annoying others
- Refusing to comply with reasonable requests
Impact on Daily Life
Adjustment disorder symptoms can significantly affect many areas of a person's life:
- Relationships: The behavioral changes can strain relationships with family members, friends, romantic partners, and colleagues. Arguments may increase, and others might start avoiding the person because of their unpredictable behavior.
- School or Work: Performance often suffers as the person may skip classes or shifts, have trouble concentrating, or get into conflicts with teachers, classmates, or coworkers. Grades might drop, or work quality may decline.
- Legal Consequences: Some behaviors associated with disturbance of conduct might lead to legal problems, especially if they involve breaking laws, damaging property, or aggressive actions.
- Self-Esteem: As problems mount in different areas of life, the person might feel worse about themselves, creating a cycle where stress leads to problematic behavior, which creates more stress.
- Physical Health: The ongoing stress and behavioral issues can affect physical health, leading to problems like headaches, stomach troubles, or sleep difficulties.
It's important to remember that these impacts aren't happening because the person chooses to be difficult. They're struggling with a genuine adjustment problem that needs understanding and proper support.
Causes and Triggers
Adjustment disorder with disturbance of conduct doesn't have a single cause. Instead, it develops from a combination of factors:
Stressful Life Events. The most obvious trigger is exposure to a stressful situation or significant life change. It might be:
- A major loss (death of a loved one, divorce, job loss)
- A significant transition (moving, changing schools, retirement)
- A sudden change in health (diagnosis of a serious illness)
- Family conflicts or domestic problems
- Financial hardships
- Workplace stress or academic pressure
Personal Vulnerability. Not everyone who faces these stressors will develop an adjustment disorder. Personal factors that might increase risk include:
- Previous mental health challenges
- Childhood experiences of trauma or instability
- Limited coping skills
- Lack of strong support systems
- Certain personality traits
Environmental Factors. The context in which the stress occurs matters too:
- Cultural factors affecting how stress is perceived and handled
- Availability of social support
- Concurrent stressors happen at the same time.
- Economic resources available to cope with challenges
Diagnosis and Assessment
Getting an accurate diagnosis of adjustment disorder with disturbance of conduct involves a thorough evaluation by a mental health professional, typically a psychiatrist, psychologist, or clinical social worker.
The Assessment Process:
- Clinical Interview: The professional will talk with you about your symptoms, when they started, recent life events, and how your functioning has changed.
- Medical History: A review of your physical health and any medications you take helps rule out medical causes for behavioral changes.
- Psychological Evaluation: You might complete questionnaires or assessments to measure your symptoms and their severity.
- Collateral Information: With your permission, the clinician might speak with family members, teachers, or others who have observed your behavior changes.
- Differential Diagnosis: The clinician will consider whether your symptoms better match other conditions.
Treatment and Management
Therapy Options
The good news about adjustment disorder with disturbance of conduct is that it responds well to treatment, especially when started early. Amae Health offers some main treatment approaches:
Cognitive-Behavioral Therapy (CBT): This approach helps identify and change unhelpful thought patterns contributing to behavioral problems. CBT teaches specific skills for:
- Managing anger appropriately
- Solving problems more effectively
- Communicating needs without aggression
- Recognizing triggers for disruptive behavior
Individual Psychotherapy: Regular sessions with a therapist provide a safe space to process feelings about the stressful event and learn healthier coping strategies.
Family Therapy: Since disturbance of conduct affects relationships, involving family members can be beneficial. Family therapy can:
- Improve communication patterns
- Help family members respond effectively to problematic behaviors
- Address family dynamics that might be maintaining the problem
- Teach everyone skills to support recovery
Group Therapy: Meeting with others facing similar challenges can reduce feelings of isolation and provide opportunities to practice new social skills.
Medication: While medications aren't usually the first treatment for adjustment disorder, in some cases, they might be prescribed to address specific symptoms like severe anxiety, insomnia, or impulsivity.
Supporting Long-Term Recovery
Beyond formal treatment, several strategies support ongoing recovery:
- Stress Management: Learning and practicing stress reduction techniques like deep breathing, progressive muscle relaxation, or mindfulness meditation.
- Lifestyle Adjustments: Regular physical activity, adequate sleep, and a healthy diet can improve mood regulation and reduce stress.
- Building Support Networks: Strengthening connections with supportive friends and family members provides emotional resources during difficult times.
