Group Supervision of Psychoanalytic Psychotherapy with Difficult to Treat Adolescents: Supporting the Therapist and the Therapeutic Alliance
Background: Psychoanalytic psychotherapy with adolescents with severe disturbances present many challenges
for the therapist. Different difficulties might appear: 1) at the time of the first encounter, when it is difficult to create a
therapeutic alliance with the patient; 2) during the therapy, when there are frequent risks of ruptures linked to the adolescent’s
acting out as well as the parents’ behavior, attacking the therapeutic setting and links. As a result, aggressive
counter-transference feelings develop in the therapist, which lead to therapeutic nihilism and threaten the continuation of
Method: We present the experience of a supervision group of psychoanalytically oriented therapists working in long term
psychotherapy with severely disturbed adolescents. The aim of the group is to support the practitioners in their work with
adolescent patients with severe psychopathology. Each participant contributes associations on the case being presented to
the group, and these associations are integrated together by a senior analyst. The group process supports the progress of
the patient sustains the investment of the therapist in the treatment.
Conclusions: The working through in the group supports intersubjectivity, reducing tendencies for disengagement. It highlights
particular archaic mechanisms of psychic functioning and prevents pathological repetition in the field of the therapeutic
Keywords: Adolescents, psychoanalytic psychotherapy, supervision, group supervision, long-term therapy.
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