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Abstract
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VioLit summary:
OBJECTIVE:
The goal of this study by Meeks was to present an overview of the literature on the etiology of violent behavior and to provide treatment alternatives for violent adolescent inpatients. A psychoanalytical approach was used.
METHODOLOGY:
A non-experimental review of the pertinent literature was employed for this study. Additionally, the author presented a case study to illustrate his key points.
FINDINGS/DISCUSSION:
The author stated that little has been discussed in the psychiatric literature on the management and inpatient treatment of the violent psychiatrically disturbed adolescent. The author stated that this is possibly related to the behavior of the violent inpatient adolescent. For example, the author said that violent behavior can be exhibited across a variety of psychiatric diagnoses, and violent behavior has been shown to occur episodically, not constantly. The author stated that these conditions have made it difficult to make accurate conclusions about violent adolescent behavior. Also, the author said that various predisposing factors to violent behavior have made prediction of violent outbursts difficult. Firstly, organic factors such as brain damage, or the biological effects of drugs and alcohol abuse, have been shown to contribute towards violent behavior. Secondly, research has revealed that adverse life events may result in violent behavior. For example, for many, the observation of violence in the home has resulted in the development of violent problem solving skills and those who have been victims of physical abuse have exhibited violent behavior later in life. The author stated that all factors impact on the adolescent's adaptive ability. The author stated these factors interfere with the functioning of the ego and the course of normal development of the individual. The author reported that delinquent adolescents will often exhibit low self-esteem or believe that they lack control over their life. Also, interpersonal relationships, study and problem solving skills will often be deficient.
The author discussed the concept of pseudocompetence as a spurious positive sense of self obtained by embracing non-conventional (e.g., delinquent) life-styles that permit success for the adolescent, however short lived it may be. For example, the violent adolescent inpatient may have achieved pseudo-competence by earning respect from members of a delinquent subculture for daring or violent behavior. The adolescent would have learned that violence is a short-circuit method to solving a problem, thereby making pseudocompetence even more attractive to the adolescent.
The author cited Halleck (1980) who had commented that the two most common motives for violent action include escaping oppression and raising one's self-esteem. Halleck also suggested that violent behavior can be used as a means for gaining control over others, obtaining resources, or for the satisfaction of emotional needs such as sadism and revenge. The author of this study suggested that when these motives are applied to the violent action of the adolescent inpatient, adolescents may be labelled villains or heroes. For example, the author said that according to some staff adolescents' actions are villainous. However, the author claimed that normally in the hospital setting, the adolescent engages in violent activity to gain respect by being the "hero".
The author used the clinical example of "Bobby" a violent adolescent inpatient, to illustrate the notion of "hero" type behavior and to indicate methods of treatment. The author reported that Bobby, an adolescent with problems with drug abuse, viewed his violent behavior as self-defense and also as a necessary means to securing social justice and a sense of self-esteem. Bobby was regarded a hero among his peers. Case management of Bobby included both individual and family therapy and treatment centered around two goals. The first was to acknowledge to Bobby that he possessed genuine heroic attributes, and the second was to explain his former violent behavior to him as less heroic that what he had previously believed. The author reported that although Bobby continued to disagree verbally with new versions of reality that were presented to him, his violent behavior dissipated.
AUTHOR'S RECOMMENDATIONS:
The author stated that general approaches in the treatment of the violent adolescent inpatient should consist of a statement on the non-tolerance of violence and an emphasis upon dealing with one's feelings as well as those of others. Also the author asserted that treatment needs to include: 1) the legitimizing of angry feelings and assisting the patient in understanding internal hostility; 2) empowerment of the individual; 3) assertiveness training and supervised confrontation sessions to assist conflict situations; 4) the advocacy of a value system insisting that avoiding conflict is more heroic than engaging in conflict; 5) suggestions that solutions can be found without the use of violence; and 6) making it understood that true competence can be obtained through positive interaction with others.
(CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
Juvenile Offender
Juvenile Patient
Juvenile Treatment
Juvenile Violence
Mental Health Institution
Mental Health Treatment
Patient Treatment
Offender Treatment
Violence Treatment
Literature Review
01-03
Language: en |