LISA ØIEN AND OLE GREGER LILLEVIK 88 Social Work & Social Sciences Review 17(1) pp.xx-xx. DOI: 10.1921/4503170101 Prevention of aggressive behaviour and violence in childcare institutions Lisa Øien1 and Ole Greger Lillevik2 Abstract:Thearticledescribeshowpersonalqualitiesinthehelpersareimportantmeasurestoprevent aggressionandviolentbehaviourfromadolescentslivinginchildcareinstitutions.Ourresearchquestion was: In what way does personal competence make a difference in the prevention of violence, and how is this ‘personal competence’ expressed? Through six semi-structured individual interviews and one focus group interview with staff from five state-run childcare institutions in Norway, we found that the helpers’ attitude is of great importance to avoid unnecessary confrontation. Our study indicates that staff who search to find the reason behind aggression, and who are deeply concerned about the well-being of the young people tend to ease conflict, rather than trigger it. We see their attitude as a choice of perspective in their work with adolescents, and we see it as a phenomenological-hermeneutic approach. This perspective is an integral part of the child-care workers’ personal competence, and implies recognition of the perspectives young people have on their own situation. The importance of personal competence to prevent aggression and violent behaviour is evident, and the ability of mentalisation is argued to be significant in these child-care workers. Keywords:violence;aggression;personalcompetence;childcareinstitution;mentalisation;prevention 1. Assistant Professor 2. Associate Professor Address for correspondence: AHS, Narvik University College, Postboks 385, 8505 Narvik, Norway. lisoie@hin.no Date of first (online) publication: PREVENTION OF AGGRESSIVE BEHAVIOUR AND VIOLENCE IN CHILDCARE INSTITUTIONS 89 Introduction Workers in social welfare and healthcare are particularly exposed to violence. People who work in these sectors often find themselves in threatening situations. In Norway, more than 20 per cent of all nurses, and 30 per cent of all social educators, social workers and child welfare officers experienced violence at work once or more every month (Eiken, Tynes, Grimsrud, Sterud, & Aasnæss, 2008). Working in an environment with threats and violence might result in undesired physical and psychological effects (Elklit & Brink, 2004; Trygstad, Sollund, & Johansen, 2003). Previous research on the subject violent behaviour mainly focuses on client-related variables (Woods & Ashley, 2007), and rarely mentions the importance of what happens between client and helper. Knowledge on qualities in the client that might increase risk of violence is important to be able to protect ourselves as workers, but at the same time we must acknowledge that in a relation between two people both parties contribute to the situation. A unilateral view on the conflict that only focuses on the client tends to overlook important factors linked to the helper-client relation, and furthermore the variables linked to the helper. A lot of previous research regarding threatening behaviour and violence was done on psychiatric care. Mary E. Johnson (2004) wrote a review article on 27 separate studies indicating that a controlling and authoritarian style in the helper increases the risk of violent behaviour. Johnson suggests more research that focuses on contextual factors, and mentions the way helpers act towards patients and clients as one of several factors research should address in the future. This article focuses on these contextual factors, with a specific aim on the child-care workers contribution into the relation with the young people in child - care. The aim of this article is to look past the actions and procedures, and try to understand how the attitude or personal qualities in the helper might contribute to prevent violence. Theoretical framework Toimproveunderstandingofwhatskillsthehelperhastopreventaggressionandviolence inyoungpeople,wewilldiscusstheiractionsusingthephenomenological-hermeneutical tradition and the more recent theory on mentalisation. Hans-Georg Gadamer stated that the phenomenological approach is rational and filled with meaning (Gadamer, 1960). The hermeneutical approach is about interpretation and understanding. Understanding is always moving towards new understanding, always linked to our pre-assumption (Ricoeur, 1981). We understand hermeneutics as a basic and systematic reflection of oneself and one’s surroundings, the way we perceive ourselves and the world around us. The concept ‘mentalisation’ was initially developed by psychoanalysts in France LISA ØIEN AND OLE GREGER LILLEVIK 90 at the end of the 1960s (Lecours & Bouchard, 1997). Today the concept is used to understand psychopathology and development of the social brain, in liaison with attachment theory. Mentalisation involves both a self-reflective and an interpersonal component, to understand yourself as well as others. Mentalisation-Based Therapy or Mentalisation-Based Treatment (MBT) is a specific type of psycho-dynamically oriented psychotherapy designed to help people with borderline personality disorder (Fonagy, György, Jurist, & Target, 2002). More recently, a range of Mentalisation - Based Treatments is used; MBT-C (directed at children), MBT-F (families), MBT-A (for adolescents) and AMBIT (treatment for chaotic multi-problem young people). We use the term as a universal human phenomenon, present in the childcare worker, as Mr Skårderud puts it: ‘(….) the ability to understand