Adolescence is a period marked by rapid growth changes and specific psychosocial challenges (Kumar, 2013). This constant flux of change, accompanied by a limited ability to cope with difficult situations, presents a window of vulnerability in which problem behaviours such as substance abuse and self-harm begin to manifest. A broad spectrum of treatment has been introduced in a bid to intervene and positively alter a trajectory of unhealthy behaviours and poor outcomes in adolescents. This paper seeks to briefly review two counseling approaches – Dialectical Behaviour Therapy and Motivational Interviewing. It will also discuss the effectiveness of these approaches with reference to the following case study. .
Case Study .
Shelley is an eighteen year old, living rough with a history of self-harm and drug abuse. She is coming for counselling as part of a deal to get her a council flat and enable her to start looking for work. Shelley is shabbily dressed, smokes incessantly and smells. She is hostile and surly and refuses to open up or discuss anything at length. A brief letter from her GP apprises you of the following facts: alcoholic mother who was in and out of a series of relationships when Shelley was a child; broken schooling due to Shelley having to look after her mother. A period of sexual abuse by one of her mother's boyfriends at the age of 17 led Shelley to attempt suicide and subsequently she has frequently inflicted injuries on herself. She finally moved out of her mother's house and ever since she has been stealing to support her drug habit.
Dialectical Behavioral Therapy (DBT).
Non-suicidal self-injury (NSSI), the intentional damaging of body tissues without the intent to die, is typically seen in Shelley's case. NSSI is conceptualized as a physical manifestation of profound psychological wounding often inaccessible to the sufferer; it functions as an instrument for self-regulation (D'Onofrio, 2007).