Mental health professionals working in adolescent residential treatment facilities face various challenges in delivering effective treatment to their patients. Establishing therapeutic alliance is often regarded as particularly daunting. Adolescents' acting-out behaviors, emotional dysregulation, and difficulty in trusting adults can trigger strong reactions in mental health professionals. These reactions may increase the risk that mental health professionals respond to adolescents' behaviors in similarly unmodulated ways and become involved in a reciprocal pathological process. The Rorschach test can provide vivid imagery and response content that depicts the subjective dilemmas adolescents are struggling with during their recovery in the treatment center. In this paper we show how to use Rorschach imagery to allow the mental health professionals working in adolescent inpatient treatment centers to understand their patients and increase empathy in response to adolescents' troubling behaviors. We illustrate this procedure through the case of an adolescent patient who engaged in severely disruptive acting-out behaviors with the treating staff. Even though the staff were considering terminating his treatment in the facility as the only viable option, they instead found new empathy and a way to work with him after discussion of his Rorschach led by the inpatient center psychologist.
- residential treatment