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Clinical treatment of adolescent with behaviour disorders : an evaluation survey of patients admitted to Crease Clinic, (British Columbia), 1956-1958 Rolston, Joyce Fairchild

Abstract

As a short-term psychiatric centre, Crease Clinic was designed for the treatment of adults. In common with many other adult mental institutions in North America, however, it has increasingly been asked to assume responsibility for the care of adolescents, because of the lack of more appropriate resources for young people. Conscious of the fact that the younger patients need a type of treatment different from that of adults, the Clinic has, at various times, tried to introduce modifications within its main psychiatric programme for the benefit of this age-group. Nevertheless, adolescent patients have continued to pose problems to both the hospital and community, and there are serious questions on both sides as to what legitimate achievements can be expected from their treatment in the Clinic. Accordingly, this study surveys the problems and needs of a selected group of adolescent patients, namely, those suffering from behaviour disorders. In the light of dynamic knowledge of their personality structures, it seeks to evaluate the degree to which the Clinic is meeting the needs, and the directions in which its programme might be strengthened or modified. The group of adolescents, those thirteen to nineteen years of age who were admitted to Crease Clinic in the period 1956 - 1958, numbers forty-four in all. Information derived from the clinical records covers the problems they presented, their family backgrounds, and their living circumstances at the time of admission. The clinical treatment programme is examined in its basic aspects of: (1) "milieu" and activity programmes; (2) psychotherapy and somatic therapies; (3) participation of parents; (4) the role of social service. Data were obtained on this portion of the study from the files of the sample group of patients, from interviews with staff members, and from the writer's personal experience as a social worker in Crease Clinic. The main conclusion reached is that there is a clear need for a specific unit for the treatment of adolescents, whether it be attached to the mental hospital, or established separately within the community. The treatment currently available within the Clinic for these young patients is not adequate to meet their needs; some of the primary deficits appear to be: (1) the limit upon the period of residence in the Clinic; (2) insufficient structuring and coordination of the various therapeutic programmes, and (3) the lack of individually planned treatment related to each patient's particular needs and problems. There is evidence that Crease Clinic can offer this type of patient limited service as an emergency resource for suicidal or assaultive youngsters, as a diagnostic resource for those needing immediate assessment or a period of observation, and as a treatment unit for the minimally-disturbed adolescent whose "acting-out" seems to stem from current situational stresses. However, to effect permanent treatment gains for this group of disturbed adolescents, an appropriately-staffed In-patient resource, designed specifically to meet their needs, is essential.

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