Meeting Them “Where They're At”

Abstract

Child maltreatment is associated with serious psycho-social difficulties and enormous direct and indirect societal costs. As such, it is an area for which new and promising interventions are highly important. The purpose of this exploratory research is to examine intensive school-based psychodynamic therapy for severely maltreated children experiencing significant difficulties, by obtaining perceptions of therapeutic effectiveness by the children's parents, teachers and therapists. Themes include: therapists', parents', and teachers' perceptions of child's changes; parental perceptions of therapy and relationship with the therapist; therapists' perception of relationship with parents; school as the location of therapy; teacher-therapist relationship; and the child's academic status.     

Parent–child attachment as a mediator of the relationship between parenting style and gelotophobia among adolescents

Fear of being laughed at and family interaction are highly related. Parental over‐control and over‐protection influence children's excessive anxiety over being laughed at. Conversely, parental attachment is an important index of the parent–child relationship and is closely correlated to children's gelotophobia. However, is it the style of parenting or the outcome of parenting (i.e. attachment) that influences a child's gelotophobia? To answer this question, the present study analysed the relationships between gelotophobia, perceived parenting of children and parent–child attachment, as well as the mediating role of attachment between parenting and children's gelotophobia, using a sample of 373 high‐school students. The results show that being highly communicative and close attachment completely weakened the negative correlation between warm, caring parenting and the child's gelotophobia; moreover, being highly communicative and close attachment, together with over‐protective and over‐controlling parenting, influence children's gelotophobia. In sum, this study indicates that parent–child attachment has a direct and indirect influence on perceived parental care and protection and children's fear of being laughed at.     

Working Through Physical Disability in Psychoanalytic Psychotherapy With an Adolescent Boy

The narcissistic injury that may be caused by physical disability in infancy and the possible familial traumatization may block the integration of the infant's body and self-image, and can consequently hinder the child's identity formation. This article presents how an adolescent boy with cerebral palsy in short-term psychoanalytic psychotherapy works through the mental impact of his physical disability using a story. Transference and countertransference reactions are discussed. The positive impact of short-term psychoanalytic psychotherapy highlights the importance of caring for the mental health of children with physical impairments.     

Behavioural Problems in Children with Headache and Maternal Stress: Is Children's Attachment Security a Protective Factor?

Headache is a potentially disabling condition involving enduring pain that negatively influences the quality of family life. Behavioural problems are more common in children with headache and are potentially associated with higher levels of parental stress. The aim of this study was to evaluate the extent to which children's behavioural problems were associated with maternal stress and how the child's perception of security in the maternal attachment relationship moderates this association. Seventy‐one school‐aged children with headache (headache group (HG), age M = 9.8 years old, SD = 1.3) and 71 children from a low‐risk normative population (control group (CG), age M = 9.2 years old, SD = 1) and their mothers were involved in the study. Mothers' reports of children's behavioural problems were associated with higher maternal stress in the caring task both in the HG and in the CG. Results also showed that the HG was more at risk for behavioural problems, whereas no difference between groups was detected for parenting stress and for attachment insecurity. In children with headache, perception of attachment security decreased the strength of the association between maternal stress and externalizing behavioural problems. Secure attachment may provide children with headache and their parents with support in managing the negative emotions that arise in the context of significant health issues. Implications for practice are discussed. Copyright © 2015 John Wiley & Sons, Ltd.     

Foster Children and ADHD: Anger, Violence, and Institutional Power

This paper explores the ways in which foster children and attention deficit hyperactivity disorder (ADHD) intersect as social and medical categories. Through the method of interpretive biography based on the official case file, this paper shows how the experiences of violence and ADHD become linked in the child's life through the emotion of anger. In this way, it is possible to see how the power dynamics of the medical, educational and welfare systems lock the diagnosis with its embedded meanings into the child's life. It is also possible to see how counter forces like a caring foster family can challenge medical and welfare authorities.     

Primal splitting as a basis for emotional and cognitive development in children

This article discusses the importance of good primal splitting as the basis for the child's emotional and cognitive development. A theoretical introduction analyses the possible pathologies of primal splitting, as they were first pointed out by Melanie Klein and then by some post-Kleinian authors, in particular Donald Meltzer. This is followed by some excerpts from the clinical material of the first year of the psychoanalytic psychotherapy of a three-year-old child suffering from eating problems. Starting from the child's play activity, the author tries to identify the splitting problems that underlie the child's view of the world, and to address these with him. The article shows how at times it can be useful to speak also to the child's intelligence, combining the usual analytic work (containment of anxiety and analysis of transference) with the analysis of the child's distortions and cognitive misconceptions. The article also suggests that faulty primal splitting tends to be transmitted from one generation to the next.     

