Recognizing the teen-ager who needs to be pregnant: a clinical perspective

Based on the last three years' clinical experience with 600 inpatient adolescents at the Adolescent Center of Houston International Hospital, this paper reviews the pregnancy issue in terms of primary, secondary, and tertiary prevention. The majority of the patients were white middle-class girls ranging in age from 12 to 17. The clinical symptoms which especially identified at-risk patients were (1) failure experiences, (2) stymied aggression, (3) rights of passage proclamation, (4) parental complicity, (5) the guaranteed spouse, (6) perceived love deprivation, (7) contrived need for parental acceptance, and (8) pseudoknowledge. Secondary prevention is described in terms of (1) parents' group for the parents of the young parents, (2) use of peer group psychotherapy, and (3) parents' groups as a means for dealing with "pregnancy substitutes." Tertiary prevention is depicted in terms of (1) peer group psychotherapy in the postabortion phase, (2) use of peer groups and parents' groups to avoid further pregnancies, and (3) peer/parents' group psychotherapy as a source of contraceptive information. Illustrative vignettes are included for each category. Follow-up at six months after hospitalization has supported the effectiveness of the methods of intervention described.