Brief psychotherapy in late adolescence: a psychodynamic and developmental approach

Four cases were discussed in which college students presented themselves in crisis for psychiatric treatment; each was dealing with a normal developmental crisis of late adolescence centering around separation-individuation issues. A type of brief psychotherapy was described which maintained the focus on the primary dynamic conflict and promoted ego development by interpreting the unconscious intrapsychic conflict. The incestuous, aggressive, and regressive themes were explored, and defenses were actively interpreted whenever they interfered with the awareness of autonomous strivings consistent with the ego ideal. Although other authors have emphasized the necessity of establishing a contract early which specifies the number of visits, we have emphasized the importance of maintaining strict therapeutic neutrality, especially regarding the duration of treatment with late adolescents. We view this as an important cornerstone of technique in assisting the healthy late adolescent in his quest for increasing autonomy, ego-ideal integration and ego mastery.