READINESS FOR PSYCHOANALYTIC TREATMENT IN LATE ADOLESCENCE - DEVELOPMENTAL AND ADAPTIVE CONSIDERATIONS

Clinical experience during two and a half decades in a university ment al health service suggests that late-adolescent college students do no t readily avail themselves of the opportunity for longer term psychoan alytic psychotherapy, even when such treatment is quite accessible. At the same time, late adolescents do make significant use of psychologi cal services for briefer contacts. The psychoanalytic literature is ge nerally cautious about the possibility of involving adolescents in tre atment. In addition to the intrapsychic dynamics described in the lite rature, this article addresses the impact of the unique relationship t he late adolescent develops toward the adult environment on readiness for treatment. An adaptive framework is proposed that outlines the int erwoven influences throughout development of environmental adaptations and intrapsychic dynamics. It is suggested that these intertwined, ad aptive-intrapsychic changes engender a particularly charged, transfere nce-like relationship that detracts from the kind of internalization o f conflict necessary to engage in psychoanalytically oriented treatmen t. Given this developmental context, the type of clinical services tha t are most suitable for late-adolescent patients are discussed, includ ing problems inherent in time-limited treatments and the importance of establishing a collaborative alliance with the late-adolescent patien t from the outset of the initial evaluation.