MedicalResearch.com Interview with:
Alfio Maggiolini, MD
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Antisocial behaviour is common during adolescence and it incurs significant costs both for society and for the young people themselves. Persistent antisocial behaviour places a heavy burden on the community, the justice system and the public health system. Responses to juvenile crime have always seen a tension between a focus on the understanding and the rehabilitation of the youth and the need to enforce discipline and public safety through punishment and threat.
The treatment of young offenders was traditionally deemed particularly difficult, and often ineffective. In recent years, therapeutic nihilism has given way to cautious optimism. While punitive-based approaches, at all levels, are hardly ever effective in the long term, the most popular and effective programs tend to focus on behaviour control. Common core elements of such programs include positive reinforcement, problem solving skills training and role playing, as behavioral problems are often assumed somewhat inherently wrong, or a “lack of something”, the programs aims at improving or changing.
The study presents a developmental approach that understands behavioral problems as the result of intentions, values and goals that need to be taken in full consideration and that are usually legitimate, even though carried out in ways that prove dysfunctional for both the young person and society. In other words, we consider antisocial behaviors as maladaptive responses to legitimate developmental tasks, a deviant way of meeting positive goals and taking control of one’s life. In the program we describe, a developmental understanding is combined with a psychoanalytically informed perspective on treatment and delivered in multi-modal terms. It has been carried out in Italy for the past 20 years, with positive outcomes, both in private practice and within the juvenile justice services.
MedicalResearch.com: What should readers take away from your report?
Response: Practitioners should be more optimistic about the treatment of young offenders, not only in terms of behavior control but, perhaps more interestingly, by developing working alliance, helping them overcome the helplessness that may underpin their actions and pave the way for their future.
All readers should on the contrary be very skeptical about punitive-based approaches, as they tend to increase rather than decrease juvenile crime and miss the opportunity to act like the responsible adults we ask young offenders to become.
MedicalResearch.com: Is there anything else you would like to add? Any disclosures?
Response: Psychological treatment should not just aim at improving one’s skills, repairing psychological damage or overcoming some deficit. The capacity to respond to psychological, social and developmental needs should inform studies on the outcomes of psychotherapy and treatment.
This seems particularly applicable to the work with young offenders, which questions the role of family, the environment and society at large. Society has the responsibility to promote young people’s development and growth, besides punishment and rehabilitation.
Maggiolini, A.; Suigo, V. Developmental Psychotherapy for Antisocial Adolescents. Adolescent Psychiatry, 2018, Vol. 8. DOI: 10.2174/2210676608666180502101353
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