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Peer-Impact Diagnosis and Therapy

Peer-Impact Diagnosis and Therapy: A Handbook for Successful Practice with Adolescents

Vivian Center Seltzer
Copyright Date: 2009
Published by: NYU Press
Pages: 348
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  • Book Info
    Peer-Impact Diagnosis and Therapy
    Book Description:

    Adolescents are infamous for their rebellious behavior. Indeed,much of the focus of therapy and clinical intervention with troubled adolescents focuses on their presumed need to rebel against their parents as they define their own identities. Yet psychologist Vivian Center Seltzer argues that approaching work with adolescent clients with this presumption in mind is likely to miss the roots of their problem behavior.Rather than acting out against parental authority, adolescents in need of clinical help are most often dealing with their disappointing comparisons with their peers - the most relevant others to them during this period of their development. Seltzer explains that it is countless interactions with their peers, at school and elsewhere outside of the home, that are the primary mode of psychological and social development for adolescents. Practitioners must recognize this crucial influence, and perhaps forgo traditional approaches, in order to better work with their adolescent clients.Peer-Impact Diagnosis and Therapy is a practical professional guide for how to approach and aid troubled teens by accessing the wealth of insight to be gained from understanding the influence of peer interactions on development and on behavior. Full of diagnostic categories and protocols for use with all types of adolescents, as well as guidance, tips, case studies, and offering a targeted model for adolescent group therapy, Seltzer provides professionals with all the tools they need to assist teens on their road to adulthood.

    eISBN: 978-0-8147-4102-3
    Subjects: Psychology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-x)
  4. Introduction
    (pp. 1-16)

    This book is meant to aid professionals in understanding their adolescent clients by offering a theory and method of practice with adolescents. It differs from books in current circulation in connecting both normative and troubling behaviors to development and growth dynamics. With perhaps the exception of methods influenced by psychoanalytic theory, most current practice with adolescents has not been anchored in a theoretical road map. Yet without such a road map, it is not possible to determine which behaviors are deviant and which are not or what the therapeutic task is. Thus, this book fills an empty space in the...

  5. PART I Forces of Adolescent Development

    • 1 Dealing with Development: Four Domains of Adolescent Growth
      (pp. 19-45)

      It is important for professionals to bear in mind that from time to time it may seem as if the adolescent with whom you are working is quite different from the way he or she was just a few days before. This perception may be due to shifting moods but may well be a manifestation of a periodic integration of the gradual change occurring during this stage of growth, when child turns into adult. As noted in the introduction, development occurs in four domains: physical, cognitive, emotional, and social. Each domain proceeds along its individual calendar. Sometimes physical growth is...

    • 2 Dynamic Functional Interaction (DFI): A Revisionist and Sequential Theoretical Model of Adolescent Psychological Development and Behavior
      (pp. 46-63)

      The Basics Dynamic Functional Interaction (DFI) is the theory on which the practice model of this book is based.¹ DFI theory offers explanations for common problems we see in adolescents today. Its concepts explain the processes and dynamics of growth. According to DFI, problem behaviors are defensive actions, which occur when the psychological growth tasks of adolescence become too difficult and painful. Practical applications of DFI frame the diagnostic model of defensive glitches, diagnostic protocols, and PAL group therap presented in later chapters.

      Dynamic Functional Interaction describes and explains the functional purpose of most adolescent interactions and how adolescents push...

    • 3 Societal Designations: Adolescents Who Are Minorities
      (pp. 64-77)

      Being open, free, and welcoming is not easy in early and middle adolescence, the point when adolescents first move away from guidance of parents to seek their own individuality. It is an emotionally unsteady period. Adolescents’ preference to be with familiar age-mates and new ones who look and act similar is not a lack of openness. Rather, it reflects a developmental need for equilibrium. Being with others like oneself supports self-security and balances new uncertainties that arise on the road to psychological and emotional self-sufficiency. At this point in developmental time, most adolescents prefer being with others of their own...

    • 4 Societal Designations: Adolescents Who Are Gay
      (pp. 78-90)

      The preceding chapter looked at the impact of minority status on the adolescent experience. This chapter focuses on adolescents of one of those minority groups, those who are homosexual or still working out confusion about their gender identity or preference.¹ Such adolescents are found in all majority and minority groups. Notwithstanding their differences, it must be remembered that each is first and foremost an adolescent.

      A shift in attitudes in the first half of the twentieth century influenced theAnnals of Psychiatry’s designation of homosexuality as a category of mental illness. Currently, homosexuality is not listed inThe Diagnostic and...

    • 5 Parenting Adolescents
      (pp. 91-104)

      It may be strange to think of home as being a haven for adolescents. It is more common to think of home as the place adolescents consider full of restrictions, rules, and limits. In reality, it is both.

      Along with dramatic changes of puberty in the four domains of growth comes the psychological need to individuate and discover one’s own identity. As we have seen, age-mates become peers and attachment others, highly relevant as models of personality, talents, behaviors, character, and life-style choices. Parents and elders have exhausted their attachment currency. Indeed, one growth task of adolescence is to rework...

  6. PART II Defensive Glitches

    • 6 Defining and Detecting Defensive Glitches
      (pp. 107-121)

      A defensive glitchis a response to pain that brings a halt to the normative developmental process. The category of glitches includes a variety of defensive flights from unbearable psycho-emotional pain resulting from unexpected disappointing findings of comparative acts with peers over a period of time. The termglitchis apt because it implies the possibility of reversal.

      As we have seen, the DFI perspective on adolescent psychosocial development defines the psychological goal of adolescent development as cognitively and emotionally selecting self-elements that together constitute a sense of self, a sense of who the adolescent is. This collection of elements...

