Cycles of Understanding and Hope: Toward an Integrative Model of Therapeutic Change in Child Psychotherapy*

ABSTRACT

This article presents an integrative theory of pathological development in childhood and an inclusive model of therapeutic change, based on a contemporary understanding of children's emotions. In this model, effective therapies for children and adolescents, whether through empathy and understanding or through active efforts to change patterns of thought and behavior, arrest malignant emotional processes, especially vicious cycles of painful emotions and pathogenic family interactions. Our most successful interventions then set in motion positive cycles of healthy emotional and interpersonal experiences - increased confidence and engagement in life and more affirming interactions between parents and children. Over time, successful therapy strengthens in children and adolescents a more encouraging, less critical inner voice and, perhaps most profoundly, more positive expectations for their future - a new sense of what is possible in their lives.     

Play and emotional availability in young children with Down syndrome

This study investigates mother–child interaction and its associations with play in children with Down syndrome (DS). There is consensus that mother–child interaction during play represents an important determinant of typical children's play development. Concerning children with DS, few studies have investigated mother–child interaction in terms of the overall emotional quality of dyadic interaction and its effect on child play. A sample of 28 children with DS (M age = 3 years) took part in this study. In particular, we studied whether the presence of the mother in an interactional context affects the exploratory and symbolic play of children with DS and the interrelation between children's level of play and dyadic emotional availability. Children showed significantly more exploratory play during collaborative play with mothers than during solitary play. However, the maternal effect on child symbolic play was higher in children of highly sensitive mothers relative to children whose mothers showed lower sensitivity, the former displaying more symbolic play than the latter in collaborative play. Results offer some evidence that dyadic emotional availability and child play level are associated in children with DS, consistent with the hypothesis that dyadic interactions based on a healthy level of emotional involvement may lead to enhanced cognitive functioning.     

Possible Environmental Causes of Stages in Moral Reasoning

Both children (6-, 10-, and 14-year-olds) and their mothers were interviewed. The children's responses to moral dilemmas were classified into Kohlberg's three main categories—preconventional, conventional, and postconventional. The mothers were presented with a variety of hypothetical situations—e.g., they had just found out that their child had stolen something, and were asked to tell what they would say or do to their child in each situation. The mothers' hypothetical responses to such situations were divided into either the preconventional, conventional, or postconventional category depending on the level or moral reasoning such responses would imply to their children. The results indicated that as the age of the children increased, both the level of moral reasoning used by the children and the level of moral reasoning implied by the mothers' treatment of the children increased. Even with age partialed out, there was a significant positive relationship between the mothers' implied level of moral reasoning and the children's level of moral reasoning. Thus, although causality cannot be established, the results indicate that there is at least the possibility that environmental changes—i.e., changes in the way the mother treats the child—may be responsible for the appearance of stages in the child's development of moral reasoning.     

Exploring sex differences in the emotional content of mother-child conversations about the past

In this study, the ways in which mothers and their 30–35-month-old children discussed the emotional aspects of past experiences was explored. Although previous research has established that children this age talk about emotions, and some studies have found sex differences between mother-daughter and mother-son dyads in these conversations, no study has examined explicitly the way in which emotions about the past are discussed. This is an important research question because emotional aspects of events may help provide an evaluative framework for thinking about and talking about the past. The results suggest that, with daughters, mothers focus more on positive emotions and tend not to attribute negative emotions to the child. With sons, positive and negative emotions are discussed equally. Moreover, mothers never discuss anger with their daughters but they do with their sons. Finally, mother-daughter conversations emphasize the emotional state itself, whereas mother-son conversations often discuss the causes and consequences of emotions. The way in which these patterns might contribute to children's developing understanding of gender-appropriate emotional reactions are discussed.     

When Baby Maisy came to school: Mothers' interview styles and preschoolers' event memories

Fifteen 4–5-year-old children experienced a surprise event in their classroom — the visit of their former teacher and her new baby. The same day, children were interviewed about the event by their mothers, who had not been present and were naive to details. Mothers questioned their children in whatever way they wished. Three weeks later, children were interviewed by a researcher who had not been present during the original event and who had no information about the content of the parent–child interviews. Results showed that mothers' conversational style predicted the amount of information children provided during the mother–child interview, which in turn predicted how much accurate information children remembered during the researcher–child interview. The findings suggest that parent–child memory talk affects children's long-term memory reports, even when parents do not share in the event and have no knowledge of its details.     

