Child and Adolescent Therapy: Science and Art

"My graduate students loved the first edition of this book there′s nothing like it. The broad array of theoretical approaches that are covered helps to develop a comprehensive understanding of intervention approaches and provides a very solid foundation in child and adolescent therapy. This new edition has added an excellent chapter on mindfulness–based therapies and has infused a sophisticated neuroscience framework throughout the book."
Sandra W. Russ, Distinguished University Professor, Louis D. Beaumont University Professor, Department of Psychological Sciences, Case Western Reserve University

A THOROUGHLY REVISED INTRODUCTION TO THE THEORY AND PRACTICE OF CHILD AND ADOLESCENT THERAPY

Child and Adolescent Therapy: Science and Art, Second Edition offers practitioners an updated edition of this acclaimed guide. It includes the fundamentals of the various forms of psychotherapy that are grounded in the most current evidence–based research on child and adolescent therapy. Comprehensive in scope, this important resource bridges the gap between proven research and the art of practice and contains explanations of all major theoretical orientations and the techniques associated with each.

The text puts the focus on the day–to–day challenges of clinical practice and explores how expert therapists execute solid treatment plans and make productive clinical decisions. Theoretical concepts, empirically supported treatments, and best practices are presented in a concrete, detailed form, along with numerous illustrative examples.

Child and Adolescent Therapy: Science and Art, Second Edition contains:

Both the fundamentals of the profession and advanced theories and techniques for treating children and adolescents A review of proven theoretical approaches including behavioral, cognitive, mindfulness–based, psychodynamic, constructivist, and family systems Information for planning effective treatment strategies that consider outcome research, cultural factors, and individual client characteristics Treatment planning that connects the diagnostic characteristics of the major chiladolescent disorders

Child and Adolescent Therapy: Science and Art, Second Edition is filled with the knowledge and skills professionals need to provide effective psychotherapy to children and adolescents.

Preface: The Therapist s Challenge xi

Acknowledgments xiii

PART I THE TOOLS OF THE THERAPIST

1 Therapy Fundamentals 3

The Therapeutic Orientation Toward Clients 4

Getting Started 8

Basic Child Therapy Skills 13

Overcoming Obstacles to Client Engagement 25

Simple Therapeutic Interventions 33

Therapeutic Collaborations 37

Termination 39

Summary 41

2 Behavior Therapy 43

Learning Theory 44

Assessment and Case Formulation 50

Change Processes 54

Outcome Research 55

The Therapist s Style 58

Exposure 59

Contingency Contracting 60

Relaxation Training 67

Social Skills Training 69

Summary 73

3 Cognitive Therapy 75

Cognitive Theory 76

Assessment and Case Formulation 82

Change Processes 86

Outcome Research 87

The Therapist s Style 89

Self–Monitoring 91

Self–Instruction 93

Self–Reinforcement 94

Socratic Questioning 96

Cognitive Restructuring 98

Tests of Evidence 100

Personal Experiments 103

Using Spectra to Develop Moderation 104

Summary 108

4 Mindfulness–Based Cognitive–Behavioral Therapies 110

Mindfulness and Psychotherapy 111

What Causes Mental Health Problems? 115

Assessment and Case Formulation 117

Change Processes 121

Outcome Research 124

The Therapist s Style 127

Mindfulness Training Exercises 128

Implementation of Dialectical Behavior Therapy 132

Implementation of Acceptance and Commitment Therapy 141

Summary 147

5 Psychodynamic Therapy 149

Psychoanalytic Theory 150

Assessment and Case Formulation 161

Change Processes 163

Outcome Research 168

The Therapist s Style 170

Facilitating Expression of Material 171

Interpretation and Insight 172

Dynamic Psychoeducation 176

Corrective Emotional Experience 179

Summary 181

6 Constructivism: Solution–Focused and Narrative Therapy 184

Postmodernism and the Social Construction of Reality 185

Assessment and Case Formulation 189

Change Processes 192

Outcome Research 196

The Therapist s Style 198

Solution–Focused Techniques 199

Narrative Therapy Techniques 208

Summary 215

7 Family Systems Therapy 218

Systems Theory 219

Assessment and Case Formulation 227

Change Processes 230

Outcome Research 233

The Therapist s Style 234

Combining Family and Individual Modalities 235

Facilitating Communication 235

Systemic Insight 237

Reframing 238

Treating Enmeshment and Disengagement 242

Therapist Directives 243

Treating Positive Feedback Loops 245

Summary 250

8 Atheoretical and Transtheoretical Techniques 253

Miscellaneous Techniques 254

Parent Counseling 259

Balance Between Extremes 261

Psychoeducation 265

Values in Psychotherapy 272

Incorporating Experiences Into New Structures of Meaning 277

Overcoming Fear of Failure 288

Summary 293

PART II THE NEEDS OF CLIENTS

9 Cultural Factors in Therapy 297

The Role of Culture in Psychotherapy 298

Assessment and Case Formulation 307

The Therapist s Style 314

Connecting the Cultures of Therapy and Client 315

Conflicts Between Client Cultures and the Predominant Culture 318

Addressing Prejudice and Discrimination 319

Culturally Specific Adaptations of Therapeutic Approaches 320

Bringing Spirituality Into Therapy 321

Summary 324

10 Disruptive Behavior in Children 326

Diagnoses Treated in This Chapter 327

Clinical Presentation and Etiology 327

Assessment 332

Treatment Planning 333

Behavioral–Systemic Parent Training 339

Collaborative Problem Solving 352

Individual CBT With the Child 355

Psychodynamic Therapy 358

Summary 359

11 Disruptive Behavior in Adolescents 362

Diagnoses Treated in This Chapter 363

Clinical Presentation and Etiology 363

Assessment 369

Treatment Planning 370

Behavioral–Systemic Therapy 374

Psychodynamic Therapy 391

Parent Counseling 393

Summary 394

12 Aggression and Violence 396

Diagnoses Treated in This Chapter 397

Clinical Presentation and Etiology 397

Assessment 402

Treatment Planning 403

Addressing Decisions About Fighting 406

Cognitive–Behavioral Therapy 410

Psychodynamic Therapy 426

Systems–Oriented Intervention 427

Summary 428

13 Anxiety 430

Diagnoses Treated in This Chapter 431

Clinical Presentation and Etiology 432

Assessment 438

Treatment Planning 440

Cognitive–Behavioral Therapy 443

Psychodynamic Therapy 453

Parent–ChildWork 458

Summary 461

14 Depression 463

Diagnoses Treated in This Chapter 464

Clinical Presentation and Etiology 465

Assessment 471

Treatment Planning 472

Special Topic: Suicide Risk 476

Cognitive–Behavioral Therapy 479

Psychodynamic Therapy 489

Systemic Intervention 493

Summary 494

15 Stress and Trauma 497

Diagnoses Treated in This Chapter 498

Clinical Presentation and Etiology 498

Assessment 504

Treatment Planning 506

Cognitive–Behavioral Therapy 509

Coaching Clients in Coping 515

Psychodynamic Therapy 518

Constructivist Therapy 518

Systems–Oriented Intervention 519

Therapy for Parental Divorce 520

Therapy for Bereavement 522

Therapy for Sexual Abuse 525

Summary 530

Afterword: The Therapist s Experience 533

References 537

Author Index 613

Subject Index 635

JEREMY P. SHAPIRO, PHD, is a Clinical Child Psychologist and an Adjunct Faculty Member of the Psychology Department and Mandel School of Applied Social Sciences at Case Western Reserve University.