Transference-countertransference issues with adolescents: personal reflections.

The concept of transference-countertransference is an important theoretical construct and critical for therapists to understand and utilize when working psychotherapeutically with adolescents. Freud introduced the concept, hypothesizing that the patient "transferred onto the analyst feelings and thoughts resulting from a reactivation of previous psychological experiences, usually a recapitulation of early unconscious libidinal impulses." Jung included sociocultural aspects by stating that "by virtues of the collective content and symbols, transference transcends the individual's personality and extends into the social sphere." Fromm-Reichmann viewed transference as "transferring onto the therapist as a present-day partner, early experiences of interpersonal relatedness," and Sullivan believed that in any therapeutic interaction "two ... persons come to deal with the issues of one." It is my position that transference-countertransference is a phenomenon that exists in every encounter with a child and adolescent patient and includes the full spectrum of emotions and reactions--eager anticipation, dreaded waiting, envy, joy, anger, love, and hate. Working with and through this phenomenon creates a corrective emotional experience for the patient and the opportunity for him or her to mature in a more normative healthy fashion.

Three group psychotherapy settings with long-term adolescent inpatients: advantages and disadvantages.

The authors describe three types of group psychotherapy settings on an adolescent service. The group setting which included all patients on the unit and employed multiple therapists and several nursing staff provided better communication, cohesiveness, and greater opportunity for staff training. Small groups provided comparatively more time for patient participation, less distraction, and better disclosure. Mixing patients from different units resulted in objective and keener observations by patients, but hall meetings became increasingly necessary to work out interpersonal issues among patients from the same unit. These observations by staff were confirmed by a patient questionnaire.

Psychosis during adolescence. A review.

All indicators of emotional illness rise sharply during adolescence including the utilization of outpatient psychiatric clinics and hospitalizations for psychiatric illness and suicide. Psychoses secondary to drug ingestion, manic-depressive illness, and schizophrenia are not uncommon. This paper reviews the various forms of psychoses during adolescence. Special emphasis is on the diagnosis and treatment of adolescent schizophrenia, the most common psychosis in this developmental period.

"Out of control" behavior in adolescents.

The physician should approach a problem of "out of control" behavior in an adolescent as a family issue rather than an individual issue, for not only the behavior itself bu the parental response to the behavior are key factors in understanding and coping with it. Areas of commonly encountered misbehavior are explored.

Visual-motor problems of adolescents who attempt suicide.

Using the Canter Background Interference Procedure with the Bender-Gestalt Test, a group of 18 adolescent suicide attempters earned test scores indicating they had significantly more problems with visual-motor coordination than did a control group of 21 adolescents. There were also a greater number of school failures and behavior problems among these suicide attempters. The findings suggest that learning disabilities may be an unrecognized factor which increases the risk of suicide attempts by adolescents.

Adolescents who attempt suicide.

A suicide prevention program for teen-agers was established and at the completion of the first two years a review of the data was undertaken. A group of 65 adolescents who attempted suicide were identified in that time period. The median age group was 16 years, and 75% were girls. Ingestion was the predominant method used in these suicidal attempts. The major characteristics of these youngsters included long-term family disruption, social isolation, and academic difficulties. A subgroup of 25 adolescents received psychologic tests. When compared to a matched control group there was a significantly higher rate of minimal brain dysfunction for those adolescents who attempted suicide.