The Regress of Pure Powers Revisited

The paper aims to elucidate in better detail than before the dispute about whether or not dispositional monism—the view that all basic properties are pure powers—entails a vicious infinite regress. Particular focus is on Alexander Bird's and George Molnar's attempts to show that the arguments professing to demonstrate a vicious regress are inconclusive because they presuppose what they aim to prove, notably that powers are for their nature dependent on something else. I argue that Bird and Molnar are mistaken. It is true that dispositional monism is popularly assumed to characterize powers as dependent entities, but this is not what the arguments aim to prove. They merely aim to demonstrate that it would be absurd to assume that all properties are dependent in this way. Finally, it is argued that there is an unresolved tension in Bird's and Molnar's accounts of powers. They characterize them as being for their nature dependent on the manifestations that they are for, and yet ontologically independent of those same manifestations. Until that tension is resolved, their accounts are not equipped to remove the threat of vicious regress.     

Zones of Proximal Emotional Development — Psychotherapy Within a Neuroaffective Perspective

This article outlines a conceptual framework for assessing personal and emotional functions of a person’s zone of proximal emotional development. The framework is based on the integrative theory Neuroaffective Developmental Psychology (NADP), which brings together attachment theory, neuropsychology, developmental psychology, and trauma theory. Within the NADP framework, this article describes a way of understanding children’s normal emotional mental organization and of examining how this mental organization may be developed or disturbed by relational issues. It also describes how a child’s mental organization can be disturbed and thus, without intervention, disturb the child’s personality development on a lifelong basis. The article presents three case vignettes, describing three children growing into adolescence with three different attachment patterns and suggested individually tailored intervention plans for each of them, relevant and useful for clinicians working with vulnerable children and families. Because the nervous system retains its plasticity throughout life, attachment is not necessarily an unchangeable pattern. That is why we as clinicians should develop psychotherapeutic methods and a research-based way of determining “what works for whom” by assessing the zone of individual proximal emotional development. The text outlines the characteristics of NADP and how it can be used to structure an intervention plan.     

The Language of Becoming: Helping Children Change How They Think about Themselves

In this article, I describe the language of becoming, which is a way of speaking to children that enables them to see themselves as continually evolving and changing. By noticing and reflecting back the specific ways the child is becoming, the parent gives a meta-message that one's personality is not set in stone but, rather, evolves and changes over time. In order for parents to use the language of becoming, the child must actually act differently. I will describe a three-pronged approach to helping children try new behaviors. The language of becoming helps parents and children see the child's personality, not just his or her behavior, as fluid rather then static. This helps parents and children break the vicious circles and self-fulfilling prophesies of rigid definitions of self. An understanding of stages of cognitive development in the construction of beliefs about the self and the implications of these stages for using the language of becoming is also discussed.     

Book review of Joining and leaving religion: research perspectives Leslie J. Francis and Yaacov J. Katz (Eds) Leominster,Herefordshire, Gracewing, 2000, 336 pp. £20.00 ( pb) ISBN 0 85244 517 2

Children and young people have the capacity to conjure feelings of faith and hope when experiencing emotional and psychological distress. World myths, legends and fairy stories as part of early child development offer a rich source of material to draw from and enlist in the therapeutic endeavour. Fairies often act in a healing capacity in mythology, or they appear as agents between the world of human affairs and the invisible forces of nature. Mythological beings also possess helping powers in advance of mortals achieving superhuman tasks, but they can also when used as metaphor, frighten children and potentially cause psychological harm. This paper suggests that mental health practitioners can utilise such powerful narratives therapeutically and in a culturally respectful and spiritually innovative way. Harnessing the child's imagination can be a powerful vehicle for a transforming experience at the psychic level with consequent positive benefits for emotional well-being.     

