Adolescents' narrative constructions of their experiences in residential treatment: Key therapeutic elements and processes

Sheryl Ann Kamman-Russman (1989)

Past research efforts focusing on specific therapeutic techniques and/or outcome data have been unable to sufficiently illuminate key elements contributing to therapeutic change in adolescent residential treatment. These youth are the focus of many therapeutic endeavors, yet they are seldom asked for their perceptions of the process. In fact, when self-report data are elicited, they are often considered inaccurate or suspect. It is the purpose of this study to address the significance of adolescent perceptions of change in the residential milieu--to what do these adolescents attribute their improvements? An overview of the development of residential treatment and current research results regarding this treatment modality provides the context and foundation for this project. A social constructivist perspective, which views reality as being actively created through social interaction, is suggested as a means for understanding how therapeutic change occurs in this setting. The nature of constructions, and the meanings assigned to past events, persons, and experiences as developed through social interchange are explored, with an emphasis on their role in self-report data. A narrative framework is proposed as a methodology for gathering and analyzing adolescents' experiences and perceptions of change. Preliminary findings illuminate the developmental nature and sequence of therapeutic change in residential treatment. The development of a meaningful adult-child relationship is identified as a key therapeutic element leading to adaptive functioning.