feelings, cognitions, intentions and meaning in oneself and in others’ (2007: 323). From a phenomenological-hermeneutical scientific tradition we recognise the idea that a phenomenon is meaningful. The term ‘the anticipation of perfection’ was introduced by Hans-Georg Gadamer, who claimed it was right to assume that phenomena are rational, and filled with meaning (Fjelland & Gjengedal, 1995). To understandthemeaningofaphenomenonthewaytheoneexperiencingitfeelsinvolves a phenomenological perspective (Martinsen, 1991). The pathway to understanding a phenomenon is reflection and interpretation. In the tradition of phenomenology, the term lifeworld is used. The term includes activities and experiences in everyday life, formed and shaped by previous experiences in a person’s life. This lifeworld is not entirely foreseeable for us, but through interaction and relation we will be able to comprehend bits and pieces of another person’s lifeworld (Hummelvoll, 2012). As the informants access part of their clients’ lifeworld, they use it to interpret the meaning of the clients’ actions. Taking into account that every situation is special, it does not mean that there is nothing to learn from it. What you learn from a unique situation may be used in another. The ability to make deliberations regarding the unique of one situation is possible based on previous experience (Martinsen, 1991). The informants take for granted that the actions and expressions of their clients are filled with meaning. By their concern with the youngsters’ lifeworld, the informants are able to adjust their actions to avoid unnecessary conflict. Aggression as a counterweight to powerlessness Our understanding of the terms frustration and aggression is based on the frustrationaggression hypothesis developed by Dollar, Miller et al (1939) and further developed by Miller, Barker et al (1941) and Berkowitz (1969). The hypothesis states that frustration and aggression are sometimes linked with a reaction pattern when you are prevented from reaching your goals or needs. Frustration and aggression might be described as conditions characterised by the subjective experience of powerlessness PREVENTION OF AGGRESSIVE BEHAVIOUR AND VIOLENCE IN CHILDCARE INSTITUTIONS 91 in an individual. Powerlessness can be described as a condition of deficiency. Lack of predictability, overview, control, influence, being seen and heard, as well as a lack of alternatives, might result in a feeling of powerlessness. In a situation of powerlessness you might find it impossible to turn the situation around, impossible to alter things as they are right now. Per Isdal (2000) states that violence might be described as a counterweight to powerlessness. In this perspective, everything that can be done to reduce the feeling of powerlessness in young people will implicitly be preventive to aggression and violence (Lillevik & Øien, 2010). Conducting qualitative interviews and how we analysed the material Our research question was: In what way does personal competence make a difference in the prevention of violence, and how is this ‘personal competence’ expressed? We contacted the leaders of five state-run childcare institutions in Norway. The institutions are facilities of care for adolescents admitted on both a voluntary and involuntary basis. The institutions are relatively small, with four to ten adolescents at the age of 13–18 in each. Most of the adolescents in these institutions have serious behavioural problems. One criterion for inclusion in the study was that the staff member had a good report from his or her superiors and co-workers as someone who was adept in the prevention of violent behaviour in aggressive adolescents. The leaders gave the workers information on our study, and those who chose to participate contacted us directly. We recruited informants from all the institutions. Our informants had an average work experience in child-care institutions of 10 years. Formal competence was not a criterion for inclusion, and three of our informants had no formal education in social sciences, child – care or health. We conducted six individual interviews and one focus group interview. The aim of a qualitative interview is to let the informants share their experience freely. To ensure that the informants were as comfortable as possible in this situation, they chose the location for the interview. We asked the informants two main questions. ‘Can you tell me about a situation where you experienced threatening behaviour and/ or violence that you feel you handled well?’ and ‘Can you tell me about a situation where you experienced threatening behaviour and/or violence that you feel you did not handle well?’ The interviews, ranging from 45 to 90 minutes, were recorded, and shortly after transcribed verbatim. We first conducted the individual interviews, and the informants’ experience on working with violent young people, their role in the relationship with the young people, and their attitude towards these young people – which showed through the interviews, were subsequently presented as subjects/ issues for discussion in the focus group. Focus groups can be useful when you want LISA ØIEN AND OLE GREGER LILLEVIK 92 to discuss a few already determined subjects. If the focus group is successful, the group dynamics might stimulate to reflections and ideas you would not get in an individual interview. It will help get better insight into a phenomenon (Tillgren & Wallin, 1999; Wilkinson, 1998). The transcribed material was analysed using