Developmental psychotherapy for antisocial adolescents
Antisocial behavior is common during adolescence and incurs significant costs both for society and for the young people themselves. While most adolescents will not continue on a trajectory of antisocial behavior as they age, they may still be affected years later in terms of educational and employment opportunities. Moreover, persistent antisocial behavior places a heavy burden on the community, the justice system, and the public health system. Consequences include high levels of personal injury and financial damage for victims, and increased costs of policing and security.
Responses to juvenile crime have always seen a tension between a focus on the understanding and the rehabilitation of the youth and the need to enforce discipline and public safety through punishment and threat. Despite stated goals of rehabilitation, there is a tendency for society to focus on harsh sentencing and punitive approaches, which have not been demonstrated to work. Punishment is often an attempt to restore control and authority: from a psychological point of view, deprivation of liberty may be seen as a way of imposing control over someone who does not seem capable of self-control. Similarly, convictions and judgments dictate from the outside something that appears to be missing inside (i.e. guilt).
The work with young offenders was traditionally deemed ineffective, but in recent years there has been a shift from therapeutic nihilism to cautious optimism. Common core elements of effective treatments include positive reinforcement, problem-solving skills training, role-playing, and good working alliance. Their treatment goal is behaviour change or control, and they tend not to focus on the actual intention of the behavior and its subjective meaning.
Developmental psychotherapy for antisocial adolescents goes beyond rehabilitation and behavioral control and aims at helping antisocial young people and young offenders become responsible adults, as the intervention takes into account the values and goals of the individual. A developmental understanding of adolescent antisocial behaviors consider them as maladaptive responses to age-related psychological tasks, a deviant way of meeting positive goals and taking control of one's life, such as achieving emotional independence, attaining a masculine or feminine social role, with new and more mature relations with age-mates of both sexes and socially responsible behavior. Antisocial and violent behaviors often relate to developmental needs of developing a sense of worthiness, achieving a social reputation, and increasing one's sense of agency.
Understanding behavioral problems as a result of intentions, values and goals, rather than as a "lack of something" is at the core of a treatment approach that incorporates a developmental understanding of delinquent youth with a psychoanalytically informed perspective on treatment. Its strength lies in the combination of a psychoanalytic and developmental understanding, delivered as part of multi-modal treatment. It has been employed successfully over the past 20 years in Italy both in rehabilitation efforts with young offenders and in private practice and it has proven to be a viable and feasible approach.
This kind of therapeutic alliance is rooted in a shared understanding of the meanings and symbolic motives of behavior, within a developmental frame that puts young people's needs, values and goals first. The cornerstone of the approach is the interpretation of the meaning of the disruptive behavior and on helping the adolescent and his family achieve developmental needs and take responsibility, improving his sense of agency. With an approach in the juvenile justice system informed by developmental psychotherapy, youth offending teams may promote real change and help young offenders resume their developmental path and take responsibilities for their lives.
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Reference: Maggiolini, A.; Suigo, V. Developmental Psychotherapy for Antisocial Adolescents. Adolescent Psychiatry, 2018, Vol. 8. DOI: 10.2174/2210676608666180502101353
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