Child Psychotherapy: Integrating Developmental Theory into Clinical Practice

311 Pages·2012·3.664 MB·English

by  Robbie Adler-Tapia

Child Psychotherapy Robbie Adler-Tapia
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Integrating Developmental Theory T
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Into Clinical Practice p
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a Child
Robbie Adler-Tapia, PhD
C Psychotherapy
All too often, children are diagnosed and medicated without the consideration that their symptoms
may actually be a healthy response to stressful life events. This integrative guide for mental
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health practitioners who work with children is the only book to assimilate foundational develop-
mental theories into the practice of any method of child psychotherapy. The text underscores the i
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importance of considering the etiology of a child’s symptoms within a developmental framework
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before making a diagnosis.

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Providing advanced training and skills for working with children, the book guides the therapist and
student, step by step, through assessment, case conceptualization, and treatment, with a focus on s Integrating Developmental Theory
the tenets of child development and a consideration of the impact of distressing life events. It em- y
phasizes the need for professionals to consider alternative hypotheses for children’s behavior before
c Into Clinical Practice
arriving at a diagnosis of pathology. The book addresses child development from the perspective of
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numerous disciplines, including recent findings in neurodevelopmental trauma and neurobiology.
Assessment measures and the impact of divorce and the forensic/legal environment on clinical prac- o
tice are discussed. Also included are recommendations for HIPAA compliance and evidence-based
t
best practices for treating children. Woven throughout are indications for case conceptualization,
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including consideration of a child’s complete environment.
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Key Features:
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• Provides an integrative approach to child psychotherapy from the perspective
of healthy development
• Offers an alternative to the medical model
• Discusses key theories of child development and psychotherapy
• Integrates a multimodal approach that considers a child’s daily environment
• Includes a template for organizing and implementing successful practice
ISBN 978-0-8261-0673-5
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New York, NY 10036-8002
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Child Psychotherapy
Robbie Adler-Tapia, PhD, is a licensed psychologist who has worked with individuals impacted by
trauma, attachment, and dissociation for more than 25 years. After conducting her doctoral study on
the iatrogenic effects of foster care on children, she developed a specialty with young children and
their families. Dr. Adler-Tapia’s work as a psychologist, educator, researcher, and writer has taken
place in community mental health and child welfare settings, statewide adolescents-at-risk programs
in Pennsylvania and Arizona, and as the clinical director at Childhelp’s Children’s Center—a national
nonprofit center for children who are victims of crime. Currently in private practice, Dr. Adler-Tapia
provides counseling, consultation, and psychological services for children and families referred
by child welfare, the Division of Developmental Disabilities in Arizona, and law enforcement. She
works with emergency responders, law enforcement, and in a forensic role as an expert witness in
the juvenile, family, and criminal courts. She has been coinvestigator on several research studies on
the assessment and treatment of children. Recent publications include EMDR and the Art of Psycho-
therapy With Children (Adler-Tapia & Settle, 2008) and the accompanying treatment manual; “Healing
the Origins of Trauma: An Introduction to EMDR in Psychotherapy With Children and Adolescents”
( Adler-Tapia & Settle, 2009) in The Clinician’s Guide to Evidence-Based Practice Series, Volume 2, Treat-
ment of Traumatized Adults and Children (Rubin & Springer, 2009); and “EMDR Assessment and Desen-
sitization Phases With Children: Step-by-Step Session Directions” (Adler-Tapia & Settle, 2009) and
in EMDR Scripted Protocols: Special Populations (Luber, 2009). Robbie has presented trainings on eye
movement desensitization reprocessing (EMDR) with young children at EMDR International Associa-
tion (EMDRIA) International Conferences, at the International Society for the Study of Trauma and
Dissociation ( ISST-D) Conference, and at the San Diego International Conference on Child and Family
Maltreatment. In 2010, she presented at the National Association of State Directors of Developmen-
tal Disabilities Services (NASDDDS) Conference with Gail Ford, and in February 2011, Robbie and
Gail provided a teleconference for NASDDDS on using EMDR with individuals with intellectual and
developmental disabilities. In 2009, Dr. Adler-Tapia copresented at the ISST-D Conference on using
EMDR to treat attachment trauma and dissociation in children. Along with her research and writing,
Robbie has taught graduate-level coursework and supervised masters- and doctoral-level interns. She
is an EMDRIA Certified Therapist and Approved Consultant, an EMDR Institute Facilitator, and an
EMDR Humanitarian Assistance Program (HAP) Trainer. On a volunteer basis, Robbie is promoting
EMDR HAPKIDS, providing EMDR HAP training throughout the United States and in Kenya, and
applying for Substance Abuse and Mental Health Services Administration (SAMHSA) approval for
EMDR with children.
Child Psychotherapy
Integrating Developmental
Theory Into Clinical Practice
Robbie AdleR-TApiA, phd
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ISBN: 978-0-8261-0673-5
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Library of Congress Cataloging-in-Publication Data
Adler-Tapia, Robbie.
Child psychotherapy : integrating developmental theory into clinical practice / Robbie Adler-Tapia.
p. cm.
ISBN 978-0-8261-0673-5
1. Child psychotherapy. 2. Developmental psychology. 3. Behavior disorders in children—Treatment.
I. Title.
RJ504.A345 2012
618.92’8914—dc23
2012019524
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Printed in the United States of America by Bradford & Bigelow.
I owe more to the children whom I have had the privilege to observe than
any other source of knowledge; not merely because they were objects of
study, but their gifts as teachers.
Dr. Buford Jeanette Johnson
Baltimore, Maryland
September, 1932

