10 - Individual psychotherapy with adolescents

Summary

Introduction

Various psychotherapeutic techniques have evolved out of the ‘client-centred’ methods developed by Rogers (1951). In these, the therapist plays a nondirective role, restricting his interventions to comments on the emotional significance of the patient's statements. Although there are many approaches, the basis of this type of therapy is invariably verbal interaction between the patient and the therapist. The verbal interaction is intended to bring about the following changes (Wolberg, 1969; Kind, 1982): (i) remove, reduce or modify symptoms, (ii) minimize disordered behaviour, (iii) encourage normal development and personality maturation.

Verbal therapeutic methods vary according to the degree to which attempts are made to influence the patient (Fig. 10.1). Thus, while client-centred therapy is considered an essentially ‘non-directive’ technique, rational emotive therapy involves a more directive approach, and psychoanalytically orientated psychotherapy lies somewhere between the two.

In clinical practice, especially with adolescents (Lehmkuhl et al., 1992), therapists do not usually adhere strictly to a single technique. A combination of several different techniques may be better suited to meet the specific needs of patients. An excessively rigid approach should be avoided, and sessions should be flexible, responding to the reactions of the patient to avoid feelings of being misunderstood or not being taken seriously.

It is important to bear in mind the developmental stage of a child or adolescent when undertaking psychotherapy (see also Chapter 1 and 2).

Rogers considered the relationship between patient (‘client’) and therapist to be of paramount importance in psychotherapy.