Background: Violence among youth continues to be a serious public health concern across the nation.
Researchers have increasingly argued that effective violence preventions efforts and practice must consider
the lived experience of youth. Retaliatory violence (i.e., violence in response to a perceived attack or
threat) is a major concern and risk issue for young people, and has been increasingly linked to lethal violence.
Primary care and mental health practitioners can play a vital role in helping young people who struggle with
retaliatory violence to understand the emotions and decisions associated with these situations. However, there
is limited research advising clinicians on how to help youth negotiate these issues in treatment.
Methods: In this paper, we offer a brief review of the literature regarding youth and retaliatory violence, discuss
the role of psychotherapy with this population using case reports, and offer clinical recommendations for
clinicians working with this population. Clinical case reports from a community clinic in an urban neighborhood
in the northeast are utilized to illustrate challenges and successes involved in psychotherapy aimed at
helping youth manage retaliatory violence.
Results: Clinician responses that validate the complexity of threat and identity issues experienced by clients
but also offer face saving non-violent options are beneficial. We also discuss gender and fighting behaviors
that have implications for how girls learn to resolve conflicts in later life.
Conclusions: It is critical that clinicians use interventions that are grounded in the norms in which youth live
and help them generate non-violent responses to perceived threats, but enable both parties to save face and
therefore preserve a sense of identity and dignity.