At-Risk Youth Part IV
By Sonya M. Thompkins and Robert C. Schwartz, PhD
Recent evidence suggests that personal resilience can have positive therapeutic implications for guiding youth at risk toward improved coping skills and enhanced functional outcomes. Various clinical issues presented by child and adolescent clients are particularly challenging for psychotherapists. It is not uncommon for psychotherapists to feel helplessness, frustration and confusion regarding the issues that children and adolescents manifest in therapy.
Implications for Psychotherapists
Because youth at risk are by definition exposed to behavioral, familial, educational, and societal adversity, these individuals often present in psychotherapy as unmotivated, defiant, oppositional, and possibly hostile. The potentially explosive combination of prior trauma, current maladaptive coping styles, and reduced personal resilience can make it difficult to develop a therapeutic relationship which does not elicit anger, resentment of authority, or rebellion. As Hanna and Hunt (1999) stated, “Adolescents [especially youth at risk] are among the most difficult of all the various populations that present themselves in therapy. Within a very short time frame, adolescents can be insulting, spiteful, charming, lovable, conniving, compelling, and deceitful” (p. 56). This sentiment is echoed by Hanna, Hanna, and Keys (1999), who noted that youth at risk are often extremely difficult to engage fully in therapy, even for the most well-trained and skilled psychotherapists. These challenges implore the question, “How can psychotherapists connect with and motivate (at-risk) youth in order to build resilience during the psychotherapeutic process?” Clinical wisdom must be developed and implemented in order to successfully work through client opposition, competing negative environmental influences. Often precarious behavior patterns can potentially make or break effective treatment (Hanna & Hunt, 1999).
General Interventions for Psychotherapists
Due to the numerous issues faced by youth at risk, it is often difficult to know, in reliable terms, which treatment approaches best fit each at-risk behavior. This validates the need for general interventions to be available to psychotherapists to use with all youth at risk. The following general interventions cut across all professional orientations, demographics, client characteristics and clinical diagnoses.