- Developing Coping Skills: Working on problem-solving abilities, emotional awareness, and communication skills creates resilience for future challenges.
- Environmental Changes: When possible, modifying or removing ongoing sources of stress can reduce symptoms.
When to Seek Help
It's essential to reach out for professional help if you notice these signs in yourself or someone you care about:
- Behavioral changes that persist for several weeks after a stressful event
- Actions that are causing problems at school, work, or in relationships
- Aggressive behavior that could harm the person or others
- Declining performance at school or work
- Withdrawing from previously enjoyed activities
- Getting into legal trouble
- Using alcohol or drugs to cope with stress
- Expressing hopelessness or having thoughts of self-harm
- Behavioral problems that don't improve despite your best efforts to help
Early intervention for adjustment disorder with disturbance of conduct can prevent symptoms from worsening and reduce the risk of long-term consequences. Remember that seeking help is a sign of strength, not weakness.
How Amae Health Can Help
At Amae Health, we understand that facing an adjustment disorder can be challenging, but you don't have to go through it alone. Our compassionate team specializes in supporting people through difficult life transitions.
Our approach to treating adjustment disorder with disturbance of conduct is personalized, comprehensive, and evidence-based. We offer:
- Expert assessment and diagnosis by experienced mental health professionals
- Individual therapy using proven approaches like Cognitive-Behavioral Therapy
- Family therapy to strengthen your support system
- Skills-based groups focused on anger management and stress reduction
- Coordination with schools or workplaces when helpful
- A warm, welcoming environment where you'll feel understood and respected
Our goal is to help reduce symptoms and empower you with tools and strategies that will serve you long after treatment ends. We believe in building resilience to help you navigate future challenges more effectively.
Frequently Asked Questions
What is the difference between adjustment disorder with disturbance of conduct and conduct disorder?
A specific stressful event triggers adjustment disorder with disturbance of conduct and typically lasts less than 6 months. Conduct disorder isn't linked to a specific stressor, develops more gradually, and tends to persist much longer with more serious violations of others' rights.
How long does adjustment disorder with disturbance of conduct last?
Adjustment disorder symptoms typically resolve within 6 months after the stressful situation ends. With proper treatment, many people see improvement much sooner.
Can this condition resolve without treatment?
Mild cases of adjustment disorder may improve independently, especially with good social support and after the stressful situation resolves. Professional help can speed recovery and prevent complications.
What are the most effective treatments for this subtype?
Cognitive-behavioral therapy and psychotherapy focusing on coping skills and addressing problematic behaviors are most effective. Family involvement in treatment often improves outcomes, especially for children and teens.
Is medication necessary for managing conduct-related symptoms?
Medication is not usually the first-line treatment, but might be prescribed temporarily in some cases. It's typically only considered for specific symptoms like severe anxiety or sleep problems.
When should someone seek professional help?
Professional help should be sought when behavioral changes after a stressful event interfere with daily functioning or cause relationship problems.
Can adults also experience adjustment disorder with disturbance of conduct?
Yes, adults can experience adjustment disorder with disturbance of conduct. In adults, the symptoms might appear as workplace conflicts, reckless behavior, or legal problems that weren't present before the stressful event.
Is this condition considered a mental illness or behavioral issue?
Adjustment disorder with disturbance of conduct is classified as a temporary mental health condition that affects behavior in response to stress. With proper support, most people return to their usual functioning without long-term mental health concerns.
# min read
7 Key Benefits of Mental Health Counseling
By
Leslie Kolb
|
May 8, 2025
Mental health counseling is a professional form of support. It aims to help people overcome emotional and psychological problems. It is a therapeutic relationship between professional and client, designed to promote positive change and personal growth. Counseling is based on confidentiality, empathy, and non-judgmental acceptance.
The goal of health counseling is to provide a safe space. It is a place where people can explore their thoughts, feelings, and behavioral patterns. And they can also develop effective coping strategies. In today's world full of stress, information overload, and social expectations, maintaining mental health has become desirable and essential for a fulfilling life.
Mental health treatment plays a crucial role in overall well-being by directly affecting:
- Physical health
- Quality of relationships
- Employability
- The ability to find joy in everyday life
Psychological problems can exacerbate physical illnesses and vice versa, confirming the importance of a holistic approach to health. Regular individual therapy sessions can significantly improve quality of life. It helps to develop psychological flexibility and resilience to stress.
