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This chapter extends the traditional psychosocial understandings of adolescent development that informed the author's early art psychotherapy work, and includes contemporary sociological and postmodern ideas to investigate and understand current and culturally complicated clinical work. It is useful to look at the mental health difficulties that adolescents experience in the context of the expanded developmental theories. The three cases that are discussed in the chapter are specifically chosen to explore the experiences of adolescents who struggle at the marginalized edges of communities: immigrating and acculturating adolescents; gang affiliating adolescents; and incarcerated adolescents. Their responses to the art therapy process poignantly illustrate the suitability of image-based psychotherapy for these youth whose complex clinical issues can best be understood when psychological development is contextualized in the broadest way possible.
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