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Introduction to Psychotherapy with Children & FamiliesPLEASE NOTE!!!Second NoteLearning ObjectivesSlide 5Approaches to Child Treatment: OverviewCharacteristics of “Psychotherapy”Characteristics of PsychotherapyChildren versus Adults in PsychotherapySlide 10Slide 11Level of Cognitive DevelopmentSlide 13Level of Dependence on OthersSlide 15Slide 16Slide 17The Complexity of Child TreatmentBasic Principles of PsychotherapyElements of ChangeElements of ChangeGeneral Factors in Psychotherapy“Therapist Offered Conditions”Therapist Offered ConditionsSlide 25Specific Factors in PsychotherapySlide 27Slide 28Interpretation in Child TherapyPaving the Way for InterpretationsThe Role of Interpretations“Working Through”Psychotherapy: The Big PictureStages of Psychotherapy: From Referral to TerminationReasons for ReferralSlide 36Assessment for PsychotherapySlide 38Slide 39Slide 40Slide 41Slide 42Slide 43The Setting for PsychotherapyThe Structure of PsychotherapyThe Initial Stage of PsychotherapySlide 47Slide 48Slide 49Setting Limits in TherapyDealing with Limits in Child TherapyLimits in Child TherapySlide 53The Middle Stage of TherapySlide 55Slide 56The Termination PhaseSlide 58Slide 59Slide 60Implementing TerminationMore on TerminationA Final Note on Phases of PsychotherapyEthical Dilemmas in Child TreatmentEmpirical Support for Effectiveness of Child PsychotherapyPsychotherapy EffectivenessMyths of psychotherapyMyths and ResearchIntroduction to Psychotherapy with Children & FamiliesPSY 4930Melissa SternOctober, 17th, 2006PLEASE NOTE!!!THE FINAL EXAM WILL BE HELD IN CLASS ON DECEMBER 5th!!!! We will not be having lecture that day, just the final examSecond NoteWe will be having lecture after the second exam. Part of it will be a guest speaker so please plan on staying the whole time!Learning Objectives•What is child psychotherapy and how does it differ from other treatments?•Who is a good candidate for child/adolescent psychotherapy?•How does child psychotherapy differ from adult psychotherapy?•What are the factors in child psychotherapy that bring about behavioral and personality change?•What are the primary stages in the psychotherapy process and what are the issues dealt with at each stage?Learning Objectives•What kind of ethical dilemmas does one confront when engaging in child psychotherapy?•What empirical support is there for the effectiveness of child psychotherapy?•What are the “Myths of Psychotherapy”•How does and understanding of these “Myths” lead to better research?Approaches to Child Treatment: Overview•Approaches to the treatment of behavioral or psychological problems in children:–behavioral (operant, classical conditioning)–cognitive-behavioral –psychopharmacological–family therapies –group therapies–residential treatments–And others . . .Characteristics of “Psychotherapy”•Most treatments discussed could be viewed as "psychotherapy" in the most general sense•Psychotherapy is commonly thought of as an interpersonal process, involving a verbal and/or nonverbal interchange between a patient who exhibits psychological problems and a professional who wishes to be of help•These approaches are usually based on a “Medical Model” of psychologyCharacteristics of Psychotherapy•Within this context the therapist attempts to:–gain an understanding of the patient's problems–utilize the nature of the relationship and various therapeutic techniques–to facilitate constructive personality and behavior change. •Psychoanalytic and Interpersonal approaches would fall into this categoryChildren versus Adults in Psychotherapy•Some argue that the basic principles involved in child treatment are similar to those involved in the treatment of adults•The major difference between working with adults and children is the need to alter therapy techniques to accommodate the child's level of cognitive and emotional development–5 y/o with PTSDChildren versus Adults in PsychotherapyImportant child differences that impact treatment:–conceptually more concrete –linguistically less competent –less introspective–less likely to see themselves as displaying difficulties –less likely to see the value of talking about problems –often less motivated to participate in ongoing treatment and –less likely to share common treatment goals with the therapistChildren versus Adults in Psychotherapy•Two most important issues to consider in psychological treatment of children:1. Level of cognitive development 2. Level of dependence on the parentsLevel of Cognitive Development•Greater emphasis be placed on non‑verbal communication and interactions •Child psychotherapy is often carried out within the context of play activities rather than involving the level of verbal discourse characterizing adult or even adolescent psychotherapy•Play is often considered a major vehicle for change in child psychotherapyLevel of Cognitive Development•As the age of the child increases there is typically a corresponding increase in the degree to which verbal interchanges predominate during therapy sessions•Even with older children, however, the use of games, which serve as a medium for therapeutic interaction and expression, is common•Can often be a useful buffer in therapy sessions –Playing checkers while talkingLevel of Dependence on Others•Therapist deals with persons (e.g., parents, caregivers, teachers) other than the patient more than when working with adult patients•Children seldom refer themselves for treatment •Referral may reflect:–the child's need for treatmentOR–the parents level of tolerance for what is essentially normal, although possibly problematic, child behaviorLevel of Dependence on Others•Intervention efforts may be focused on:–the child's problematic behaviorAND/OR–factors such as parenting stress, parenting skills, or perceived lack of competence in the parenting role which may contribute to strain on the parent-child relationshipLevel of Dependence on Others•Parents may also influence the outcome of child treatment •With adults, continuing in therapy is related to variables such as:–the patient's relationship with the therapist–current levels of patient distress–whether the patient feels that therapeutic gains are being made •With children, whether the child stays in treatment often has as much to do with parental as with child factorsLevel of Dependence on Others•Parental/family


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UF PSY 4930 - Psychotherapy

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