What are the Benefits of Mental Health Counseling?
- Improved Communication and Interpersonal Skills
- Enhanced Self-Acceptance and Self-Esteem
- Development of Coping Strategies
- Relief from Mental Health Conditions
- Improved Problem-Solving and Conflict Resolution
- Greater Sense of Purpose and Fulfillment
- Better Emotional Regulation and Stress Management
1. Improved Communication and Interpersonal Skills
Mental health counseling helps to improve the way we communicate and interact. Clients learn to effectively express their thoughts and needs - the foundation of healthy relationships.
Counselors help clients to develop active listening skills and set healthy boundaries. Individual therapy teaches how to identify and assert personal boundaries while respecting the boundaries of others. This fosters the formation of deeper relationships.
2. Enhanced Self-Acceptance and Self-Esteem
Many people seek mental health treatment because of a negative self-image. Therapy helps to reframe self-critical beliefs that undermine self-esteem.
In the safe environment of health counseling, clients explore the sources of low self-esteem and develop a more positive perception of themselves. Counselors help recognize the client's strengths and intrinsic value.
3. Development of Coping Strategies
Mental health counseling teaches clients effective coping strategies. Counselors help develop adaptive coping mechanisms applicable to a variety of stressful situations. These skills are especially valuable during life transitions, crises, or unexpected changes, when habitual ways of responding may not be sufficient.
In individual therapy, clients practice anxiety management techniques:
- Breathing exercises
- Progressive muscle relaxation
- Cognitive restructuring
- Mindfulness practices
These tools help to cope with emotional problems in everyday life. This further prevents the accumulation of stress and the development of chronic psychological conditions. Importantly, these techniques can be practiced independently. This promotes the development of self-sufficiency and confidence.
Health counseling also helps identify and replace ineffective strategies (such as avoiding difficult situations, suppressing emotions, self-medicating with alcohol or other substances) with healthier alternatives. Counselors work with clients to develop a personalized "toolkit" for stress management, taking into account individual differences and life circumstances.
4. Relief from Mental Health Conditions
Mental health treatment plays a key role in the treatment of clinical mental health conditions. Professional counselors use evidence-based techniques to alleviate symptoms and improve functioning.
Cognitive behavioral therapy is one of the most researched forms of individual therapy. It helps identify and change maladaptive thoughts. Other approaches include dialectical behavioral therapy and mindfulness-based therapy.
For many, health counseling becomes an essential component of the treatment plan, sometimes in combination with drug therapy.
5. Improved Problem-Solving and Conflict Resolution
Mental health counseling develops problem-solving and critical thinking skills. Clients learn to analyze problems objectively and develop constructive solutions.
Individual therapy provides an environment for practicing conflict resolution skills. Clients learn how to communicate effectively in tense situations and find compromises.
These improved skills lead to more harmonious relationships and reduced stress.
6. Greater Sense of Purpose and Fulfillment
Many people seek health counseling when they feel a sense of emptiness. Therapy helps to explore values and dreams, creating a clearer vision of life's path.
In mental health counseling, clients learn to set meaningful goals that align with their values. Counselors help develop concrete steps to achieve these goals.
Finding deeper meaning is associated with improved psychological well-being. Individual therapy helps clients live more authentic lives.
7. Better Emotional Regulation and Stress Management
A key benefit of mental health treatment is the development of emotional regulation skills: the ability to recognize and manage one's emotions.
In the process of health counseling, clients learn to identify emotional triggers. They develop strategies for managing emotional states. This includes mindfulness techniques to help them stay in the present moment.
Effective stress management is another crucial benefit of individual therapy. Clients learn relaxation and self-care techniques that help reduce the manifestations of stress.
Why Consider Mental Health Counseling?
Despite the growing recognition of the importance of mental health treatment, there are many myths surrounding the therapy. One is that seeking help is a sign of weakness. It demonstrates strength and self-awareness.
Another misconception is that health counseling is only for people with serious disorders. In reality, counseling can be helpful for just about anyone.
Many people believe that therapy should be long-term. However, even short-term individual therapy can lead to significant positive changes.
