Normal adolescence requires a successful resolution of identity crisis, which results in the
development of satisfying relationships, success in school/work pursuits, and achievement of
personal goals. Adolescents, who do not resolve this crisis, are at high risk for problems
in those areas of functioning. Transference Focused Psychotherapy for Adolescents (TFP-A) is
a treatment that specifically addresses these issues, permitting adolescents to develop
satisfying friendships, more appropriate interactions with authority, and achieve realistic
This study will evaluate the application of TFP-A, (a empirically validated treatment for
adults with identity disturbance), to adolescents exhibiting the same behavioral and
identity pathology. Subjects will be females; ages 14-21, with behaviors associated with
identity problems, interpersonal difficulties with teachers, parents and/or peers, and live
with their families. These adolescents will be randomly assigned to one of two treatment
cells, TFP-A or Treatment as Usual (TAU). Subjects in TFP-A will receive weekly individual
therapy for six months. The TAU group will receive standard individual therapy in the
Outpatient Department. Both will receive medication as necessary. All subjects will
participate in initial, weekly, and bi-monthly assessments during the six-month treatment
period, and participate in a naturalistic follow-up study for an additional six months.
Adolescents with identity problems as seen in interpersonal, school, and/or family
difficulties in the Transference Focused Psychotherapy for Adolescents (TFP-A) group will
reduce these problem behaviors and improve management of their feelings and moods compared
to adolescents with identity problems in the treatment as usual control group (TAU).
1. Female Adolescents, ages 14-21
2. A score of five out of nine critical items on the Borderline Personality Disorder
Dimension Interview Scale.
3. Have interpersonal difficulties in school, family, and/or peer functioning.
4. Live at home with family.
5. Willingness to attend evaluation sessions and weekly, individual therapy.
1. The presence of psychosis, substance dependence, non-verbal learning disability,
antisocial behavior, and/or primary diagnoses of eating disorder, bipolar disorder,
and obsessive-compulsive disorder.
2. The need for hospitalization for symptom management.
3. Significant cognitive impairment (Full Scale IQ <85).
4. The presence of a life-threatening medical illness.