The middle phase of psychotherapy with antisocial adolescents

Through a long series of trials and errors psychotherapeutic techniques for treating antisocial adolescents were developed based on the adolescents' dynamics and functioning. Basic psychoanalytic concepts were used as organizing principles, but not as an ideal to try and reach. This paper focuses on the middle phase of psychotherapy. Some characteristics of this phase, which include more regular attendance, more ability to introspect, and a sense of continuity between sessions, are described. The vehicle for change is the establishment and maintenance of a therapeutic situation that would allow regression and transference on one hand, while dealing with reality and problem-solving on the other. Several issues that affect the therapeutic situation are discussed. These include the level of the therapist's activity, the source of material brought up in the sessions, the therapist's use of the self and the handling of unreported antisocial acts. Finally, specific therapeutic interventions, namely listening, clarifications, confrontations, suggestions and interpretations are defined and discussed.