The Assessment of Object Relations Phenomena in Adolescents: Tat and Rorschach Measures

By Francis D. Kelly | Go to book overview

In the follow-up disposition conference with the mother, school personnel, and newest therapist, the psychologist shared impressions and concerns relating to the need to reconsider and alter the treatment direction based on Michael's faltering behavioral adjustment at home and his marginal adaptation at school. Referral for a residential placement was the primary recommendation. This was based in part on psychological test material highlighting prominent and consistent impairment, distortions, and highly compromised object representations mirrored by his erratic, unpredictable, and increasingly troubled behavioral adjustment, especially in the home setting. The SCORS and MOA material suggested a more aggressive and integrated therapeutic course was indicated. His mother, despite her good intentions, appeared increasingly unable to provide containment, structure, and an adequate environment to parent her son. Michael required a setting that would enable him to quell his acting out and begin to experience and internalize stability, predictability, and consistency. Of paramount concern was the fact that he had demonstrated recent serious loss of impulse control (e.g., threatening his stepfather with a baseball bat) and also voiced intrapunitive ideation (i.e., suicidal and self-destructive thoughts).


SUMMARY

This chapter was designed to illustrate two points relating to assessment and treatment. First, with respect to both of these adolescents, the initial assessment of object representations informs and advises clinicians as to how differences in the content and structure of object representations dictate the most appropriate type and subsequent level of therapeutic intervention. Second, object representation measures provide the clinician with a sense of how effective therapeutic interventions have been. This is reflected by examining measures demonstrating the modification of how adolescents view themselves and others--that is, how their object representations were altered and modified.

In the first case, that involving Tim, the nature of the therapeutic treatment was largely predetermined by the fact that he was in a setting emphasizing a multimodal treatment paradigm. Initial measures of object representation served to define potential treatment pitfalls as well as critical therapeutic interventions that would expedite and promote improved and more differentiated inner modifications with respect to his sense of self and others. Follow-up impressions attested to the utility of SCORS and MOA data in providing information that perceptible inner changes and alterations of this adolescent's inner object representational template had occurred following 2 years of residential treatment. These

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