Audit in psychoanalytic psychotherapy with children and adolescents

The importance of multidisciplinary audit in child and adolescent psychiatry, including the work of child psychotherapists, is discussed. Research is highlighted which shows that certain groups of children in particular benefit from psychoanalytic psychotherapy. The problems related to auditing psychoanalytic psychotherapy are discussed, and a possible method of audit based on peer review of notes, which takes into account both inner and outer change, is presented.

A patient is discussed whose notes have been audited using the audit form. It is suggested that this form of audit has good educational potential as well as ensuring a high standard of patient care.     

Franklian psychotherapy with adults molested as children

A Franklian approach to treatment with adults who were molested as children recognizes that the trauma client's experiences of trauma and terror as a child can be transformed to discover real meaning potentials in the adult's daily life. In this paper the authors present a five-stage treatment approach based upon the Logotherapy concepts of Viktor Frankl which they have found to be helpful with adult survivors of childhood sexual abuse. Case material is presented to illustrate the described intervention approach.     

Psychodynamic psychotherapy for children with disruptive disorders

Findings from a clinical project aiming to make psychodynamic psychotherapy more effective for children with disruptive disorders are summarised and discussed. In this project a supportive expressive model was used and the therapists worked with both children and parents. Nine boys aged 6 – 10 years were treated; all were reported to function better socially after therapy, but improvements were less marked in those boys who in addition to the initial diagnoses of ODD or CD had ADHD. Collaborative meetings with school teachers were associated with more positive effects.     

Ethical considerations in the use of nonerotic touch in psychotherapy with children

Although touch frequently occurs in psychotherapy with children, there is little written on the ethical considerations of therapeutic touch. Because physical contact does occur, therapists must consider if, how, and when it is used, for both their clients' safety and their own. In this review, I further develop the issues suggested by Aquino and Lee (2000) in the use of nurturing touch in therapy by considering many types of touch that occur in psychotherapy with children; the possible positive role of touch; clients' perception of touch in therapy; considerations related to the therapist, the child's safety, and any history of abuse in the child's and family's background; and other practical considerations. I list guidelines.     

Activities and games for group psychotherapy with sexually abused children

As increasing attention is given to the practice of group psychotherapy with sexually abused children, clinicians are using games and activities designed to address issues related to sexual abuse and its prevention. This paper describes how specific games and activities can be used in group therapy with child victims. These games and activities include: prevention films, role plays, and communication board games. Benefits and risks associated with the use of these resources are also discussed.     

Dilemmas and countertransference considerations in group psychotherapy with adult children of alcoholics

This article will explore special leader issues that emerge in psychodynamically oriented therapy groups with adult children of alcoholics. Particular focus will be on countertransference feelings that get stirred up in group leaders and techniques for dealing with some of these special dilemmas. Specific issues include (a) assumption of sameness between the therapist and the patient (the therapist assuming that he or she "understands" because of having also grown up in an alcoholic family); (b) the "will to restore," which may be destructive when the therapist, whose own self-esteem is dependent on the patient's progress in therapy, forces a "rush to recovery" on the patient; (c) other personal issues in the life of the therapist that may also resonate with experiences of the patient; (d) "countertransference goodness and availability" as it affects therapists' abilities to set reasonable limits on their patients, as well as reasonable expectations for themselves; and (e) special issues regarding therapist transparency and self-disclosure.     

Evaluation of psychoanalytic psychotherapy with children: Therapists' assessments and predictions

Meaningful and clinically relevant evaluation of psychoanalytical psychotherapy requires new models for research. Such evaluation needs to take account of the complexities of personality and innerworld change as well as the more simply assessed changes in external behaviour.

A pilot study to develop a suitable methodology is described. These preliminary results are on a consecutive series of twenty in care and adopted children entering psychotherapy at the Tavistock Clinic. The project evolved from a previous study of psychotherapy with severely deprived children (Boston & Szur 1983), but the method could be used with any group of children in psychoanalytic psychotherapy, and possibly also, in an adapted form, with adults.

Therapists' initial aims and predictions are compared with later assessments of both external, and a wide range of internal, changes. Methods of validation are discussed and case-illustrations given.     

The impact of group psychotherapy on social development in children with pervasive developmental disorders

Thirty-nine children with a diagnosed pervasive developmental disorder (PDD) participated in homogeneous psychotherapy groups. Their social development was assessed at home and at school both before and after treatment. Significant improvements in social functioning were observed in both settings, and these gains were not attributable to demographic variables or cognitive development. This research provides psychometric validation for the Vineland Adaptive Behavior Scale (VABS; Sparrow, Balla, & Cicchetti, 1984) and the Tyminski Social Skills Checklist (SSC), a new index designed to assess children's social functioning in educational settings. The results suggest that group therapy may be an important modality for better understanding and developing crucial social skills among the growing number of children diagnosed with a pervasive developmental disorder.     

Free writing: Evaluation of a preventive program with elementary school children

Eight-session free-writing workshops focusing on developing elementary schoolchildren's use of different describing words, reference to self, expression and clarification of feelings, and expression of stress responses were introduced to 324 fifth-grade children living on the northern border of Israel where the probability of war-related crisis is particularly high. The purpose of the study was to evaluate (a) the effectiveness of the workshop and (b) the applicability of free writing in an actual stressful event. Results indicated that the workshop group exhibited higher mean scores than the nonintervention control group on all behavior measures, both after the workshop and following a stressful event (shelling of the town). The theoretical background for free-writing conceptualization is given and the implications of the results are discussed in light of large-scale preventive intervention.     

Group psychotherapy in a school setting for adolescent children of alchoholics

Adolescents experiencing personal difficulties commonly evidence their problems while in school. Group psychotherapy within the school setting can be an effective means of helping an adolescent subject to stress at home. Parental alcoholism is the problem shared by a group composed of six students led by a clinical social worker. The broader implications of group therapy in a school setting as a means of helping young people with problems that interfere with their education and socialization are also considered.