Parental self-esteem and behavior problems in children: Similarities between mothers and fathers

The relationship between parental self-esteem and behavior problems in children was investigated using 1624 married couple's responses from the National Survey of Families and Households. The sample was weighted to be nationally representative in terms of race and ethnicity. It was hypothesized that the existence of behavior problems among children would be associated with low self-esteem among parents and that the parent's gender, child's gender, parents' gender role attitudes, and parental employment would moderate this relationship. The results indicated that parental self-esteem is negatively associated with behavior problems in children. However, none of the moderating variables had a significant impact. This suggests that the relationship between parental self-esteem and behavior problems among children is robust and does not vary appreciably with the gender of the parent, the gender of the child, the attitudes of the parent, or the employment of the parent.     

Mothers' and fathers' negative responsibility attributions and perceptions of children's problem behavior

Parents' negative responsibility attributions about their child's misbehavior are related to a perception that the child has more behavior problems. This study used a dyadic framework to explore how mothers' and fathers' attributions relate to their own perceptions and to their partner's perceptions of the child's externalizing problems. Participants included 102 couples interviewed when children were 7 years old. Results confirmed that mothers reported more externalizing behavior problems in their children than did fathers, and fathers of boys reported more child behavior problems than fathers of girls. Dyadic analyses suggested that parents' negative responsibility attributions of the child's behavior were associated with greater perceptions of child externalizing problems on behalf of parents and their partners.     

A Goodness-of-Fit Approach to Informed Consent for Pediatric Intervention Research

As children and adolescents receive increased research attention, ethical issues related to obtaining informed consent for pediatric intervention research have come into greater focus. In this article, we conceptualize parent permission and child assent within a goodness-of-fit framework that encourages investigators to create consent procedures “fitted” to the research context, the child's cognitive and emotional maturity, and the family system. Drawing on relevant literature and a hypothetical case example, we highlight four factors investigators may consider when constructing consent procedures that best reflect participants' rights, concerns, and well-being: (a) the child's current assent capacity and the likely impact of study information on the child's mental and physical development, (b) parents' understanding of their child's treatment needs and distinctions between treatment and clinical trials research, (c) the family's history of shared decision making, and (d) the child's strivings for autonomy within the context of their parents' duty to make decisions in the child's best interest.     

Creative potential and the sociometric status of children

The social adaptation problems of highly creative children were first discussed by Torrance (1961a, 1961b), but there is still no clear consensus as to whether or not creative children suffer from social rejection. The social status of these children in classroom groups deserves attention because of the educational and developmental importance of sociometric position. The present study utilized a multivariate approach to sociometric status (exploratory principal‐components analysis). The principal components were subjected to cluster analysis, which produced a clear sociometric taxonomy, comprising “neglected,”; “popular,”; “academic,”; and “rejected”; groups. Most of the highly creative children were in the neglected group. Further exploration using path analysis demonstrated that the child's self‐perceived social distance from other group members represents an intervening variable which is related to creative potential and is negatively associated with popularity in classroom groups.     

Assessing the impact of a family nurse-led intervention on young mothers’ references to internal states

A mother's propensity to refer to internal states during mother–child interactions is important for her child's developing social understanding. However, adolescent mothers are less likely to reference internal states when interacting with their children. We investigated whether young mothers’ references to internal states are promoted by the Family Nurse Partnership (FNP) intervention, an intensive home-visiting programme designed to support adolescent mothers in England. We also investigated family, maternal, and child factors associated with young mothers’ references to inner states during interactions with their children. Adolescent mothers (n = 483, aged ≤ 19 years when recruited in pregnancy) and their children participated in an observational substudy of a randomized controlled trial investigating the impact of FNP compared to usual care. Mother–child dyads were video-recorded during free play, and mothers’ speech was coded for use of internal state language (references to cognitions, desires, emotions, intentions, preferences, physiology, and perception). We found no differences in mothers’ use of internal state language between the FNP and usual care groups. A sample-wide investigation identified that other features of mothers’ language and relationship status with the child's father were associated with internal state language use. Findings are discussed with reference to targeted interventions and implications for future research.     

Emotionally Focused Family Therapy and Play Therapy Techniques

Emotionally Focused Family Therapy provides a framework for understanding children's behaviors in terms of attachment needs of comfort and support. However, when working with young children, play therapy is often developmentally preferred over “talk therapy.” By integrating play therapy techniques within an Emotionally Focused Family Therapy theoretical framework, therapists can help parents understand and meet their child's needs for affection and comfort. This article will discuss how play therapy techniques can be integrated with an Emotionally Focused Family Therapy theoretical framework for work with young children and their families.     

