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Annotated contract technic: special adolescent groups.

Fifty-six consecutive adolescent inpatients at the Adolescent Center of Houston International Hospital were subjects of a prospective study reviewing the efficacy of the Annotated Contract technic. Three primary diagnostic groups evolved: adjustment reaction of adolescence (ARA); borderline schizophrenia (BL-S); and antisocial personality (A-P). Follow-up of 6 to 20 months showed the technic overall to be extremely useful for ARA group, useful for BL-S group, and of questionable value for A-P group. The contract technic was initially accepted by all groups; it was facilitative in family conferences for 89%, 80%, and 56% of the ARA, BL-S, and A-P groups respectively. Most patients were able to use the contract as a barometer of their own progress; the A-P group used the contract largely to ventilate hostilities and/or limit parental demands. Only 18% of the ARA, compared to 50% of BL-S and 94% of A-P groups, ultimately ignored the contracts altogether. The technic is adaptable for clinical research as well as office practice.