a three-stage structure analysis. By hearing their stories we got access to material that expressed moral and ethical thinking (Lindseth & Nordberg, 2004). This was not always expressed explicitly, and the challenge was to analyse this to seize and visualise it. The transcription was conducted immediately afterwards, and during this process the authors discussed thoughts and reflections. These thoughts were not written down, but acted as background for the more systematically conducted three-step analysis. The first reading of the transcribed material was done separately by the authors, giving us an overall impression of the texts. We submitted these first impressions into separate documents before discussing the preliminary findings. Attitudes, thoughts and actions that appeared in the different stories we read were also written down, as well as a résumé written from memory. This was later held up against the original text to see if they concurred. Afterwards, the preliminary thoughts and ideas were discussed by the authors, and expressions of attitudes and ethical and moral action revealed by the interviews were then condensed into main subjects. The texts were read again, this time with the main subjects as guidelines through the material to find whether they were representative for all informants. We found that they were. Finally, the authors reflected over and discussed the implications of the findings. Ethical considerations The informants knew that participation was voluntary, and that they at any time in the process, without further explanation, could withdraw from the study. A declaration of consent was signed before the interviews were conducted. Participants in the focus group interview were able to withdraw up to the day of the interview. We chose this approach because of the difficulty it would cause to separate one person’s statements from the rest of the group later on in the process. The focus of this study was the experience with being threatened or even exposed to violence, with the possibility of reactivating traumatic experience in the informants. They were assured that they at any time during the interview could stop if they felt they needed to. On the other hand, talking about difficult incidents might also provide relief (Gaydos, 2005). Several of our informants later expressed relief; that it felt good to recall the incidents, and reflect over them in a retrospective view. Personal data linked to the informants were handled in a way that did not require notification to the Norwegian Social Science Data Services (NSD). PREVENTION OF AGGRESSIVE BEHAVIOUR AND VIOLENCE IN CHILDCARE INSTITUTIONS 93 Findings and discussion Analysing the material we have found two main characteristics of attitude common to the informants. These represent our findings. We chose to describe these two characteristics as: 1. They are confident that aggression has a meaning 2. They are genuinely concerned with the well-being of the young people In the following text we will discuss these findings in the context of a phenomenological framework of understanding, and by the child-care worker’s ability of mentalisation. Aggression and violence as a meaningful expression All the informants had the conviction that aggression and violence have some kind of meaning for the one expressing it, and they were committed to finding and understanding this hidden meaning. Through telling their stories, they reflected on what led to the aggression and reflected on their own role in the situation, talking about how their relationship with the client might have affected the situation one way or another. They established that when a client acts out, it is an expression of meaning – though sometimes hidden. There is always an explanation for the anger, not necessarily an obvious one. The eagerness to find this meaning reflects in the way the informants talk about incidents, and it also seems to affect the way they act in given situations. One of the informants told us about an incident where an adolescent threatened her with a knife: (…) I think it was the fact that I felt … I could feel what had triggered this. I knew what the purpose was. He was afraid, and he used the anger to control his fear. Understanding evolves through reflection on different experiences in life. Sometimes the aggression is based on something specific, while other times the meaning might be more subtle, hidden for the helper and sometimes even for the one who is angry. They cannot always give the reason for their own aggression. Another informant said: ‘I could not understand what triggered it; I did not see it coming. I felt impotently helpless in the situation.’ The informant shared a story that showed how not knowing the reason for the aggression, not being able to understand the meaning behind it, made her unable to be ahead of the situation, and unable to turn the situation around when the youngster suddenly chose to act out. One of the informants said: ‘(…) when I realised he had just been talking to the people back home, I chose not to push him oncleaninghisroomthatafternoon.Thatwasnotwhatheneededfrommerightthereandthen. LISA ØIEN AND OLE GREGER LILLEVIK 94 This, as we interpret it, indicates that the informant takes into consideration the ‘lifeworld’ of the child, thus avoiding unnecessary conflict. A few hours later, or the next day even, was just as suitable for cleaning room. One of the informants expressed frustration towards some of his co-workers that showed no interest in finding the meaning