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Technical adaptation to the needs of adolescents is considered in so far as it concerns three age groups: early (12–14), middle (14–16), and late (16–18) adolescence. The first period is marked by group identification and rejection of the adult. Repression of the oedipal conflict is intense and some regression sets in. Treatment is not easily accepted except where problems are painful; material is scanty and phantasy life difficult of access. The second period, marked by intense fear of the drives and readily accessible phantasy, but as well by real need for the adult as a helper and interpreter of life, provides easier contact for the analyst, but some danger of precipitating chaotic reactions. In the third period work approximates to adult analysis, with occasional shifts towards earlier periods.
The following technical differences are discussed. Transference reactions but not a true transference neurosis coexist with a relationship of need for the analyst as a real person. Interpretation of the latter factor may undo the treatment aim, though negative feelings should be consistently interpreted. A greater amount of help in learning to test reality is needed. A greater effort has to be made to increase the ego's tolerance of pathogenic conflicts. A consistent and systematic analysis of all defence mechanisms is not possible and in some instances is contra-indicated. The adolescent resorts to many temporary defences in an endeavour to deal with conflicts which in their intensity are passing and immediate analysis may well surrender him to the id. Certain defences which distort reality must, however, be taken up. Because of the continual eruption of changing id processes working through is almost always inadequate and limited.
Case material is used to illustrate technical modifications and to emphasize the need for perceptiveness as to their meaning in the analysis and in the total development of the child.