Certain signs indicate the need for mental health counseling:
- Persistent feelings of sadness, anxiety, or helplessness
- Difficulty performing daily tasks
- Problems in relationships
- Alcohol or other substance abuse
- Intrusive or disturbing thoughts
- Significant changes in sleep, appetite, or energy
- Thoughts of self-harm
How to Get Started with Mental Health Counseling
Finding the right professional for mental health treatment is an important first step. Research qualified professionals through online directories, referrals, or integrated mental health counseling platforms such as Amae Health, which make the process much easier by bringing together trusted professionals from various backgrounds.
When choosing a counselor, pay attention to their specialization and experience with problems similar to yours. Many specialists and modern clinics, including the Amae Health team, offer a free initial consultation. This allows you to assess compatibility and comfort with the interaction.
Consider practical considerations: location, cost, insurance coverage, and availability of online counseling. The advantage of comprehensive psychological support centers is the ability to flex the therapy format to fit your lifestyle. Trust in the therapeutic relationship is a key factor in the success of individual therapy.
The first step toward mental health treatment
Deciding to seek mental health treatment is a powerful and transformative step toward a better quality of life. Counseling provides a safe space to explore your thoughts, emotions, and behavioral patterns and professional support as you make changes. It is important to remember that the journey to psychological well-being is a marathon, not a sprint, requiring patience and consistency.
Caring for mental health is now recognized as important as caring for physical well-being. They are inextricably linked, shaping the overall picture of a person's well-being. Health counseling represents a meaningful investment in yourself that can benefit all aspects of your life, from improving your well-being and vitality to developing deeper and more satisfying relationships.
Regardless of the challenges you face - whether it's overcoming traumatic experiences, managing chronic stress, improving relationships, or finding greater meaningfulness - individual therapy can provide the tools and support to overcome them effectively. Remember, seeking professional help is not a sign of weakness but of strength and determination to make a difference. Everyone deserves the opportunity to live a full, harmonious life, and professional counseling is one of the most effective ways to achieve this goal.
# min read
What is Attention-Seeking Behavior?
By
Leslie Kolb
|
April 29, 2025
Attention-seeking behavior are ways individuals express their need for connection, validation, or reassurance. Such behavior can manifest in different ways, from exaggerated emotionality and dramatization of events to provocative statements or unusual dress.
To a greater or lesser extent, attention-seeking behavior is inherent in all people. It is a natural part of human nature. We are all social beings; recognition and acceptance are basic psychological needs. However, the intensity of this need varies considerably depending on age and life circumstances.
In children, attention-seeking behavior is a normal stage of development. Babies may cry loudly, become cranky, or throw tantrums. This is their way of trying to get their parent's attention. As they grow older, most people learn to get the attention they need in socially acceptable ways. However, in times of stress or uncertainty, even adults may resort to more overt forms of attention-seeking.
During adolescence, attention-seeking often intensifies. This is due to identity formation and increased sensitivity to peer opinion. In adulthood, this behavior usually becomes more restrained. But, it can become more active during life crises or when social interaction is lacking.
Is Attention-Seeking Behavior a Sign of a Disorder?
It is essential to distinguish between normal attention-seeking behavior and pathological attention-seeking behavior. Typical behavior of this kind:
- Is situational and not persistent
- Does not significantly disrupt daily life and relationships
- The person is usually aware of their motives
- Does not cause significant distress to the person or others.
Pathological attention-seeking behavior, on the other hand, is characterized by:
- Persistent and compulsive
- Serious impairment of social and professional functioning
- Inability to control impulses
- Extreme distress at not receiving the desired attention
- Willingness to take extreme measures to get attention
Associated Mental Health Disorders
Excessive attention-seeking can be a symptom of a variety of mental disorders:
- Histrionic personality disorder. This problem is characterized by excessive emotionality, theatricality, and constant attention-seeking. People with this disorder often dramatize events. They may use provocative behavior and seek to be the center of attention.
- Borderline personality disorder. It can also manifest itself in intense attention-seeking behavior, often associated with fear of loneliness and abandonment.
- Narcissistic personality disorder. In this problem, attention-seeking is accompanied by a grandiose sense of self and a need for constant admiration.
- Anxiety disorders. These sometimes manifest themselves through attention-seeking behavior to gain validation and reassurance.
- Bipolar disorder. This problem during manic episodes may be accompanied by increased attention-seeking behavior.
- Oppositional-defiant disorder. In children and adolescents, oppositional defiant disorder often manifests itself through attention-seeking behavior, including deliberate rule-breaking.