behind the anger expressed by the adolescents. She said: Some say it’s just to get attention. Well, maybe so – but they crave attention for a reason. When a man has fallen through the ice and is shouting; it’s to get attention, isn’t it? But we need to understand the cry for attention has a reason, and stop to help. We can’t just walk away. How can we help someone if we don’t understand? Toseeyourselfandbeawareofinterpersonalaspectsarecomponentsintheconcept of mentalisation. You might say it is the ability to see oneself from the outside, and others from the inside (Allen & Fonnagy, 2006). It includes an ability to see oneself with the eyes of others. The informants’ eagerness to find meaning in others, to see things from their clients’ perspective, seems to have a significant capacity of mentalisation. Skårderud in ‘Eating one’s words’ (2007: 325) points out that the concept of mentalisation has a lot in common with terms like empathy, emotional intelligence, psychological mindedness, metacognition, insight, observing ego, mindfulness, interpretation and reflection. Mentalisation differs from these other terms in the way that it involves both a self-reflective and an interpersonal component: To understand yourself as well as others. Lack of empathy is often a common feature in young people with severe aggressive andviolentbehaviour.Workingwithadolescentswhohavegrownuplackingthesecure base of attachment needed to develop the social brain (Bowlby, 1969) often involves trying to adjust the adolescents’ ability to mentalise. Skårderud and Sommerfeldth (2008) suggest that the principles of mentalisation may even be helpful to the helpers. It might enable us to see our own reactions and actions more clearly, adjustment of our own reactions, self-regulation, and may help us withstand the feelings and demanding behaviour from some of our clients. Our informants are convinced that the adolescents’ aggression is meaningful. They also seem to have the ability to comprehend what the meaning is. The way we see it, they meet the youngsters with a phenomenological attitude, whereas mentalisation is an important factor in the prevention of aggression and violence. As soon as they sense the young person is starting to get agitated, they move from implicit mentalisation, to a more explicit mentalisation. Implicit mentalisation is what happens in a conversation; we accept body language and facial expressions, adjust to the person we are communicating with, listen to the tone of voice and the content of the words spoken. If the conversation takes a different turn, and becomes difficult to comprehend, we tend to use the more explicit form of mentalisation, asking ourselves: What is this person trying to express? Sometimes we also show PREVENTION OF AGGRESSIVE BEHAVIOUR AND VIOLENCE IN CHILDCARE INSTITUTIONS 95 this search for meaning through our body-language (Bateman & Fonagy, 2010). The child-care workers’ aptitude of mentalisation also affects how they choose to respond to the young people who are in an agitated state. When the informants understand what the agitation is about, they are more able to visualize alternative ways out of a situation, and by that, they are empowering the young people. Empowerment is the antithesis of paternalism. Powerlessness is an important factor to frustration and aggression. The asymmetrical relationship between child-care worker and client is a factor of importance when it comes to aggression and violence from clients (Shepherd & Lavender, 1999). Power and powerlessness is not always explicit and obvious in the interaction between client and child-care worker. Power is embodied in routines and institutional structures, impacting the way we think and act (Lillevik & Øien, 2012). The power does not only exist in what we do, but also in what we might do (Emerson, 1962). In a childcare institution the possibility that we might use force will always be a factor of power in the relationship between child-care worker and client. The informants display a high level of creativity in their effort to help the young people find ways out of a state of agitation. They work hard to find something to help ease the situation. They all try to give alternatives within the framework of the institution, and the guidelines and rules that apply for the young people. The informants are adamant that institutional rules are necessary, and it is crucial that they do not deviate from these rules to please the young people. Loyalty to the rules is important to avoid chaos and frustration amongst the young people, and must be obeyed by everyone. There must, on the other hand, be room for alternatives within the framework, to avoid unnecessary stress. The informants state that when given an alternative way out, the young people will often choose this, rather than acting out. Even when the level of aggression is high, the helper believes it is still necessary and possible to meet the needs of the young people. Whentheyoungsterisstandingthere,inmyface,onlyhalfaninchfrommynose,Ikeepthinking: ‘You can still turn this around, kid; you can still make this work.’ He is not able to see the way out of the situation when he is so angry, that’s when it becomes my job to help him do that. Mentalisation requires action. When they understand the young people, the informants also feel responsible for helping him out. Wishing the best for another human being: To see and to recognise It is essential to be sincere when building a relationship to another human being. It is not what you do as much as how you do it. This underlines the importance of relationships to the quality of care, and suggests it is highly personal. It is not merely a procedure, but based on qualities integrated in the personal competence of the LISA ØIEN AND OLE GREGER LILLEVIK 96 child-care workers. If our recognition of someone becomes a procedure, it will not appear sincere. There is a great difference in making a decision to be supportive, and a spontaneous recognition. Schibbye (2004: 261) states that the immediate response has a quality that makes the helper appear participative in the relation, as opposed to a scheduled response that is based on external knowledge in the helper. All the informants showed a deep-felt and sincere concern for the young people through their stories. Even young people that have been challenging, and experiences they could very well do without, are spoken of with warmth and kindness. They indicate an attitude of recognition and respect for the young people. Their stories reflect a confirmation of the point of view of the adolescents, and the way the situations are presented reflects a great deal of empathy for them. Their attitude is displayed both explicitly and implicitly. They use words like respect, humility, honesty, creating confidence and creating space for the young people. Recognition of the client is apparent in stories about everyday life in the institution, but also in stories on situations of difficulties and conflict. Their sincerity helps them build relations with the young people, and enables them to reach out to the young people in conflict situations, though not even the best succeed every time. One story was about how a whole group of boys barricaded themselves in a room, broke windows, set off the fire alarm; a story of complete chaos. The police were finally called in, and the young people brought in by them. I remember one of the boys especially; he couldn’t have been more than 14 years old. My heart bled for that kid. The police brought him out, laid him on the ground and put handcuffs on him. It must have been a terrible experience. In situations where the integrity of the youngster is threatened – through rules, restrictions and constraint – the need to regain control of your own life and the situationyouareinwillarise.Thisindicatesthatstrictrules,useofforceandconstraint might increase the danger of aggression and violence. Several of the informants spoke of the adolescents’ powerlessness in certain situations. Powerlessness is reduced by securing participation and self-determination. Phenomenologyandhermeneuticsrepresentanethicalperspectivewhenfacingone searching for help. A hermeneutic-phenomenological approach to these adolescents might provide the ability to understand actions and social interaction. Searching for comprehension is diametrically different to using protocols and procedures (with their certainty they have the answer to all problems). Mentalisation concerns our ethics in a similar way. Understanding someone else is not just a feature or trait, it is a question of good will as well. It is about a curiosity that drives us in search of meaning. The better we understand another human being, the harder it gets to treat this person as an object, a thing. Being in a situation where you do not get recognition for your own perception of reality, but have someone else’s worldview forced upon you, feels like a violation. It feels like being robbed of your own integrity (Honneth, PREVENTION OF AGGRESSIVE BEHAVIOUR AND VIOLENCE IN CHILDCARE INSTITUTIONS 97 2003). By recognising the adolescent, the informants help to preserve integrity and autonomy, thus preventing the feeling of powerlessness. One informant talks about an incident with a youngster, and reflects on what he now sees as insensitivity and bad judgment. I had brought him into my office to talk about some money he claimed he had earned. The person at work the day before, on the other hand, claimed the boy had not performed his duties as he was told, and that he shouldn’t get his money until his room was properly cleaned. So, there I was, in MY office, more or less looming over this poor kid. I am not a small person, and the kid was skinny as a straw, and I more or less pushed him into a corner. He needed his money, but he wasn’t getting any from me. So I told him, and I could sense his frustration from the very start. I should have sat down, I should have given him some space, and I should have let him tell me his version first. I suddenly realised that there were two possible outcomes of this situation. One – the kid would start crying, two – he would hit me. Of course, he struck out to hit me, and then ran out. It was all, my fault. I felt so stupid! If the child-care worker does not consider the individual needs of the young people, they might see it as an invalidation, and thereby a violation of the clients’ self-understanding. This will most likely increase the feeling of powerlessness in the adolescents. When recognition came up as a subject, the informants also spoke of infringement as a phenomenon, and the opposite of recognition. (…) sometimes you work with people you think should not be in this kind of profession (…) they are there to make money, full stop. They are either afraid or simply not able to care for other people. They are certainly not able to care for those who live here. Sometimes, when I come in to work, all I have to do is see who has just left work, and I realise what the agitation is all about. To see the young