Contexts of intervention

Finally, Michel Born emphasises the contexts of intervention. Depending on what country you are in, and depending on particular offenses, the framework, the structure, the human personnel and therapeutic means available are all likely to be different. It is appropriate to take stock of all these things, to determine their functions and to establish objectives in order to maximise the effectiveness of a given form of intervention. “The team, the dynamic that affects the team, and the institutional dynamic are of capital importance, and our evaluation of a particular institution, considering that we may lose our health there or even our soul, must not be a naive one.” The author gives details about the role of an educator; about organisational arrangements; he insists on the importance of the impression that is produced by the physical setting, which must provide support to the patient without being too permissive. Born also underlines the importance of an analysis of the institutional framework. He pays special attention to sexual delinquents and addicts, and recommends specific treatment modalities for these categories of offenders.

Born also talks about “moralising” therapies in the treatment of sexual delinquency, which may be highly structured but which do not necessarily prevent expression; the binary, good vs. Bad discourse that is associated with this type of therapy is in Born’s view no more than congruent with the world view of many adolescents. As regards addiction, treatment cannot succeed unless it is based on a therapeutic alliance, and unless there is continuity in monitoring patient status.

For or against placement?

Michel Born prefers to speak of personalised solutions, and on one hand points out the harmful character of the social context that generates a young person’s slide into delinquency (especially if a particular young person becomes a gang member). He also emphasises the importance of bonds with the family and the school… How can this paradox be resolved? “I am not one of those therapists who always protest placing young people as a matter of ideology, in the manner of certain movements that were begun in the 1970s and are still present today. There are situations where the seriousness of delinquent acts makes it necessary to confine the person who committed those acts. Simple realism tells us to confine certain young people, because in some cases that is the only way that leads to a new construction of self and the possibility of reinsertion. Michel Born is not a supporter of this kind of solution as such, and he believes that it must be as rare as possible, but his position is nonetheless intelligent, moderate, pragmatic and professional. “The true question, the real question is: what really works? This is to be evaluated in the context of a strategy for recovery, not just in terms of punishment. As for existing facilities for such placement, I am in favour of their improvement, but I am certainly not in favour of their elimination.”