The adolescent whose acting-out behavior requires treatment in a psychiatric hospital suffers from psychological damage that occurred during their second and third year of life, the normal infant-mother symbiosis and separation having failed to occur and they not developing a secure "sense of self," sense of who they are, and "soothing introject," ability to self-sooth themselves.
Earlier life problems and symptoms now become exacerbated from distress at their inability to cope with basic adolescent goals: separation from parents; exploring intimacy through dating; and the creation of realistic educational and vocational goals.
Revolving-door/short-term treatment cannot aid such youth who require a secure therapeutic environment within which their defective ego capacities can redevelop sufficiently for them to function in the adult world they will soon enter. For the more disturbed youth, residential treatment is needed; others can accomplish the needed psychological changes through individual psychodynamic out-patient psychotherapy.