儿童忽视与同伴接受：消极社会行为的中介作用

运用问卷调查法和同伴提名法,考察小学4、5年级共503名儿童的消极社会行为（攻击行为、退缩行为、受欺负行为）、同伴接受和儿童忽视间的关系。结果发现,儿童忽视与退缩行为、受欺负行为之间存在显著正相关,与攻击行为之间相关不显著;儿童忽视与同伴接受有显著负相关。忽视通过消极社会行为的两组中介变量作用于儿童的同伴接受。     

The impact of social experience on neurobiological systems: illustration from a constructivist view of child maltreatment

In this article, I highlight the discipline of developmental psychopathology as an integrative framework that builds upon the historical underpinnings of a constructivist perspective. After presenting illustrative developmental psychopathology principles that I consider to be central to a constructivist view, I turn my attention to the role of experience on brain development. This serves as the entree into a discussion of research conducted with maltreated children on brain event-related potentials (ERPs) and the cognitive processing of emotional stimuli, neuroendocrine functioning, and acoustic startle. Each of these components of brain functioning serve to underscore how different neurobiological systems reflect the way in which individuals ascribe meaning to traumatic experiences. Research on child maltreatment, an “experiment of nature,” reveals that maltreated children actively construct their reality at both the biological and psychological levels of analysis, at least in part based on the meaning these children impute to their caregiving experiences.     

Parental Attention Deficit Disorder

abstract   This essay considers the moral status of certain practices that aim to enhance offspring traits. I develop an objection to offspring enhancement that draws on an account of the role morality of parents. I work out an account of parental ethics by reference to premises about child development and to observations about parenting culture in the United States. I argue that excellence in parenthood consists in a dual responsibility both to guide children toward the good life and to accept them as they are. I conclude that prenatal manipulation of healthy and normal characteristics in human offspring fails to balance the dispositional extremes of control and restraint to which many parents today are susceptible. I apply this account of good parenting to the challenging case of height enhancement for short but otherwise healthy children. Finally, I reply to objections, first, about the phenomenology of bearing normative obligations to people who do not yet exist and, second, about the moral logic of criticizing embryo selection in the context of assisted reproduction when we accept child selection in the context of adoption.     

Preschoolers’ autobiographical memory specificity relates to their emotional adjustment

Reduced autobiographical memory specificity (AMS) has robust associations with psychopathology. As such, understanding the development of AMS (or its inverse, overgeneral autobiographical memory) and how it may be unique from other aspects of memory performance is important. In particular, it is unclear whether child AMS is distinct from autobiographical memory performance in other contexts, such as during mother–child reminiscing, and whether reduced AMS during early childhood is associated with emotional adjustment as found later in development. In this study, associations between children’s AMS and memory performance during mother–child reminiscing were evaluated. Moreover, the contributions of each type of child memory performance to child internalizing and externalizing symptoms were examined. Participants included 95 mother–child dyads drawn from a diverse, low-income community. Children’s ages ranged from 3.5 years to 6 years. Dyads participated in a joint reminiscing task about 4 past events, children participated in assessments of AMS, and mothers rated children’s emotional adjustment. Path analysis results indicated that children’s AMS was not significantly related to children’s unique memory contributions during reminiscing. Child AMS was negatively associated with emotional symptoms, whereas child memory during reminiscing was not.     

SITUATIONS SOCIALES À POTENTIEL CONFLICTUEL ET CARACTÉRISTIQUES SOCIO-COGNITIVES D'ENFANTS AGRESSIFS ET REJETÉS*

Twenty aggressive and rejected children (boys and girls), twenty socially competent and popular children, and twenty children having average social skills - all of which were first and second graders attending regular school - participated in this study. All were presented on videotape with nine typical peer-conflict situations. Each child was asked about the way that he/she felt, and the way that he/she would resolve each problem situation. In addition, each child had to specify what he/she thought to be the offender's intentions in each problem situation. Several points differentiated first grade from second grade subjects. However, aggressive, socially skilled and average subjects distinguished themselves on only a few items. Differences relating to subject's sex were also scarce. Data support the view that aggressive children know as well as other children how to appropriately resolve interpersonal conflict situations. However, they do not use this knowledge because of impulsivity control problems, an inability to correctly identify others' intentions or a lack of motivation.     

