Child and Adolescent Psychotherapy Research: Developmental Issues

Describes developmental issues that pose current challenges to the design of treatment outcome investigation with children and adolescents. Normal childhood development and the development of childhood disorders are discussed using the transactional model of development. Challenges in diagnostic decision making, the selection of the most appropriate treatment regimen, and the measurement methods are highlighted. Recognition of the need to study child treatments through long-term follow-up periods underscores the need for resolution of these developmental issues.     

Psychoanalytic Psychotherapy with People in Abusive Relationships

Summary

Psychoanalytic perspectives on violence between partners is describedand forms a foundation for an approach to group and individual psychotherapy of men and women in relationships in which there is physical violence between partners. The empirical results of a study of the outcome of psychoanalytically oriented psychotherapy are described. Nineteen men and 16 women completed research measures before beginning psychotherapy and after completing 16 sessions of group psychotherapy. Twelve people who completed group psychotherapy continued in individual psychotherapy and completed measures again after 16 sessions of individual psychotherapy, and nine people completed measures again after the 16 sessions of group and 32 sessions of individual psychotherapy. Statistical analyses addressed outcomes in terms of verbal and physical aggression and dysphoric affects and anger. Both research and clinical outcomes are discussed.     

An Attachment Perspective on Reunions in Couple Psychoanalytic Psychotherapy

Psychoanalysis has been slow to acknowledge attachment theory as one of its own. Yet traditions of observational and representational research associated with it have much to offer in shedding light on intrapsychic as well as interpersonal phenomena. This paper explores these traditions and their potential clinical utility for couple psychoanalytic psychotherapy. In particular, attention is drawn to behaviour and representations associated with the experience of reunion in therapy sessions.     

Treating a Chronically Depressed Adolescent Female Using the Cognitive Behavioral Analysis System of Psychotherapy: A Case Study

A case is presented of an adolescent female with double depression who was treated using the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). CBASP is designed to teach a social problem-solving procedure called Situational Analysis (SA). Generalized treatment effects were measured through monitoring of diagnostic status, two administrations of the Minnesota Multiphasic Personality Inventory-Adolescent, weekly administrations of the Child Depression Inventory, and acquisition performance ratings on the SA task. The results showed that CBASP appeared to be an effective treatment. The double depressive disorder remitted, and the patient learned to identify behavioral consequences as well as target and attain her interpersonal goals. CBASP can be effective for adolescents, although modifications of the adult form of the therapy may be necessary.     

Self Psychology, Dreams and Group Psychotherapy: Working in the Playspace

This paper presents one leadership style within a self-psychological approach to working with dreams in group psychotherapy. It stresses an empathic attunement, the creation of safety, and an experience-near playful relationship. Playful is not used lightly here. It is used in the spirit of Winnicott's intermediate space where a mother suspends questions of what is real or not real and what is me and not me. Freud's analogy to a playspace forms a metaphor for the creation of a special atmosphere in a group, or for that matter in individual work as well, that encourages exploration, risk taking, and vulnerability. Working with dreams in this playspace deepens the curative process, not only for the dreamer, but for the entire group.     

Group Therapy with Individuals and Families Coping with Illness or Disability in Israel

This paper illustrates a group intervention with individuals and family caregivers coping with illness/disability, and focuses on the relationship between the process of group development and the process of coping with the illness/disability. People experiencing illness/disability cope with a great deal of pressure and stress that stem from the illness's biopsychosocial demands. A group can provide encouragement and support and reduce helplessness, isolation, and despair through cooperation and use of mutual resources. The design of the intervention was based on our clinical experience with numerous groups for ill/disabled individuals or their family. The process is described and analyzed using examples from three documented groups, and is presented in terms of four variables: group process, group atmosphere, group content, and group intervention.     

Integrating Cognitive and Existential Treatment Strategies in Psychotherapy With Dependent Patients

A dependent personality orientation is associated with increased risk for a broad array of Axis I and Axis II disorders. Although traditional treatment interventions have modest ameliorative effects on problematic dependency, the multifaceted nature of dependency suggests that integrated treatment strategies may hold more promise than traditional treatment approaches. This article outlines one potentially useful integrated treatment strategy, combining elements of cognitive and existential therapy to alter dependency-related thought, behavior, and emotional responding. Procedures for implementing an integrated cognitive-existential treatment model are outlined, and challenges in use of the model are discussed.     

Confrontation Group Psychotherapy with Gifted, Dually Diagnosed, and Self-Destructive Adolescents in a Residential Setting

An adolescent mutation has proliferated since the late 1960s who has been immune to traditional therapeutic and educational approaches. It takes a new breed of group leader to work with this difficult-to-treat youth, who either self-medicates abusing psychoactive substances and/or takes prescribed and potent psychotropic medication. Innovative and humanistic treatment techniques are needed to convince an unconvinced youth to use, rather than abuse, superior intellectual and artistic abilities.     