    • 7 Understanding Specific Defensive Glitches
      (pp. 122-150)

      As we have seen, adolescents who adopt defensive glitches for one reason or another have found comparisons with peers just too painful to bear and have taken psychological flight. Among them are those who take physical flight in substance use or abuse. Some individuals with glitches can be readily recognized; others are well disguised. All, when chronologically mature, will risk problems in adult functioning, including relationships and employment, though often problems will not be signifi-cant until a crisis arises. They also have not learned, through continuing comparisons and deliberations about the findings, which attributes carry intrinsic value and which do...

  7. PART III The Peer Arena Retrospect (PAR) Protocols

    • 8 Getting to Know the Adolescent: An Introduction to the PAR Protocols
      (pp. 153-168)

      Though adolescents are most focused on their peers, and on learning what is hot and looked on favorably, too many models of therapy seem to pass right over this vital piece of adolescent reality despite its ubiquity, evident in their conversations, music, fashion, and activities. Adolescents’ resistance to therapy can many times be connected to its outmoded emphases on familiar family matters that miss what is on their radar, from cell phones, text messaging, and Facebook to face-to-face exchanges about the latest or forthcoming peer haunts and happenings. The DFI approach focuses from the outset on adolescents’ daily concerns in...

    • 9 Phase I: Basic and Circumstance-Specific Auxiliary Protocols
      (pp. 169-187)

      When adolescents are in the admissions and diagnosis period, it is necessary to gain as much information as possible about the circumstances of their situation. This information is most efficiently elicited by the professional through use of a Basic protocol and, if necessary, one or more of the Circumstance-Specific Auxiliary protocols, which are designed to elicit information from a specific source area. The Phase I Basic protocol that is ordinarily used first is PAR-A (Adolescent), the most comprehensive of the Basic protocols.

      There are some matters of clinical judgment in using the protocols. For example, practitioners should feel free to...

    • 10 Phase I Continued: Supplementary Protocols for Further Exploration
      (pp. 188-205)

      Many of the questions in the Supplementary protocols focus on peers and friendship, on comparative-act dynamics in the Peer Arena and their results and impact on matters of interest to adolescents in the present and on their future goal setting (issues introduced in parts 1 and 2 of this book). Embedded in the Supplementary protocols are questions that may seem quite neutral but actually elicit the information sought or lead up to eliciting qualitative information such as emotional reactions to comparative acts with age-mates. A few questions may be recognized as having been asked in prior protocols; they are asked...

    • 11 Phase II: Defensive Glitch Protocols
      (pp. 206-222)

      The Phase II protocols are used with adolescents who have been determined to have psychologically turned off Peer Arena comparative acts, thus aborting or seriously delaying development. Notwithstanding these adolescents’ psychological turning off, most of them remain in settings with peers, though some do flee these settings altogether. They engage defensive behaviors that I have been referring to asdefensive glitches, some serious and some less so. But all these glitches divert energies away from normative tasks of growth. As discussed in chapters 6 and 7 glitches are defenses that adolescents build up to shield themselves from painful and disillusioning...

  8. PART IV Peer Arena Lens (PAL) Group Therapy

    • 12 Working Together
      (pp. 225-243)

      Group therapy with adolescents that simply replicates adult group therapy is not geared to adolescents’ particular needs. Nevertheless, such approaches have been dominant, with little recognition that just as children and adolescents are not the same, adolescents and adults are not the same. Adolescents are not little adults, just as they are not big children. They are an independent, different kind of individual. They are persons under development. Thus, the type of group therapy that will be effective must replicate the dynamics of the psychological world in which they live, not the psychological worlds of children or adults. Simply stated,...

    • 13 PAL Group Therapy in Action: Two Case Studies
      (pp. 244-261)

      Two case examples in this chapter and a somewhat longer one in chapter 14 illustrate the structure and process of PAL group therapy. The first case, that of Sally, concentrates primarily on Sally’s experience. The precise role of the professional is mentioned little, except for noting the diagnoses and protocols used. The second case, that of Abigail, presents information on an unusual home environment, impact of scarcity of peers for comparative acts, impact of puberty, developing a defensive glitch, use of protocols, and PAL therapy interactional dynamics. The case example in chapter 14 presents a different type of professional challenge....

    • 14 PAL and the Professional: Davey’s Story
      (pp. 262-292)

      In this chapter, a third case example, that of Davey, is presented in greater detail than the case examples in chapter 13 in order to provide a look at the ever-present potential for complexity in PAL group therapy. Several examples of complexity are evident in this case, including the decision-making process that must take place to meet an adolescent’s altered “next-step” needs. Sometimes such adjustments are minor, but at other times the plan might require a radical change of course. Davey’s case also demonstrates how PAL procedures can be mixed and matched and how and when PAR protocols can be...

  9. Conclusion
    (pp. 293-294)

    In this book we have seen how useful a Peer Arena lens can be in illuminating confusing adolescent behavior. By understanding such behavior as stemming largely from psychological interactions and comparison with peers, we gain the ability to trace adolescents’ endeavors to see themselves through the stressful period of individuation and of becoming their own person. With this lens, the professional comes to understand the adolescent imperative to be together with other adolescents. Working skillfully with adolescents requires a grasp of this phenomenon. What has traditionally been perceived as a “conflict of the generations” and “rebellion” misses the essence of...

  10. Notes
    (pp. 295-304)
  11. References
    (pp. 305-320)
  12. Index
    (pp. 321-333)
  13. About the Author
    (pp. 334-334)