The movie Thirteen follows the story of Tracy, a thirteen-year-old girl in a middle school in Los Angeles living with her divorced, alcoholic mother. Throughout the course of the movie, several important topics affecting adolescents are covered, including underage sex, drug use, and self-harm, as well as developmental issues such as social change and finding identity. The central developmental issues covered in Thirteen are role confusion, relationship adjustment and risky behaviors. Erik Erikson suggested that adolescents are in a particular developmental stage described as fidelity, identity vs. role confusion. This stage typically consists of adolescents finding their own identity and starting to rely more on peers for guidance rather than their parents (Erikson, 1994). Additionally, there are often risky behaviors, such as those exhibited by Tracy, as there can be a reduced understanding of how actions affect themselves or others. In Thirteen, many of the issues covered can be seen through the theoretical lens of the characters trying to find themselves, with Tracy in particular going through role confusion as she finds a new peer group and an altered identity.
Treatment Plan
There are two main aims of treatment for Tracy. The first set of goals should be aimed at reducing risky behavior, whilst the second should be aimed at promoting the development of one identity and reducing the role confusion between Tracy the honor student and Tracy the social individual. The short-term goal should be to get Tracy and her mother to start talking about both of their issues – the mother’s alcoholism and Tracy’s drug use and self-harm. This will open up lines of communication that can then be used to strengthen the relationship (Meeus, 2011). It is likely that a strengthened relationship with the parental figure will improve Tracy’s own concept of identity (Meeus, 2011).

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The first intervention that would be used to help Tracy and her family is trauma-focused CBT. Cohen, Berliner & Mannarino (2010) suggest that this can help children and adolescents even with severe behavioral problems, including self-harm, drug taking and risky sexual behaviors. It can also be used to reach the short-term goal of improving communication between Tracy and her mother. This type of CBT may be useful as it may be that her mother’s divorce acted as a form of trauma for Tracy which needs to be addressed before the long-term goal of finding one identity and reducing role confusion can be met. Cohen et al. (2010) suggest that focusing on the trauma helps to align some of the cognitive aspects of the problem, whilst the CBT approach means that behavioral issues can also be targeted.

Another evidence-based approach that has been suggested for at-risk youth such as Tracy is Wilderness therapy. Hill (2007) suggests that this could be incorporated as it helps adolescent clients to find their identity whilst still working towards fulfilling social relationships with others in their age groups. This also supports Erikson’s theory of development, in which the need to form stronger bonds with peers as opposed to parental figures is emphasized as a part of healthy development (Erikson, 1994). Wilderness therapy is useful for younger adolescents like Tracy because it helps them to work through issues that they may not necessarily have the verbal and emotional ability to engage in traditional counseling interventions (Hill, 2007). It is also suggested that being involved in physical wilderness work helps particularly female adolescents work through their problems (Caulkins, White & Russell, 2006). This approach will be incorporated into Tracy’s treatment plan as an alternative to traditional talking therapies which may not be as beneficial for someone of her young age.

    References
  • Caulkins, Michael C., Dave D. White, and Keith C. Russell. “The Role of Physical Exercise in Wilderness Therapy for Troubled Adolescent Women.” Journal of Experiential Education 29.1 (2006): 18–37. Print.
  • Cohen, Judith A., Lucy Berliner, and Anthony Mannarino. “Trauma Focused CBT for Children with Co-Occurring Trauma and Behavior Problems.” Child Abuse & Neglect 34.4 (2010): 215–224. ScienceDirect. Web.
  • Erikson, Erik H. Identity: Youth and Crisis. New York: WW Norton & Company, 1994. Print. 7.
  • Hill, Nicole. “Wilderness Therapy as a Treatment Modality for At-Risk Youth: A Primer for Mental Health Counselors.” Journal of Mental Health Counseling 29.4 (2007): 338–349. amhcajournal.org (Atypon). Web.
  • Meeus, Wim. “The Study of Adolescent Identity Formation 2000–2010: A Review of Longitudinal Research.” Journal of Research on Adolescence 21.1 (2011): 75–94. Print.