Feeling one's way in the world: Making a life

This paper argues for the psychoanalytic relevance of the works of James Gibson and Susanne Langer in explicating the early development of the human child and makes use of this combined formulation of development to think about psychoanalytic theory and practice. From the insights of James Gibson's ecological psychology we can appreciate the embodiment and embeddedness of the child's growing mind within both her physical and social environments. Making use of Susanne Langer's concept of feeling to redefine ecological psychology's perceptual counterpart to action allows us to understand the child's seamless transition into active participation in her culture, as she learns to project her animalian capacity to feel into intersubjectively defined forms of behavior and experience with others. The paper presents a lengthy exposition of Gibson's ecological psychology, before explaining Langer's thinking and launching into the combined insights of these scholars to explicate the nature of the child's mind as she feels her way in the world and makes a life for herself within it. This is the life she will be able to remake in the embeddedness of a psychoanalytic therapeutic relationship where she can learn to feel her way in the world in a new light.     

Seven‐year‐olds’ aggressive choices in a computer game can be predicted in infancy

Concerns about the relationship between computer games and children's aggression have been expressed for decades, but it is not yet clear whether the content of such games evokes aggression or a prior history of aggression promotes children's interest in aggressive games. Two hundred and sixty‐six 7‐year‐old children from a nationally representative longitudinal sample in the UK played a novel computer game (CAMGAME) in which the child's avatar encountered a series of social challenges that might evoke aggressive, prosocial or neutral behaviour. Aggressive choices during the game were predicted by well‐known risk factors for aggressive conduct problems and the children's own early angry aggressiveness as infants. These findings suggest that children who are predisposed to aggression bring those tendencies to virtual as well as real environments.     

Holding the Baby in Mind: Discussion of Joseph Lichtenberg's “Communication in Infancy”

Joseph Lichtenberg suggests that infants are held in their caregivers' symbolic world before they create one of their own. This idea is addressed from the perspective of parental reflective functioning. This construct offers a means of further understanding how a caregiver's capacity to elaborate upon the mental life of her child sets the stage for the child's internal experiences becoming known and developed or distorted and stunted within the context of the relationship. These ideas both complement and expand upon the research and theoretical work described by Lichtenberg in his consideration of the development of communication with self and other in infancy.     

Children's response to community violence: What do we know?

This article presents a framework for understanding the developmental significance of violence-related trauma in the lives of young children. It emphasizes the importance of the distinction between acute and chronic trauma. Acute trauma is more readily dealt with through “psychological first aid” and a “therapy of reassurance.” Chronic trauma requires a more systematic reconstruction of the child's “social map” of the world. The socioeconomic and demographic correlates of violent trauma predict an accumulation of risk factors in the child's life that compounds the problem of developmental disability. The problem community violence poses for the child must be understood in the larger context of greater risk for family disruption (including less than secure attachment) as well as domestic violence, poverty, and minority group status. The increasing incidence and prevalence of community violence poses a major challenge to the mental health of children.     

Distress of Japanese parents of children with intellectual disabilities: Correlations with age of parent and negative mood regulation expectancies

Parents caring for a child with an intellectual disability (ID) face many challenges. Few studies in Japan have focused on parents of children with an ID. We investigated the psychological factors that might help these parents maintain well‐being, in particular negative mood regulation expectancies (NMRE). NMRE are beliefs about one's ability to diminish one's negative moods. Research has shown NMRE to buffer the effects of stress: stronger NMRE are associated with less symptoms of distress, including depression and anxiety. We examined the associations of NMRE, coping, and severity of the child's ID with parental distress (somatization, depression, and anxiety) among 106 Japanese parents (mean age = 56.7 years) caring for at least one child with an ID. The age of the parent was negatively associated with parental distress, particularly anxiety. NMRE were also negatively related to distress, independent of the age of the parent and coping. The severity of the child's ID was not related to coping or parental distress. Stronger beliefs that they could control their negative moods and being older seemed to protect parents of an ID child from symptoms of distress.     

Narrative Child Family Therapy

In this article, child family therapy is presented as a hermeneutic activity shaped by an interest in the evolving narrative. Over brief, analytic play interviews, the therapist documents a child's narrative understanding of the presenting family problem. This allows psychological meaning to be jointly constructed in therapeutic conversation with the child and family. The idea of play as narrative integrates child psychotherapy into recent social constructionist thinking in family therapy. The article also discusses how narrative therapists can use prior theory and training.