Time-limited Psychodynamic Psychotherapy with Children and Adolescents: An interactive approach

A contextual analysis of time-limited psychodynamic psychotherapy with children, young people and parentsIntroduction and overview. Psychodynamic therapy and the changing emotional and social landscape of childhood and parenthoodCurrent concerns about child and adolescent mental health. Challenging articles of faithActing as advocates for the childWhy we should be concerned about instrumental treatments for children and young people: Challenging the existing paradigmDissenting voicesThe need for a refreshed vision for psychodynamic workChallenging articles of faithWhy should psychotherapy with children and young people be long term?Introducing an interactive model to time-limited psychodynamic psychotherapyA short history of time-limited psychodynamic psychotherapy with adultsThe British pioneers David Malan and Michael BalintNorth American pioneers of Brief Psychodynamic PsychotherapyPeter SifneosHabib DavanlooLester Lurborsky and Supportive-Expressive PsychotherapyContemporary approaches to time-limited psychodynamic psychotherapy with adultsA critical assessment of research and outcome studies of time-limited psychodynamic psychotherapy with children and young peopleThe pursuit of the randomised controlled trialThe limitations of studies on time-limited psychodynamic therapy for children and young peopleCurrent research dilemmas in the aftermath of modernityBroadening the scope of time-limited psychodynamic psychotherapyPsychodynamic psychotherapy with children and young people at a crossroadsA conceptual and practice framework for time-limited psychodynamic psychotherapy with children, young people and parents Reconfiguring a psychodynamic approach for current times. Refreshing and redefining the psychodynamic enterpriseThe four domains as cornerstones in time-limited psychotherapy with children, young people and their parentsCommencing with widening the field as part of the therapeutic endeavourRecalibrating the psychodynamic enterpriseThe primacy of the developmental taskRestating the duty of care to children young people and their parentsPsychodynamic signposts in therapeutic work: How theory and practice convergeAttachment: The connecting thread between the individual and systems theoryThe contribution of family therapy and systems thinkingThe making of meaning and the unity of brain and mindRecognising the capacity for health and growth in the child and young personThe psychodynamic perspective on groups and organisationsWhy more than ever, we need a psychodynamic perspective on child adolescent and family mental health problemsThe clinical method in time-limited psychodynamic psychotherapy with children, young people and parentsAsserting the legitimacy of the psychodynamic method and the making of meaningSupporting psychological mindedness in parentsAttending to the developmental scaffold and the core developmental taskAdhering to unifying principles of child and adolescent developmentThe involvement of parents and caregivers in the therapeutic processThe parenting and couple relationshipBuilding resources around the child and young person; Involving fathersThe beginning of the therapyWorking with the right people: Divorced and blended familiesCreating a position of trustThe clinical technique in time-limited psychodynamic psychotherapy with children, young people and parentsSetting up the conceptual frame for the therapeutic processStarting outHow long is time-limited psychotherapy?Taking a different view of time and therapeutic outcomeBeing active in the therapeutic processEstablishing a partnershipWhere and when does therapy begin?Establishing a defined assessment processThe first session: Taking a therapeutic history of the child and the parentsIdentification of the problemTaking a therapeutic history of the childKey points to keep in mind: Resisting being ‘blinded' by the symptomTaking a therapeutic history of the parentsThe therapeutic history and the rule of threeHistory taking with single, divorced and bereaved parentsSummarising the problem: Towards articulating a formulationPlacing the child and young person in the therapeutic framePreparing the child and young person for the assessment processtwo of the assessment: Meeting with the child, young person and parentsEncouraging communicationConsiderations of technique: Looking for capacityFeedback and forward planningA living cooperative endeavourContinuing the treatmentLooking for leverageDissolving the boundaries between the therapist and the wider networkAn adolescent in transitionTime-limited psychotherapy with children and young people experiencing loss and traumaThe place of hypothesis formulation and feedbackThe dynamic nature of the ‘here and now’What happens to the transference?Fluidity and transformation in time-limited psychotherapyThe journey from children to parents and backClinical challenges. The potential of the time-limited modelClinical challengesRevisiting the use of formulationApplying the practice framework to clinical challengesEmbedded problems within the adolescentWhy parents need to be involvedThe assessment and formulation process with parentsExamples of embedded problemsCreating a space for history takingHow the symptom is lived out in the familyThe assessment and formulation process with the young personThe adolescent, the young person, the parents and the therapistHelping parents to change the dynamic of the embedded problemResisting response to ritualsMaking practical changes: Working together as a parenting teamThe parallel developmental task for parentsThe impact of practical changes on the adolescent and young personRisks and reactionsAttention to the total field: The school settingThe case management functionConsolidating health and growthEmbedded problems in younger childrenWhen the body speaksDevelopmental and task confusionsEmotional triggersThe interactive connection: Work with parentsEmphasising health and growthIncontinence and ritualistic behaviourThe interactive connection: Work with the childCarrying the burden of family difficultiesMaintaining the momentum for changeReconnecting with developmentWidening the fieldEmpowering parents in times of changeThe impact of information technologyThe flattening of hierarchy between children and their parentsWhat do children and young people need?The role of time-limited psychodynamic psychotherapyIdentifying the three key elements that underpin child-parent conflictConfusion about the use of authority and parental authorityThe use of therapeutic scaffoldingBlurring of boundaries and the flattening of hierarchyThe changing circumstances of parenting and the blurring of boundariesEmpowering parentsConfusion about developmental milestonesParenting young and older childrenTransition for the adult and for the adolescentAcknowledging the rightful place of hatred and aggressionThe clinical outcome. Implications for training and researchThe end of the therapy and the clinical stanceHow do we evaluate change? The place of the reviewThe place of the double taskAssessing therapeutic outcomeWhat constitutes a positive outcome?Reframing the meaning of the symptomCreating a reflective process to promote long-term resilienceSupporting parents to assume authority and ‘own’ what they knowShifting the paradigm towards positive mental health for children, parents and young peopleRevisiting research: Making it meaningfulResearch and restating our duty of careDoing research differentlyBeing at the forefront of preventionTraining for the futureCombining practice, training and researchBibliography
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