Psykologisk intervention til børn og unge på sikret institution

Abstract

This theoretical project investigates the research question, "How can psychological understanding and intervention be applied to children and adolescents in secure institutions from a mentalization-based perspective?" It explores the complex heterogenic psychological issues faced by this vulnerable group and how mentalization-based interventions can address these challenges. Secure institutions are settings with a strong pedagogical focus while psychological aspects may be lacking – hence the need for the investigation on psychological interventions. Child maltreatment is identified as a central factor contributing to affective and behavioral dysregulation, attention disturbances, interpersonal difficulties, and impaired mentalization, which often result in behaviors leading to placement in secure institutions. Mentalization theory offers a framework for understanding and intervening in the presenting issues. Individual interventions focus on enhancing mentalization and affect regulation through an explicit focus on mentalizing in therapy. Challenges such as attention deficits, epistemic mistrust, and maintaining engagement necessitate adaptations like Stealth Therapy, which builds alliances through frequent informal presence, and Animal-Assisted Therapy, which supports attention and alliance and offers a healing attachment relationship with the animal. Family interventions aim to strengthen caregivers' mentalization capacity, improving their understanding of affective states in themselves and their children, leading to more appropriate responses to challenges. This dual approach addresses both individual and systemic issues within the family unit. The discussion includes a critique of mentalization theory, noting its primary focus on caregiver-child relationships and potential oversight of broader social contexts. Additionally, it is argued that mentalization is not a novel concept but a reformulation of existing psychological ideas, yet regarding certain groups has its merits. Further, the role of social inheritance is emphasized, noting that children in secure institutions often come from disadvantaged backgrounds, highlighting the need for both treatment and prevention. Effective intervention requires addressing broader societal structures. The discussion also touches on the psychologization debate, which considers the risk of pathologizing normal reactions versus recognizing genuine distress that must be addressed. Seen as underlying the discussion, the strengths and weaknesses of pedagogical and psychological approaches are compared, advocating for an integrated approach to provide comprehensive support. The project's limitations include the need for a more nuanced understanding of the target group as well as possible challenges in implementing theoretical findings in real-world settings. Despite these limitations, the project underscores the feasibility and necessity of psychological interventions in secure institutions where both formal and informal approaches to intervention are possible. In conclusion, mentalization theory provides a valuable framework for understanding and intervening with children and adolescents in secure institutions. With appropriate adaptations, mentalization-based interventions may improve the well-being and development of this population.

A master thesis from Aalborg University

Psykologisk intervention til børn og unge på sikret institution - i et mentaliseringsteoretisk perspektiv

[Psychological intervention for children and adolescents in secure institutions - in a mentalization-based perspective]