It is very important that this conference focused more on understanding and preventing the anti-social behavior of young people, both at the social and psychological level. After all, we are in the land of Hippocrates and we know from him that "it is better to prevent it or to cure it".
Unfortunately, many times in daily practice, we are called upon to deal with children and teenagers who have shown delinquent behavior and then we realize the gap that exists in Greece, in terms of the special therapeutic treatment of such situations.
It is generally accepted that the official reaction of Society against misconduct should be directed in such a way as to aim at the least harm and the most profit. This is how the serious problem of "characterization" arises. It posits that while almost all young people are delinquent to some degree, one of the most powerful factors in creating a delinquent career is being caught and convicted and thus labeled a 'delinquent' or even worse a 'criminal'. . The label may change the attitudes of parents, teachers, the social environment, but it also affects the "self-image" of the young person himself, who now feels that he is a "lost cause" and a "bad guy".
Matters are made even worse if the designation results in the youth being isolated in "reformative" institutions that gather like-minded individuals and are governed by a secret hierarchy system dominated by the most antisocial and dysfunctional inmates.
In support of the above is the research of Gold and Williams, who studied two groups of boys who had self-reported four serious offenses; half had been arrested for the last offense and the other half had never been arrested.
Testing the case, those who had not been arrested subsequently had fewer convictions than those who had dealt with the courts.
Therefore, the problem of strict planning and construction of special therapeutic units is posed, with such conditions as to achieve the maximization of therapeutic efficiency.
I. Tsiantis mentions the following in the structure of the Child Psychiatric Services in Greece:
"It is a fact that changes in laws are not always accompanied by programs that require financial expenditure.
It is necessary to create a corresponding infrastructure to implement the new legislative measures.
For example, it will only be an exercise on paper if the more progressive and more humane legislative treatment of youth delinquency is not accompanied by the corresponding creation of appropriate treatment centers and hostels, which will be staffed by properly trained personnel."
In any case, it should be made clear from the beginning that the exact design of the treatment unit requires a long-term, expensive and collaborative study of many experts from different sciences. I emphasize that a single center, even an ideal one, cannot offer, from the outset, the same results to all delinquent young people since all delinquents are not the same.
Therefore, different planning is required for children who are starting out than those who already have a criminal career. Different design for socially oriented children and different for antisocial children. Different design for children who will be expected by a family, even with problems, and different for those without any family support.
Therefore, the issue is not only the creation of an "ideal" treatment unit, but the creation of a network of autonomous specialized treatment centers.
But there are also some common elements in the structure, which constitute and justify the use of the term "therapeutic" and which I will describe.
A therapeutic Unit to be therapeutic should combine on the one hand the therapeutic framework and on the other the necessary therapeutic staff.
THERAPEUTIC CONTEXT
The therapeutic framework is the maximum of the offer. Children are at risk of being treated either as "evil and dangerous perpetrators" or as "distracted and helpless victims".
Corresponding to the two perceptions, accumulated experience shows that a unit dealing with delinquent youth is at risk from two extremes.
On the one hand, to constitute a closed system, which, focusing on the need for boundaries, tends to turn into a sterile space. Here discipline will be achieved since less problems will be externalized, but when the door is opened, the new re-enterer in society tends to relapse.
At the other extreme is a liberal form that views the youth as a victim, leading to providing as much as possible and asking as little as possible. Here the young person feels much better, to the point of sometimes seeking his entrance, but he risks not changing his behavior patterns, i.e. remaining incurable.
The therapeutic unit, however, aims at realizing the delinquent behavior but separating it from the delinquency.
Therefore, a structure is required where the young person is accepted and offered understanding, tenderness and affection, but at the same time limits are set on his behavior, which he cannot exceed without consequences.
A contract is established that sets what is allowed and what is not, what exactly are the rules of the game. Of course, this may sound punitive or harsh. But we should realize that for many of the children, it might be the first time they will experience the existence of some rules, since they come from chaotic situations. It also creates some discomfort in the demand for adaptation, but at the same time it also creates the feeling of security, since the rules do not only provide for the obligations, but also the rights of the food. As a consequence, it helps not to create personal misunderstandings between the therapists and the treated.
Here also we should talk about the program, which should be detailed and complete for each moment. An example concerns the afternoon and evening hours. Children cannot be left alone with support staff and only under the supervision of a therapist. This is unacceptable, because what has been achieved in the morning, dissolves in the afternoon. The absence of structure enables the establishment of groups-gangs where the most negative elements are imposed and dominate.
We should be categorical here. It is better not to have a closed unit, if a 24-hour program is not provided, and of course when talking about such a program on a therapeutic basis, we are not talking about an oppressive and rigid one, but about constant care and concern and the therapeutic use of every moment and of every opportunity.
Even food, cleanliness, entertainment become opportunities for mobilizing young people and exploiting any creative potential and satisfying the needs for emotional release and communication, unleashing aggressive urges.
However, no matter how ideally a treatment unit works, it should not forget that its existence is not an end in itself, but only a transitional stage, where the young person will be supported in following a more functional life. Therefore, the unit is required to be functionally connected to the Community.
This means that young people are gradually and selectively given the opportunity to re-enter society. This also means the need for intermediate forms, such as professional workshops and hostels.
STAFF
The availability of appropriate therapeutic staff is fundamental. They are the ones who will undertake to implement the treatment for the specific delinquent children.
Deep scientific knowledge and expertise are therefore required. The presence of a sufficient number of the majors is required:
- Child psychiatrists
-Psychologists
-Social Workers
- Occupational therapists
-Special Educators
But scientific knowledge is not enough. It is necessary to elect therapists who are unusually determined with extreme patience, flexibility and personal stability. Those who undertake the treatment of antisocially aggressive children must be prepared to offer acceptance and affection for long periods of time with very little in return. Still, don't be surprised when their best mood and effort is met with bad behavior, denial of personal relationship, evasion, paranoid interpretation, and hostility.
