John is a 15-year-old high school sophomore who has earned high grades every semester since middle
school. He plays on the varsity baseball team and is well liked by his classmates. Lately, his grades have
significantly dropped to the point that he is in jeopardy of failing at least one course. If his grades fall, he
may not qualify for sports. Additionally, he has been late for school or left school early without
permission at least once weekly over the past two months. His parents have recently separated and are
discussing divorce. Recently, his mother was offered a promotion out of state and she is seriously
considering accepting the offer.
Select a developmental theory presented in this module and apply it to the scenario above. Use the
chosen theory to address the following:
Explain John’s behavior.
State two (2) priority nursing concerns and related nursing interventions for him.
Base your initial post on your readings and research of this topic.
Erikson’s psychosocial stage development theory
Divorce or parents separation is associated with behavioral issues displayed by children.
This is because family separation is a challenging obstacle for the whole family. Children are
usually not emotionally mature to understand the situation; therefore, their stress and frustrations
are often manifested by changing some aspects of their behavior. Erikson’s psychosocial
development theory indicates that human undergo through a series of developmental stages.
These include; Trust vs. Mistrust, Autonomy vs. shame, initiative vs. guilt, industry vs.
inferiority and identity vs. confusion (Burn et al. 2013).
Explanation of John’s behavior
In this case, John developmental stage falls under identity vs. identify confusion stage.
This indicates that John’s behavior is driven by feelings of frustration, confusion and anger.
These negative emotions are associated with diminished school performances and achievements.
The fact that he leaves school early without permission or late of school in the past 60 days
indicated that he could be indulging in risky behavioral activities such as alcohol and drugs
(Bowden & Greenberg, 2010).
Two priority nursing concerns and nursing interventions
The main characteristic of divorce is impaired parenting. This refers to the inability of
either parent to maintain or establish an environment that promotes optimum development of
John. Therefore, the two priority nursing concerns are (Paul, 2016):
a) Poor academic performance related to social isolation, poor family cohesiveness and lack
Intervention: The nurse should use active listening to explore the child
developmental expectations and needs within the context of socio-cultural influences. This
will be achieved by interviewing the child in absence of his care taker in order to make him
express his frustrations freely (Burn et al. 2013).
a) Incidence of psychological trauma related to social isolation, changes in family unit and
maladaptive coping skills.
Intervention: The parenting styles and behaviors should be examined including
the child’s environment, type of interaction and presence of other behavioral problem.
The nurse should institute neglect/abuse protection measures if risk of neglect and abuse
is suspected (Murphy, 2012).
Bowden, V. & Greenberg, C. (2010). Children and their families. Philadelphia:
Lippincott Williams & Wilkins.
Burns, Catherine, Dunn, A., Brady, M., Starr, N. B., Blosser, C. (2013). Pediatric
Primary Care, 5th Edition. [VitalSource Bookshelf Online].
Murphy, M. (2012). Parental divorce: Relationship between ego strengths and impact of
divorce on adult children from an Eriksonian perspective.
Paul, H. (2016). How to Talk to Your Kids about Your Divorce, by S. Rodman. Child &
Family Behavior Therapy, 38(2), 184-189.