Guidelines for Choosing an "Intervention Package" for Working with Adolescent Girls in Distress
Berger, Roni, Shechter, Yuta, Adolescence
This article presents guidelines for systematic treatment planning for adolescent girls in distress. The importance of choosing an intervention plan according to differential assessment of the client has been emphasized and applied to various client populations (Turner, 1968; Gambrill, 1983; Proctor & Rosen, 1983; Kirst-Ashman & Hull, 1993). However, its application to girls in distress has not been explored.
Girls in distress discussed here are 13 to 19 years old, experience severe difficulties in school, work, and family relationships, and are poorly equipped for coping with their age-characteristic physiological changes, and are consequently extremely vulnerable and present deviant behavior. Their characteristics and unique predicaments have been discussed elsewhere (Berger & Shechter, 1989). On the basis of that previous discussion, the current article offers principles for "tailoring" treatment plans to address their specific needs.
Previous researchers have debated whether community-based work or residential care better serves the needs of these girls, developing models for psychotherapy with girls in general and discussing different treatment plans for girls in distress in residential care (Konopka, 1966; Vedder & Somerville, 1970; Steiner, 1981; Schwer & Weiss, 1986; Tenne, 1987; Matheson, 1992; Ponton, 1993). Little has been written about developing appropriate "open treatment" for adolescent girls in the community (Grigsby, 1992), and this is the focus of the current article.
The assumption here is that to be effective, interventions need to be tailored to the characteristics of each adolescent girl. First, typical profiles of the target population are presented. Next intervention packages are analyzed. Guidelines are then offered for developing a differential intervention package to match each adolescent's profile.
Profiles of Girls in Distress
A review of the literature reveals two major sets of factors which characterize girls in distress: personality traits and patterns of socialization (McBroom, 1970; Skolnick, 1973). Four types of personality and four types of socialization are described.
a. Personality traits. Studies by Cattel (1976), Grant (1961), Havel (1960), and Arad (1975) yield four types of personality: balanced, neurotic, personality with lacunae and deviant personality.
a1. Balanced personality. This type is characterized by the ability to form relationships, to distinguish self from others, differentiate external from internal realities, delay gratification, and cope adequately. Emotions are balanced and appropriate, perception is flexible. Reasonable functioning is insured by internalized social norms, calculated risk taking, responsibility, and consideration of long-term consequences.
a2. Neurotic personality. Ambivalence and assuming exaggerated responsibility are typical of this type of personality. Internalized conflict accompanied by guilt interferes with gaining satisfaction with self and is expressed through acting-out behavior or neurotic symptoms.
a3. Personality with lacunae. A combination of adequate and defective aspects with discrepancies between various areas of functioning characterizes this personality type. These girls form relationships mostly to fulfill concrete needs while their sense of belonging is impaired. Typical are "islands" of anxiety, tension, guilt, and a tendency to follow powerful figures. Social norms are partially internalized, ability to plan is limited, and fluctuations in readiness to take responsibility often occur. The emotional range is limited, with frequent fluctuations.
a4. Deviant personality. These girls were previously defined as "passive-complaining" (Beverly, 1965) and girls with perverse sub-culture (Shechter, 1984). An overall deficiency in various personality aspects characterizes these girls. They are demanding and mostly preoccupied with themselves. …