Enforced outpatient treatment of advantaged pseudosociopathic neurotically disturbed young women.

Abstract

This paper reviews the psychotherapeutic treatment of twenty-five young women who presented with problems of disturbed and antisocial behaviour including promiscuity, failing in school, alcohol and drug abuse and general social ineptitude. A combination of individual and group psychotherapy was used following an initial period of hospitalization. The principal features of the method were the use of money as a reward for remaining in psychotherapy and reporting regularly for work, together with partial or complete separation of the patient from her parents during psychotherapy. Psychotherapy was used in an active form between the therapist and the patient, and the therapeutic model containing elements of support, insight and direct advice interwoven in a flexible fashion and superimposed on the basis of a warm, real and positive relationship. An enforced program of work or job training was a requirement of continuing the psychotherapeutic relationship with the therapist. The treatment program made it possible to differentiate sociopathic from pseudosociopathic patients, and the results of treatment in the latter group were good. The outcome of therapy in the sociopathic patients was poor. The methods described are offered as a possible model which could be used in private psychiatric practice for patients who have both biological and socioeconomic advantage.