ABSTRACT
Conducting psychotherapy with adolescents is often exciting, stimulating, and thought provoking. It can also be challenging, frustrating, confrontational, and disarmingly honest. To maintain equilibrium the therapist must bring to the therapeutic journey some background in normal psychological development, that is an understanding of the early, middle, and late stages of adolescence; an understanding of changes in symptoms and clinical presentation that vary with stage; an understanding of the characteristic patterns of transference and countertrans-ference that vary with stage; and some appreciation of cognitive functioning during adolescence, most importantly with regard to abstract thinking and time perspective (Offer, 1969; Golombek & Marton, 1992). Empirical developmental research and clinical studies have demonstrated a progression of conflictual themes throughout the course of adolescence. During early adolescence, teenagers present with exaggerated feelings of dependency and neediness; during middle adolescence, with exaggerated feelings of independence and self-sufficiency; in late adolescence, with exaggerated longings for intimacy and closeness (Golombek and Kutcher, 1990). Associated with these thematic changes are changes in the predominant transference reactions. Early adolescents tend to experience a therapist as a frustrating provider. Middle adolescents tend to experience their therapists as a challenging and controlling authority figure, while late adolescents tend to experience therapists as intimate, idealized confidants. As central intrapsychic conflictual themes are experienced in the therapeutic relationship, the transference often becomes an important arena for the development of emotional insight into maladaptive, stage-specific, exaggerated personality patterns. The patterns that appear clearly in the transference are presented most often by patients in relation to difficulties with current interpersonal relationships. Reference to genetic formulations are frequently presented in the therapy but are generally experienced by patients to be of less emotional importance, particularly with early and middle adolescents.