What Drives People to Seek Attention?
The origins of attention-seeking are diverse and may have several factors:
Psychological factors:
- Low self-esteem and the need for external validation of one's worth
- Feelings of insecurity and lack of recognition
- Unmet need for intimacy and acceptance
Social factors:
- Cultural norms that encourage individualism and social visibility
- A competitive environment where attention means success
- Modeling the behavior of significant others
Environmental factors:
- Childhood experiences, especially if parental attention was inconsistent or conditioned
- Traumatic experiences that create a need for validation and safety
- The influence of social media, where attention is measured by likes and followers
Neurobiological studies show that receiving social attention activates the reward system in the brain. This triggers the release of dopamine, a neurotransmitter associated with pleasure and habit formation. This explains why attention-seeking can become self-reinforcing.
With social media, seeking attention has become easier than ever, sometimes turning likes and shares into a measure of self-worth. At Amae Health, we understand that attention-seeking behaviors often stem from deeper emotional needs. Our approach focuses on helping individuals identify these underlying factors and develop healthier ways to seek connection.
Attention-Seeking vs. Histrionic Personality Disorder
Differentiating Between the Two
Although attention-seeking is a key component of histrionic personality disorder, these concepts are not identical.
Attention seeking can be:
- A temporary state in response to certain circumstances
- Part of a normal behavioral repertoire
- Moderate and not significantly problematic
- Recognized and controlled
Histrionic personality disorder is a persistent pattern of internal experience and behavior that:
- Is present continuously rather than situationally
- Appears in all areas of life
- Causes significant difficulties in social adjustment
- It is accompanied by symptoms other than attention seeking.
Diagnostic Criteria for HPD
According to the DSM-5, histrionic personality disorder is diagnosed when at least five of the following criteria are present:
- Discomfort in situations where the person is not the center of attention
- Interactions with others are often characterized by inappropriate, sexually seductive, or provocative behavior
- Rapidly changing and superficial expressions of emotion
- Constant use of appearance to attract attention
- Speech is overly impressionistic and lacking in detail
- Demonstrative, theatrical, and exaggerated expression of emotion
- Suggestibility, easily influenced by other people or circumstances
- Perceiving relationships as more intimate than they really are
Impacts of Attention-Seeking Behavior
Attention-seeking behavior can seriously affect personal relationships:
- Create emotional strain on partners and significant others
- Cause feelings of manipulation and exhaustion in others
- Lead to shallow and unstable relationships
- Create cycles of crisis and dramatic reconciliation.
With histrionic personality disorder, these problems are exacerbated, often leading to chronic difficulty in maintaining healthy relationships.
In work and academic environments, excessive attention-seeking can:
- Disrupt group dynamics and teamwork
- Create conflict and tension within the team
- Distract from tasks and reduce productivity
- Build a reputation as an unreliable or difficult employee
People with strong attention-seeking behaviors may have difficulty in environments that require restraint and focus on the outcome rather than the process.
Management and Treatment Approaches
Cognitive behavioral therapy (CBT) effectively works with attention-seeking behavior by helping to identify and change maladaptive thoughts and behavioral patterns.
Dialectical behavior therapy (DBT) is particularly useful for histrionic personality disorder, teaching skills in emotion regulation, interpersonal effectiveness, and distress tolerance.
Group therapy provides a safe environment in which to receive healthy feedback on the effects of attention-seeking behaviors on others.
For those seeking to manage their attention-seeking, helpful:
- Mindfulness techniques to help recognize impulses before they are realized
- Developing self-reflection skills to understand underlying needs
- Developing healthy ways of receiving affirmation and recognition
- Balancing the need for attention with respect for the boundaries of others
Amae Health offers comprehensive programs for working with attention-seeking behaviors, including individual and group therapy, as well as online self-help resources.
Final thoughts
Attention-seeking behavior is a multifaceted phenomenon that exists on a spectrum from normal to pathological. Understanding its causes and manifestations helps professionals and ordinary people balance healthy attention-seeking behavior and its destructive forms.
It is important to remember that excessive attention-seeking behavior often hides unmet emotional needs, and addressing these underlying issues is key to long-term change. Whether the problem is a temporary reaction to stress or a manifestation of histrionic personality disorder, modern approaches in psychology and psychotherapy offer effective strategies for help and support.