Treating Abused Adolescents by Eliana Gil - Essay Example

Treating Abused Adolescents by Eliana Gil in APA style Treating Abused Adolescents by Eliana Gil – Book Review The book, Treating Abused Adolescents by Eliana Gil describes the abuse suffered by adolescents between the ages of 13 – 18 and the terrible consequences that blight their young lives. Using her own extensive experience working with abused adolescents and her intimate knowledge of the available research literature pertaining to abuse, psychological and developmental theories, she draws up a cohesive report of the situation as it is. She describes the toll abuse takes on hapless youngsters, treatment options to help victims for professionals designed to improve communication and to deal more effectively with these troubled individuals by understanding the exact nature and root causes of their trauma. Gil (1996) also points out the scarcity of research pertaining to adolescent abuse and says, “… this may reflect the lack of concern about the plight of older youngsters, who are perceived by many as less vulnerable, more resourceful, and more capable of self – protection than younger children” (p. 50). Gil begins the book by outlining the case of Jennifer, who was subject to sexual abuse from the age of 2. Having run away from home and several foster homes, she turned to prostitution and panhandling and becomes pregnant by the age of 13. Jennifer was a seemingly hopeless case as she had suffered too long and too deeply. Yet she dug deep within and found the courage to cope with her problems effectively. On this inspiring note, Gil proceeds to give an overview of the book. She describes the term “adolescence” and gives us a history of its roots, explaining how social and political movements and changes have influenced our perception and understanding of these individuals. Adolescence is a crucial developmental period in the life of the individual and traumatic events that disrupt normal development may have lifelong implications for the victim. This is therefore a serious issue and one that has been largely ignored because of existing misconceptions about adolescents who are in a delicate transitional phase, where they are neither children nor adults. Many people credit them with a maturity that is actually far beyond their years and are not cognizant of their innate vulnerability and therefore treat them with barely veiled hostility and suspicion. The shocking fact is that many professionals have the same misguided notions about adolescents. Gil (996) tells the case of a professional who said, “‘That girl knew what she wanted and knew how to get it’, in regard to a case of incest in which the father gave his daughter expensive gifts” (p.14). She calls for a change in this attitude and bias towards adolescent victims and points out the need for further studies and research to help them. The second chapter is entitled Theories of Adolescent Development and has been compiled with Karren Campbell. In this chapter Gil (1996) stresses that “A thorough knowledge of theories of development is essential for those who work with adolescents, particularly when it is likely that the developmental process of many such adolescents has been disrupted or compromised by maltreatment” (p. 23). Drawing from her knowledge on the available research material and referring to the work done on the subject, she analyses the factors that make adolescents vulnerable to abuse and the symptoms of abuse that are most likely to be manifested. She traces the developmental stages of adolescents and explores the hurdles and difficulties that are likely to hamper progress as the adolescent makes the journey from childhood to adulthood. In the third chapter Gil makes a distinction between current and cumulative abuse of adolescents. Current abuse of adolescents refers to those who suffer abuse only during their adolescent years, whereas cumulative abuse refers to those who have been exposed to sustained or intermittent abuse from their early childhood. With regard to the former instance, abuse is probably the result of an inability to cope with the complexities in the developmental stage for the parent as well as the adolescent. It is usually the result of adolescents chafing under rigid parental authority as they seek to establish their independence and parents who are unwilling to relinquish control. The situation can be resolved by establishing better channels of communication, defining roles and dealing with conflict and control issues. Cumulative abuse is more serious as the damage is far more palpable, leaving the adolescent bruised and battered. Since the trauma is more severe, these victims are likely to have deteriorated mentally and physically. They are also less responsive to traditional methods of treatment as they are unable to trust adults. Therefore a more intensive and lengthy care regime is called for. It is important to make this distinction, in order to understand the circumstances leading to abuse, and to develop the most suitable treatment method. As Gil (1996) puts it, “An accurate assessment of whether an adolescent client is a victim of current or cumulative abuse will allow a clinician to determine relevant therapy goals and formats” (p. 52). The next chapter deals with assessment and treatment. Gil asserts that it is necessary to ascertain the effects of adolescent abuses particularly the reactions to abuse such as acting out, anxiety, depression and other adjustment problems. Such reactions usually set off a chain reaction that culminates in extremely self – destructive behavior like substance abuse, sexual promiscuity or even suicide. Thus the symptoms of adolescent abuse need to be carefully assessed in order to fully understand the etiology and to determine the correct approach to treatment for a favorable prognosis. Gil’s treatment approach stems from knowledge gathered by reading, her studies, personal experience and collaboration with colleagues and is rather eclectic. Victims of abuse have their own unique methods of dealing with trauma and defense mechanisms most commonly employed are denial and repression. According to Gil (1996), providing treatment “…is therefore complex and challenging, and must be tailored to each