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Clinical & Research NewsFull Access

Parents, Teens Try to Heal Wounds

Published Online:https://doi.org/10.1176/pn.42.10.0033a

To search for factors demonstrating reslience in troubled teens hospitalized for psychiatric problems, researchers recorded and transcribed semistructured interviews with adolescents in High Valley Children's Center, a pseudonym for a large, prestigious psychiatric facility in the Northeast. After the youth were discharged, the researchers interviewed them and their families yearly and continued to assess them for ego development, self-esteem, self-image, and behavioral symptoms. Some of the children were psychotic, others were depressed, and some had disruptive neurological symptoms. Sometimes the juvenile-justice system ordered hospitalization for evaluation in lieu of incarceration.

Behavioral symptoms included violent outbursts, uncontrollable behavior, and self-destructive conduct such as self-mutilation or suicide gestures that made it impossible to allow them to remain at home. The center's primary concern was protecting the youth from engaging in behaviors harmful to themselves or others.

The researchers recorded yearly family discussions. Since the children were typically on bad terms with their parents, and often the parents themselves were a fundamental part of the problem, family discussions at the center let the children and parents talk with each other about their problems and let interviewers evaluate the interactions.

The annual family discussions were based on revealed differences between family members to a series of moral dilemmas to which they responded individually and to separate interviewers. Referring to Kohlberg's theory of moral development, the interviewers related stories illustrating moral dilemmas to the children and parents to see how they would justify their actions if put in similar predicaments The responses were used to help evaluate the child's or parent's moral-development stage.

The adolescents and their parent or parents were then brought together to defend their different answers and come to a family consensus.

The content and format of the discussions were kept constant each year.