Confrontation and support in group therapy in the residential treatment of severely disturbed adolescents

This paper focuses on the use of various forms of group therapy for severely emotionally and behaviorally disturbed adolescents. Group therapy is considered to be subordinate to a total systemic approach which includes individual, family, group, and milieu therapy. The author uses an eclectic theoretical frame of reference which includes some elements of psychodynamic, object relations, and structural and strategic family therapy theory. Precedents for the confrontational-supportive approach include encounter group and residential drug addiction programs, psychodynamic short-term individual therapy, and dynamic group therapy.     

Techniques for handling resistances in group psychotherapy with severely disturbed patients

There has been an increased interest in recent years in the treatment of those with severe psychopathology through application of object relations theory and modern ego psychology. Yet, for the past 20 years, such patients have been treated in day hospitals where rehabilitation and socialization concepts have been employed. This paper integrates some of the advances in psychoanalytic theory with more established methods of milieu therapy. In the patients studied, the therapists noted the presence of severe envy, dependency, passivity and with-holding, an intolerance for aggression along with an intransigent, paranoid-schizoid position. The techniques described here worked through the effects of these resistances so that the patients could use the psychotherapy group, and the entire milieu, more constructively than they did before.Ruthe Feilbert-Willis, C.S.W. was formerly Senior Social Worker in the Adolescent and Adult Day Hospital at The New York Hospital-Cornell Medical Center, in White Plains, New York.He was a psychiatric resident at The New York Hospital-Cornell Medical Center, in White Plains, New York, during the time the clinical work of this paper was undertaken.     

The Axis II group: treating severely characterologically disturbed patients

Treating the chronically mentally ill involves not only working with patients suffering from schizophrenia and other prolonged or recurrent psychotic illnesses, it also means providing treatment for patients with severe personality disorders. Many of these patients are also active substance abusers. This article examines the therapeutic and management issues raised for outpatient clinicians who work with these patients. Consideration is devoted to the special problems in treating the dual diagnosis patient, issues of patient and therapist safety, limit setting, splitting dynamics, and countertransference reactions. A set of recommendations is offered for conducting outpatient group therapy, specifying what is needed from both the clinicians and the facility in which this type of treatment is provided.     

Keeping juvenile delinquents in school: a prediction model

The purpose of this study was to test an empirically based prediction model of school dropout on a sample of 137 juvenile delinquents, some who have dropped out and some who have remained in school. The specific factors among the many found in previous research that are salient for predicting whether delinquent youths will drop out or remain in school were determined. An important finding of this study is that it required only four factors to yield a high level of prediction: misbehavior in school, disliking school, the negative influence of peers with respect to dropping out and getting into trouble, and a marginal or weak relationship with parents. The four factors identified create a model that is directly applicable to prevention strategies and is extremely parsimonious.     

A group-centered object relations approach to group psychotherapy with severely disturbed patients

This paper discusses how the application of object relations theory to clinical intervention has extended the application of psychoanalytic group psychotherapy to more severely disturbed patients. The author suggests how to structure the group based on individual and group needs. Clinical issues are presented, including the group as a container, communication peculiarities, and psychotic response to separation, sexuality, and interpretation.     

The family relations of female juvenile delinquents

This study evaluated the assumption that the family relations of female delinquents are more dysfunctional than those of male delinquents. In a 2 × 2 (gender by delinquency status) design, 32 intact families were matched on demographic variables, and the male and female delinquents were matched on arrest data. Mothers, fathers, and adolescents were administered a selfreport personality inventory and were observed during a family interaction task. Consistent with the extant literature, families of delinquents had low rates of facultative information exchange and delinquent adolescents were more dominant toward their mothers than were well-adjusted adolescents. It was also observed that fathers of delinquents were more dominant toward their wives than were fathers of well-adjusted adolescents. In regard to the primary purpose of the study, it was observed that mother-adolescent dyads and parents in families of female delinquents had higher rates of conflict than their counterparts in families of male delinquents. In addition, the fathers of female delinquents were more neurotic than the fathers of male delinquents. These findings provide some support for the view that the families of female deliquents are especially dysfunctional.This research was supported by funding to the Department of Psychology at Memphis State University granted through the Centers of Excellence Program of the State of Tennessee. We gwratefully appreciate the cooperation of Judge Kenneth Turner of Memphis Juvenile Court, and of George Relyea, who has provided statistical consultation over the years.     

Intellectual profiles and violent behavior in juvenile delinquents

Hemispheric laterality, measured by the Wechsler Verbal IQ-Performance IQ differential score, in a large group of delinquents (N = 101) was not associated with violent-nonviolent behavior. Delinquents were, however, likely to be relatively more impaired on verbal than on nonverbal intellectual capacities.     

Attention deficit hyperactivty disorder in Korean juvenile delinquents

This study was conducted to identify attention deficit hyperactivity disorder (ADHD) in Korean juvenile delinquents. Intelligence tests (KEDI-WISC, K-WAIS), the Test of Variables of Attention (TOVA), the Teacher Report Form (TRF), the Youth Self-Report (YSR), and the Rosenberg Self-Esteem Scale were administered to 98 incarcerated Korean adolescents (the delinquent group) and 84 adolescent nondelinquents (the control group). The groups were compared, and significant differences were found for ADHD; 42.4% of the adolescents in the delinquent group were identified as having ADHD, in comparison to 11.9% of the adolescents in the control group. Delinquent adolescents and adolescents with ADHD were found to have lower IQ scores, poorer TOVA performance, more severe problem behaviors, and lower self-esteem than nondelinquent adolescents and adolescents without ADHD. Delinquent adolescents with ADHD consistently fared the worst on assessments of intelligence, TOVA performance, problem behaviors, and self-esteem.