A DUAL CLINICAL FORMULATION
Given the Academy’s selection of students, it is rare that one narrow cluster of symptoms or one formal psychiatric “disorder” makes adequate sense of students’ many presenting problems. Medications usually have already been tried and have failed (alone) to remedy our students’ broadly-based troubles–at school, at home and socially. A global array of problems points to a deeper developmental source for surface symptoms, misbehaviors and repetitive failures. A delayed maturation usually has caused an underlying immaturity relative to age peers, and, despite unusual talent and intelligence, an MA student usually has struggled to meet the challenges of a modern adolescence with the unsound approach of a younger child.
To help entering students with these problems, then, requires a dual focus: first (a) upon the obstacles that have derailed psychological development ; and second (b) upon immaturity itself. Clinical help must address both dimensions, and treatment failures often result from a therapeutic preoccupation with symptoms (e.g., prescribed medications to address a deflated mood) without a concomitant effort to restore developmental momentum. The remedy must have both goals: (a) to remove or mitigate obstacles to maturity–a task that often requires clinical expertise; and (b) to encourage and prod a stuck teenager to get on with growing up. The wanted outcome, then, is not just symptom relief, but also a shift in maturity–and so a new psychological approach to the challenges of adolescence.