Conversely, because many of the delinquent youth have become experts at deception and exploitation, treatment staff may feel betrayed and be led to conclude that the youth has lost all motivation to change.
A dangerous situation that can arise for personnel is splitting. That is, the separation between the "good" and the "bad". To the "condescending" and the "strict", etc.
Needless to say, if splitting situations prevail, without being interpreted, then such strong negative feelings develop that they end up in the total destruction of the whole effort.
Therefore, it is necessary to have an experienced specialist, who acts supportively towards the staff, increasing trust and understanding and also acts as a catalyst, so that they overcome periods of crisis.
Of course, the provision of financial, educational and work incentives (e.g. increased leave) is also considered helpful for the staff.
TREATMENTS
Family Therapy
Although everyone agrees that parallel work with the family is required, its realization faces many difficulties, since many times there is no family at all.
The presence of children's delinquency is related to chaotic families with a lack of boundaries, the absence of the father or corresponding patterns of parental delinquency.
Thus, the treatment of the family should start from the first day of admission of the child to the treatment unit. A key and dominant point is to consider that the specific child-offender has the symptom. But the problem is not his alone. This is the expression of family dysfunction.
Without this overall perspective of the family, the child will be stigmatized by other members as the black sheep and lead to rejection and increased delinquency.
Therefore, a traditional type of counseling for parents can bring little benefit.
Systematic family psychotherapy combined with couple therapy is required.
These are the most difficult tasks, since the therapist will have to overcome the manifestations of hatred between family members and stop the constant recriminations about "who is to blame", he will have to remain firm and not succumb to pressures to ally with someone against the other. And he still has to expect that at times the family will make a united front to attack him.
But the therapist should be ready not only to absorb all this tension, but to find, name and reward any positive elements that exist, so as to strengthen the self-esteem, but also the transaction of the family members, breaking thus the vicious cycle of attribution and pathology that breeds delinquency.
Behavior Therapy
Rewarding every positive effort and imposing consequences for negative behaviors, in combination with dynamic therapies, can help shape better attitudes on the part of young people.
Medication
There is no medication that can help with conduct disorders.
Classical, long individual psychotherapy has a response in only a small percentage of delinquent youth. According to Grant and Grant, the findings show that only the most mature youth responded satisfactorily to the classical psychotherapeutic technique. The most common defense of these children is acting out and therefore treatment faces enormous difficulties. In addition, young people will tend to be suspicious and wary. Nevertheless, a parallel individualized supportive therapeutic work is necessary, especially in adolescents whose delinquency is a manifestation of masked depression. So the therapist has important work to do in improving the "self-image" and building a more stable "I".
Group psychotherapy is one of the most effective methods in the treatment of delinquency, especially for delinquent children with socialized behavior.
It is not just a group treatment of children, but it is a form of psychotherapy that requires a special therapist and a specific technique. Especially in the context of working with delinquent teenagers, the young person will be helped to develop a range of skills. G. and B. Vassiliou state that: In the context of group psychotherapy, the young person must (a) be able to put himself in the position of the other, which requires differentiation in cognitive and emotional processes and types of behavior' (b) learn to cooperate and enter into a dialogue with the other members of his group. Restoring this dialogue requires the young person to have basic trust in others, 'openness', honesty and not seeking to control them' (c) the person needs a functional and applied self-awareness, in the sense of what they can and cannot to do and how much he wants to do it.
The most important task, however, is the initiation of the group into positive values of being consistent towards the "process of life".
In closing, I would like to show you a motto I found written on a wall in Athens:
"MAKE THE DESTRUCTION OF THE JOY, THE JOY OF THE DESTRUCTION"
Can we talk about healing without reversing it?
BIBLIOGRAPHY
G.A. VASSILEIOU THE MAN AS A SYSTEM: A PRESENTATION FOR THE CHILD PSYCHIATRIST.
I. TSIANTIS CONTEMPORARY ISSUES IN CHILD PSYCHIATRY, 1987.
P. KHARTOKOLIS INTRODUCTION TO PSYCHIATRY, 1986.
J.KASHANI, A.DANIEL COMPARISON OF PREDELINQUENT BOYS AND GIRLS IN GROUP HOMES AND FACTORS ASSOCIATED WITH THE OUTCOME, BRIT.J.PSYCH., 1984.
J. MEEKS CONDUCT DISORDERS, KAPLAN.
D. MOSTWIN LIFE SPACE OF PREDELINQUENT YOUTH AND THEIR FAMILIES, INTERNATIONAL J. FAMILY PSYCHIATRY, 1984.
REJOHNSON MOTHER'S VERSUS FATHER'S ROLE IN CAUSING ADOLESCENCE PREDELINQUENCY, SPRING 1987.
A. WALSH, JABEYER VIOLENT CRIME AND LOVE DEPRIVATION AMONG ADOLESCENT DELINQUENTS, ADOLESCENCE, FALL 1987.
BD GOLD SELF-IMAGE OF PUNK ROCK AND NONPUNK ROCK JUVENILE DELINQUENTS, ADOLESCENCE, FALL 1987.
RG DUNHAM, GP ALPERT KEEPING JUVENILE DELINQUENTS IN SCHOOL: A PREDICTION MODEL, ADOLESCENCE, SPRING 1987.
LL GEISMAR, K. WOOD FAMILY AND DELINQUENCY: RESOCIALIZING THE YOUNG OFFENDER, ADOLESCENCE, WINTER 1987.
Dimitris Karagiannis
International Symposium on the Prevention of Juvenile Delinquency, 1988