people, and act on what you see, is all about shifting power from the system back to the young people. If the helper lives according to the idea that the young people does not know what is best for her- or himself, the attitude reflects paternalism. Empowerment is the antithesis to paternalism (Slettebø, 2002), and in childcareinstitutionswhereyoungpeopleareinvoluntaryplaced,thebalancebetween independence and constraint is particularly apparent. When the helper meets the young people with empowerment, however, it contributes to restore independence andpower.Empowermenteasesthefeelingofpowerlessness,andtherebycontributes to ease frustration, aggression and violence. Mentalisation implies an ability to see your own misunderstandings, or to be able to see the misunderstandings you are part of. ‘Impaired mentalisation’ makes it more likely to misunderstand others, and being misunderstood by others. When your own, as well as other people’s intentions are misinterpreted, false assumptions might cause confusion and trigger powerful emotions such as withdrawal, rejection, LISA ØIEN AND OLE GREGER LILLEVIK 98 overprotection, hostility and coercion (Bateman & Fonagy, 2004). The use of overprotection, hostility or coercion from a child-care worker will contribute to a feeling of powerlessness in those exposed to it. This means that the danger of aggression and violent behaviour in the young people will increase. Fonagy & Target states that an individual’s capacity to understand interpersonal behaviour is a key determinant of self-organisation and regulation of affect (1996 and 1997). The quality of being able to understand and not misunderstand, as well as not acting on negative affect, makes the child-care worker more capable to help the adolescent into control and affect regulation. The ability to reflect is necessary to be able to learn from ones mistakes. In terms of hermeneutics this is explained as the hermeneutic circle (Gadamer) or spiral (Heidegger). As you look at what you did and said in a retrospective view, you will be able to see things differently, and thereby act differently when faced to a similar situation in the future. Mentalisation is about seeing yourself with the eyes of others, and also about seeing your mistakes. In that respect you might say that mentalisation and hermeneutics are similar. They both give us a picture on how we as humans are able to evolve, to change our thoughts and actions by reflecting on the past. ‘Mentalisation - Based Therapy’ stresses that the ability to mentalise can be learned (Bateman & Fonagy, 2004). Conscious sensitivity and awareness towards the clients enable the helper to be ahead of incidents of aggression and violence. There is a potential to prevent aggression in this (Lillevik & Øien, 2012). An efficacy study made in an institution with mentally disabled adults showed a significant decrease in aggression from the clients after the staff had been trained in mindfulness (attentive awareness) (Singh et al., 2006). This suggests that personal skills, as well as targeted approach in the work-group to help the staff develop to be more aware of their own role, and how they affect the people around them, should be vital to leaders and employers in child-care as well as other sectors providing service or care for other people. Conclusion This article focus on personal competence in the helper as an important asset in the environmental therapy to prevent aggression and violence in adolescents admitted into child-care institutions. We have interviewed child-care workers that are regarded as especially skilled at de-escalating aggression in adolescents. The article shows that the child-care workers assume that aggression is meaningful for the young people. We link this to Gadamer’s term: ‘The anticipation of perfection’. The article also shows that the child-care workers who are aware of their own role, and are concerned with reflecting on their own actions in a retrospective view, develop to expand their horizon of understanding. We argue that mentalisation seems to be an important PREVENTION OF AGGRESSIVE BEHAVIOUR AND VIOLENCE IN CHILDCARE INSTITUTIONS 99 factor in these child-care workers’ personal skills. The child-care worker aims to see the perspective of the young people, seeing himself or herself from the outside, and the young people from the inside. This makes the child-care worker capable of finding purpose in the frustration and aggression that the young people is showing. The article shows how both hermeneutics and theory on mentalisation might help us see and understand these processes. Mentalisation also reflects our ability to affect regulation. Through affecting regulation the child-care worker is able to recognise the perspective of the young people, without being overwhelmed by his or her own fear or anger. It makes the helper able to meet the adolescent with an attitude of recognition, to provide alternative paths to help the young people feeling empowered and ease the feeling of powerlessness that causes the anger. Adolescents with behavioural issues sometimes struggle to regulate their own affections. Through the mentalisation of the helper, and his or her affect regulation, the young people will get both recognition of self and help to regulate their own affect in a given situation. With the idea that aggression is often a result of powerlessness, this article shows how the attitude and actions of the helper can empower the young people. 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