individual on a case – by – case basis” (p. 83). The treatment measures she endorses are very flexible, yet structured and incorporate various theoretical approaches like developmental, cognitive, humanistic and multicultural theories. She describes her own favored approaches, but she stresses the need to acknowledge the uniqueness of every case and to keep treatment options flexible. Gil deals with the structured processing of trauma in her next chapter. The processing of trauma is essential to the healing process and is conducive to recovery. In simple terms it involves accepting the fact that one is the victim of abuse, and doing the required damage control. This includes exploring issues ranging from guilt, negative feelings towards the victimizer, a cognitive evaluation of the exact circumstances of abuse and a gradual process of catharsis in which the trauma is expunged. The goal of processing is to enable victims to make their peace with an unfortunate past while enjoying the present and moving on to the future. General principles in dealing with adolescent abuse is discussed in the sixth chapter. Gil offers valuable insights in dealing with the average, recalcitrant adolescent that shows a great deal of compassion, sensitivity and wisdom. She recommends an open – minded stand in dealing with victims. A judgemental attitude and personal bias must be discarded in order to deal with the hypersensitivity and provocative, defiant behavior that are characteristic of most adolescent victims. In order to establish a comforting atmosphere that encourages communication, the victims must be allowed to feel in control and should not be pressed to reveal information that is too painful. Creative and innovative therapeutic measures built on a solid theoretical foundation are necessary to help the victims. The final chapter deals with treatment modalities. The needs of the person in question must be taken into consideration before settling on a treatment approach. Some individuals are comfortable with individual therapy as it is relatively stress – free. Others favor group therapy as they realize that they are not alone in their misery. And sometimes family therapy is recommended. However at all times, the common adage – one person’s meat is another’s poison must be remembered and adhered to. The book is peppered with case – studies and examples that provide the reader with an insider’s view of the abuse situation as it is and the horror of it all. Gil uses the case examples to illustrate her point and to accentuate the finer points in her material, while sustaining reader interest. She describes various situations in therapy, the pitfalls one can expect and the ways in which one can work around them. The case studies are particularly useful in shedding light on obscure assessment procedures and treatment methods. Gil’s own structured yet creative approach is highlighted and is extremely enlightening and inspiring. One remarkable case is particularly noteworthy. She describes the case of a 15 –year old girl, Anna who was sexually abused by her father. Anna revealed that she had had an orgasm during the abuse, and she was overwhelmed with guilt because of her response. In her eyes, this was “… proof that she was just as bad as her ‘pervert father’” (Gil, 1996, p. 116). Gil used an intervention technique to help alleviate the undeserved guilt. She brought a red onion and proceeded to cut it up, soon Anna and Gil were crying. Anna was asked to assess the situation – the two of them were in tears, though neither was particularly sad. There was a lesson to be learned here; sometimes it is not possible to control the body’s reaction to external stimuli. Anna could relate to this incident as it was similar to her orgasmic reaction and she was able to take a giant step towards recovery. Gil’s material for the book is culled largely from her formidable experience working with abused adolescents who had been referred to her by the court, social services and probation departments, the extensive research she has done and the veritable mine of information she has gathered in the course of her career. The text stems from a solid foundation of knowledge and reveals an excellent grasp of the subject matter. She covers almost all the areas pertaining to adolescent abuse as seen already from the history of adolescence to treatment modalities with revealing case material in between. However, most of the case studies she describes have positive outcomes and one cannot help but feel this is rather misleading. A look at the failures as well as the successes would have been useful in discerning the bigger picture, particularly since the whole process of dealing with adolescent abuse is so intensely complicated. Having said that it must be mentioned that otherwise the book is well – researched, describes the debilitating impact of adolescent abuse, establishes the need for further research and identifies the areas where it is most needed. The information provided in this book is likely to be helpful for anyone who reads it, regardless of whether they are laymen or professionals, since it is a well – written and coherent book. The language used though strictly academic is simple and easy to follow. The terms, theories, assessment and treatment procedures she outlines are brilliant in their simplicity. The case materials give the reader a ringside view into the therapeutic procedure and help the reader understand the nuances in the healing process for the victims of adolescent abuse. For professionals, the book is likely to supplement their existing knowledge besides adding useful intervention techniques to their repertoire. This writer recommends this book for everyone keen to learn everything about adolescent abuse. It not only describes the lifelong consequences for the unfortunate victims and the ways in which they choose to deal with the trauma but outlines numerous psychological theories plus treatment methods designed to help empathize with the abused adolescents, understand when their outward belligerence is actually a cry for help and to provide care – givers with the means to help them on the precarious road to recovery. References Gil, E. (1996). Treating abused adolescents. New York: Guilford Press. Read More