Conversation Orientation Moderates the Relationship between Information Sharing of Medically Assisted Reproduction and Child Adjustment

Parents who experienced infertility have increasingly used medically assisted reproduction (MAR) to add children to their families over the past few decades. These parents will need to decide if they will tell their children about being conceived using MAR. Although MAR information sharing operates within family contexts, little is known about the role of conversation orientation—one family contextual factor—in child outcomes associated with MAR information sharing in middle childhood. Derived from the Family Communication Patterns Theory, this study proposes that conversation orientation moderates the associations between MAR information sharing and children's psychosocial adjustment. This proposal was tested using a sample of 81 6- to 12-year-old MAR-conceived children from 55 families and a structured observational measure of conversation orientation. Multiple regression analyses showed that MAR information sharing interacted with conversation orientation to influence children's behavioral and attention problems but not emotional problems. In families with high conversation orientation, MAR information sharing was not significantly associated with children's behavioral and attention problems. In families with low conversation orientation, MAR information sharing was significantly associated with an increase in children's behavioral and attention problems. Results of this exploratory study demonstrate the potential significance of general communication orientation in understanding child outcomes of MAR information sharing and highlight the needed family context nuances in MAR research.     

儿童发展与电子媒体：基于生态科技微系统理论的视角

电子产品改变了人们社会活动的模式和生活方式,其低龄化使用也不可避免地影响和塑造了儿童的发展。生态系统理论认为儿童的发展源于儿童与周围环境之间不断的交互作用。生态科技微系统理论是在当今电子科技的环境下以生态系统理论为背景框架提出的解释电子媒体对儿童发展影响的理论模型。电子产品作为儿童学习、娱乐、沟通和展示自我的工具,对儿童的认知方式、情感互动方式和参与社会的方式等都会产生一定的影响。这些影响依赖于三个相互独立又关联的因素之间的作用：儿童自身的特点、电子媒体的内容和特点,以及儿童媒体使用的环境。未来的研究可以从研究手段和研究内容上进一步深化以探讨电子产品的使用和儿童发展的关系。     

Making sense of being fat: A hermeneutic analysis of adults’ explanations for obesity

This hermeneutic‐phenomenological study of individuals enrolled in a hospital weight management clinic is an account and analysis of the experiences of being overweight, dieting and weight cycling through in‐depth life history interviews. Participants explored their earliest recollections involving family attitudes towards food, multiple experiences with dieting and weight cycling and how they explained their weight problems to themselves. Analysis revealed that mealtimes became the arena within which control battles were waged between parent and child; food became associated with control and eating subsequently became a way to gain control over other aspects of life. Eating also became a way to numb the pain associated with child abuse, to substitute for human needs for relationship and belonging and emotional cycles of eating were identified. Insights emergeing from the interview process suggest the value of considering a psychodynamic approach to understanding emotional eating.     

The role of fathers in children's emotion regulation development: A systematic review

This systematic review summarizes the results of 43 studies that explored the potential role of fathers in emotion regulation (ER) development in children. Following a tripartite model, this review investigates the paternal modelling of ER strategies, emotion-related paternal parenting practices, father–child emotional climate, and fathers' characteristics, by identifying 16 specific themes of paternal factors that could play a role in the child's ER development. Results show that while a large number of studies investigated father–child emotional climate and fathers' characteristics and their association with children's ER, the effects of paternal modelling and the father's emotion-related parenting practices on children's ER are still understudied. This review reveals that several factors—fathers' modelling of ER strategies; positive reactions and support in responding to their child's expression of emotions; better quality of the father–child relationship; higher father–child attachment security; and positive parenting in terms of sensitivity, engagement, and expressiveness—had significant associations with children's higher ER skills. Conversely, fathers' psychopathology and harsh parenting were associated with poorer ER skills in children.

Highlights

• This study summarized existing literature that explored the association between paternal factors and ER in children.
• The review showed some evidence supporting the paternal role in children's ER development.
• Fathers' role in the development of child's ER is most prominent in infancy and toddlerhood.
• Most paternal factors significantly associated with a child's ER reflected previous findings examining maternal factors.