Chapter 00
Contents
Preface xi
Acknowledgments xv
Part I: the Need for develoPmeNtally GrouNded ChIld
PsyChotheraPy
1. In Search of Mental Health and Resiliency: The Need to Integrate Developmental
Theory Into Clinical Practice 1
Developmental Psychology and Theories of Human Development 3
Origins of Child Psychotherapy 3
Current Practice of Psychotherapy With Children 7
A Need for the Integration of Developmental Psychology Into Child
Psychotherapy 9
2. Integrating Theories of Developmental Psychology to Form a Comprehensive
Approach to Treatment 11
Theorists and Theories of Human Development and Developmental
Psychology 11
Summary of Theories of Development 35
3. From Bonding and Attachment to Self-Regulation Theory: How Relationships
Impact Human Development and Psychotherapy 37
The Impact of Attachment on the Overall Health and Development of
the Individual 37
The Contributions of the Early Attachment Theorists 39
Current Theories of Attachment 45
Attachment, Mentalizing, Intentionality, and Self-Regulation 48
The Impact of Attachment and Bonding on Child Psychotherapy 49
Therapeutic Relationships in Child Psychotherapy 51
Summary and Conclusions 53
4. How Advances in Neuroscience Impact Child Psychotherapy 55
Neuroplasticity and Considerations for Child Psychotherapy 55
Theories of Neurobiology and the Developing Brain 56
Neurodevelopment, Neurobiology, and Psychotherapy With Children 58
Mirror Neurons and the Reflection in Psychotherapy 60
What Is Trauma and How do We Treat Children? 63
vii
viii Contents
Research on PTSD Symptomatology in Children and Adolescents 63
Autistic Spectrum Disorders 66
Sensory Processing Disorders—Where Psychology Meets Occupational
Therapy 68
Summary 70
Part II: assImIlatING develoPmeNtal theory INto the PraGmatICs
of ChIld PsyChotheraPy
5. Getting Started With Developmentally Grounded Child Psychotherapy 71
Organizing Your Office for Working With Children and Families 72
Parents, Parenting, and Parenting Skills 74
Child Psychotherapy That Involves Other Professionals 78
Psychotherapy With Child Clients 80
Opportunities for Reinforcing Positive Symptoms in Psychotherapy 84
Talking to Children in Forensically Complicated Situations 85
Research on Questioning Children 87
How Children’s Social Styles and Temperament Effect Treatment 89
Summary 91
6. The Legal and Ethical Challenges of Providing Child Psychotherapy 93
Documentation for Clinical and Forensic Environments 94
Requests for Records of Minors 94
Documentation: What Records Should Therapists Keep and How? 96
Who Is Your Client: Working With Parents/Guardians, Schools, Child Welfare
Organizations, and Other Legal Systems 99
Forensic Issues and Advocating for Children 100
Providing Psychotherapy in Forensically Complicated Cases 104
The Challenges to the Therapist—Personal and Professional Risk 105
Internet References for Professional Organizations 107
Summary and Conclusions 107
7. Assessment, Diagnosis, and Treatment Planning in Psychotherapy With Children
and Adolescents 127
Ethical Guidelines 128
Gathering Data From Parents 129
Initial Intake 129
Assessing for Attachment 133
Global Assessment of Development and Functioning of Child and
Adolescent Clients 136
Assessment Through the Stages of the Child’s Life 138
Assessment in Psychotherapy 145
Diagnosis of Children From a Strengths-Based Approach 145
Psychotherapy With Children With Co-Occuring Intellectual and
Developmental Disabilities (I/DD) and Mental Health Diagnoses 149
Psychotherapy With Children Exposed to Trauma 150
Summary 154
Internet Sources for Diagnosis and Assessment Tools 155
Contents ix
Part III: Best PraCtICes IN ChIld PsyChotheraPy
8. Theories That Inform the Practice of Child Psychotherapy 157
Theoretical Orientations of Psychotherapy 158
Summary and Conclusions 171
9. Integrating Theories of Developmental Psychology Into the Enactment of Child
Psychotherapy 173
Case Conceptualization From a Multimodal Approach 174
Strengths-Based Therapy Through the Lens of Child Development 176
EMDR Case Conceptualization With a Reverse Protocol 184
The Therapist’s Role in Psychotherapy With Children 201
Summary 202
10. The Basics in Child Psychotherapy 205
Parenting 206
For Kids 209
Summary and Conclusions 236
11. A Developmentally Grounded and Integrative Clinical Approach for Treating
Complex Trauma and Dissociative Disorders in Children 237
Definition of Personality and Personality Development Theories 237
Definition and Theoretical Conceptualization of Dissociation 238
Developmentally Grounded Theory of Dissociation in Children and
Adolescents 247
EMDR Phased Treatment Approach for Working With Children and
Adolescents With Symptoms of Complex Trauma and Dissociation 248
Summary and Conclusions 264
Resources for Treating Children With Dissociative Disorders 264
Assessment Tools 264
12. Epilogue 265
New Technology and New Information 266
New Research 266
New Theories and New Evidence-Based Practice 266
References 269
Index 289