Clinical Improvement in Adolescents Comorbid for Substance Abuse and Psychiatric Diagnoses Through Multiple Group Psychotherapy

In a pilot study, the authors examined the outcome of group psychotherapy for the treatment of 19 adolescents, comorbid for substance abuse and psychiatric diagnoses, in terms of symptom reduction. They compared presenting symptomatology of treatment completers with treatment noncompleters. A retrospective study of the outcome of a multiple group psychotherapy treatment program using the Drug Use Screening Inventory-Revised Version (DUSI-R) to assess change over time was conducted. Depressive disorders were the most prevalent psychiatric diagnoses (68%), and marijuana was the substance most commonly abused on a frequent basis. Treatment completers showed improvement in behavior problems, health status, and social competence. As part of an integrated treatment program, multiple group psychotherapy is a promising treatment modality for adolescent patients, comorbid for substance abuse and psychiatric diagnoses, pending further assessment of the complex issues involved in combined treatment.     

Structure with Engagement: Toward an Integration of Trauma and Relational Psychoanalytic Models in the Treatment of Dissociative Disorders

Trauma model approaches to the treatment of dissociative disorders may provide containment and direction and yet, these same approaches may be constricting and limit exploration. However, relational psychoanalytic approaches may allow for engagement and exploration while potentially failing to provide containment and structure. This article provides an overview of key elements of both models and considers the question of whether it is possible to creatively resolve theoretical and clinical tensions between trauma model and relational psychoanalytic responses to dissociation. A review of the history of the study of dissociation in the field of psychoanalysis and concerns about psychoanalytic practice in the context of dissociation is followed by comparing contrasting conceptualizations of the assumptions of normality, definitions of dissociation, theories of etiology, goals of treatment, and theorized mechanisms of action. The review ends with a discussion of potential possibilities for clinical integration.     

Factors That Predict Premature Termination Among Mexican-American Children in Outpatient Psychotherapy

The role of demographic variables, acculturation, and therapy attitudes and expectations in predicting treatment dropout for Mexican-American families who presented for mental health treatment for a young child at a community mental health center was examined. Univariate analyses indicated that less educated parents who felt that they should be able to overcome their child's mental health problems on their own, and who felt that emotional and behavioral problems should be handled by increasing discipline were more likely to terminate prematurely. In addition, parents who perceived more barriers to treatment and expected their child to recover quickly were more likely to drop out of treatment after attending just one session. Measures of household income, acculturation, therapist–client ethnic match, perceptions of stigma, and expectations of therapist directiveness were not related to treatment dropout. When multivariate analyses were examined, parental education, perceived barriers to treatment, and belief in increased discipline remained significant predictors of treatment dropout, and client–therapist ethnic match became a significant predictor of dropout. Results are discussed in terms of implications for culturally-sensitive interventions.     

Determinants of Multiple Informant Agreement on Child and Adolescent Behavior

This study examined whether characteristics of behavioral items reported by parent and child are related to parent–child agreement. Data were collected from 20 judges rating 59 child behaviors on 11 dimensions hypothesized to affect parent–child agreement. Data from 675 parent–child dyads (85% female caregivers, 62% male children, aged 7–17) reporting on 59 child behaviors were used to examine agreement. Behavior characteristics accounted for 43% of variability in parent–child agreement. Three components, saliency to the parent, saliency to the child, and observability/willingness to report, contributed uniquely to prediction of agreement.     

Working With Fathers in Psychoanalytic Parent-Infant Psychotherapy edited by Tessa Baradon,Routledge, Abingdon and New York, 2019, 191 pp.

The American Journal of Psychoanalysis -     

Therapist Self Disclosure in Group Psychotherapy from an Intersubjective and Self Psychological Standpoint

The history of therapist self disclosure is traced from the early struggles of Ferenczi and Burrow to its valued, yet still ambivalent, contemporary status. The symmetry of self disclosure by therapist and group members is differentiated from the parity of their different roles and responsibilities. Using a case example, the process is discussed through which a therapist's self disclosure fosters task-appropriate satisfaction of selfobject needs as it also helps group members articulate and loosen archaic selfobject binds. The therapy group is described as a transitional space within which a therapist's disclosure offers members an intersubjective bridge to the therapist as well as a model for members' own active participation in the group's work.     

从心理学杂志相关文献看我国心理咨询与治疗方法的现状

对我国近年来已在实践中应用,并在心理学学术刊物上发表的心理咨询与治疗的方法进行了梳理,目的是探寻我国心理咨询与治疗方法的现状及存在问题.结果表明:我国心理咨询与治疗从业者所采用的方法绝大多数来源于国外;也有极少数本土化和本土的方法,但其研究及推广有限;从业者所采用的折衷方法多于单一方法,多数折衷方法是认知疗法和行为疗法的结合,或是将这二种方法结合其他疗法使用.     

Gender Differences in Risk and Promotive Classifications Associated With Adolescent Delinquency

How likely are children exposed to multiple risk factors to engage in delinquent behavior, to what extent do promotive factors mitigate exposure to these risk factors, and do the predictors of delinquent behavior differ by gender? To address these questions, the authors analyzed data from youths (229 boys, 187 girls) who completed the third wave of the Lehigh Longitudinal Study using Latent Profile Analysis. A unique risk and promotive class with slightly elevated rates of exposure to parental violence, mean levels of other risk factors and low levels of promotive factors was present for girls but not for boys. Additionally, for boys and girls, high-risk, low-promotive individuals were significantly more likely to engage in delinquent behavior than low-risk, high-promotive cases. Findings suggest the need to examine risk and promotive factors in combination to account for their shared influences on developmental outcomes for youth.