Child and Adolescent Anxiety Psychodynamic Psychotherapy: A Treatment Manual

ISBN : 9780190877712

Sabina E. Preter; Theodore Shapiro; Barbara Milrod
160 Pages
178 x 254 mm
Pub date
Aug 2018
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Child and Adolescent Anxiety Psychodynamic Psychotherapy, CAPP, is a new, manualized, tested, 24-session psychotherapeutic approach to working psychodynamically with youth with anxiety disorders. This book describes how clinicians intervene by collaboratively identifying the meanings of anxiety symptoms and maladaptive behaviors and to communicate the emotional meaning of these symptoms to the child. The treatment is conducted from a developmental perspective and the book contains clinical examples of how to approach youth of varying ages.

The authors demonstrate that CAPP can help youth:

· Reduce anxiety symptoms by developing an understanding of the emotional meaning of symptoms
· Enhance children's skill of reflection and self-observation of one's own and others' motivations (improvement in symptom-specific reflective functioning)
· Diminish use of avoidance, dependence and rigidity by showing that underlying emotions (e.g. guilt, shame, anger), as well as conflicted wishes and desires can be tolerated and understood
· Understand fantasies and personal emotional significance surrounding the anxiety symptoms to reduce symptoms' magical qualities and impact on the child

The manual provides a description of psychodynamic treatment principles and technique and offers a guide to opening, middle, and termination phases of this psychotherapy. It contains chapters on the historical background of psychodynamic child psychotherapy, on developmental aspects of child psychotherapy, and on the nature of parent involvement in the treatment. It will be useful for clinicians from diverse therapy backgrounds and it will appeal to the student reader, as well as to the experienced clinician.


Chapter 1: Introduction
1.1. Rationale for CAPP
1.2. Psychoanalysis, Dynamic Psychotherapy and Symptom Focused Dynamic Psychotherapy: Background and Comparisons
1.3. CAPP: Modified and developmentally adapted version of Panic - Focused Psychodynamic Psychotherapy (PFPP)
1.4. Cases: 14-year-old Marie and 13-year-old Tom
1.5. Overview of the 3 phases of treatment
Chapter 2: Time-limited Psychodynamic Psychotherapy

2.1. Theory and Clinical Issues
2.2. Reflective Functioning
2.3. Case: 7-year-old Miranda
2.4. Summary
Chapter 3: How to make sense of children's communications in psychotherapy: A walk through the developmental stages

3.1. Introduction and Theory
3.1.1. Preverbal Communication
3.1.2. Language and Fantasy
3.1.3. Development of Separation Anxiety
3.1.4. Reflecting on Others
3.2. The playing, dependent child: Normally Developing 2 12-year-old Abby and 5-year-old Emily in Brief Therapy
3.3. The talking, autonomous child: 7-year-old Alice
3.4. The Pre-teen and Adolescent Youth: 11-year-old Grace and 16-year-old Laura
3.5. Summary
Chapter 4: The three phases of CAPP: opening, middle, and end

4.1. Beginning Therapy: CAPP Opening phase
4.2. Cases: 6-year-old Sally and 16-year-old Laura
4.3. Opening phase: Tom
4.4. CAPP Middle phase
4.5. Cases: 7-year-old Max, 8-year-old Paula, 10-year-old Matt, 10-year-old Jim, 9-year-old Lilly
4.6. Middle phase: Tom
4.7. CAPP Termination phase
4.8. Cases: 15-year-old Charlie, 8-year-old Amy
4.9. Termination phase: Tom
4.10. Summary
Chapter 5: Including Parents of Children and Adolescents in Dynamic Psychotherapy of Anxiety

5.1. Theory and Clinical Issues
5.2. Cases: 7-year-old Wendy, 7 year-old Annie, 13-year-old Jimmy
5.3. Summary
Chapter 6: The Anxiety Disorders
6.1. Generalized Anxiety Disorder with Case Vignette
6.1.1. Symptoms, Signs and Diagnostic Considerations
6.1.2. Psychodynamic Factors and Conflicts
6.1.3. Treatment: Transdiagnostic Techniques and Specific Adaptations
6.1.4. Case: 7-year-old Gary
6.2. Social Anxiety Disorder with Case Vignette
6.2.1. Symptoms, Signs and Diagnostic Considerations
6.2.2. Psychodynamic Factors and Conflicts
6.2.3. Treatment: Transdiagnostic Techniques and Specific Adaptations
6.2.4. Cases: 15-year-old John and 18-year-old Brian
6.3. Separation Anxiety Disorder with Case Vignette
6.3.1. Symptoms, Signs and Diagnostic Considerations
6.3.2. Psychodynamic Factors and Conflicts
6.3.3. Treatment: Transdiagnostic Techniques and Specific Adaptations
6.3.4. Case: 8-year-old Marissa
6.4. Panic Disorder with Case Vignette
6.4.1. Symptoms, Signs and Diagnostic Considerations
6.4.2. Psychodynamic Factors and Conflicts
6.4.3. Treatment: Transdiagnostic Techniques and Specific Adaptations
6.4.4. Case: 18-year-old William
6.5. Agoraphobia and Phobic Avoidance with Case Vignette
6.5.1. Symptoms, Signs and Diagnostic Considerations
6.5.2. Psychodynamic Factors and Conflicts
6.5.3. Treatment: Transdiagnostic Techniques and Specific Adaptations
6.5.4. Case: 8-year-old Nina
6.6. (Co-morbid) Post-Traumatic Stress Disorder with Case Vignette
6.6.1. Symptoms, Signs and Diagnostic Considerations
6.6.2. Psychodynamic Factors and Conflicts
6.6.3. Treatment: Transdiagnostic Techniques and Specific Adaptations
6.6.4. Case: 16-year-old Amber
Chapter 7: Course of Marie's treatment: opening, middle, and end phase

7.1. Evaluation, Opening Phase, and Identification of Central Dynamism
7.2. Middle phase
7.3. Termination Phase
7.4. Summary

About the author: 

Sabina Preter MD, PhD, was educated in Europe (France and Germany) and in New York City. She is an adult, child, and adolescent psychiatrist and psychoanalyst in private practice in Manhattan. She is Assistant Professor of Psychiatry at Weill Cornell Medical College, teaches and serves as Director of Child Clinical Services at the New York Psychoanalytic Institute's Treatment Center. Barbara Milrod, M.D. is a child and adolescent psychiatrist and child psychoanalyst who has done pioneering work in manualizing brief, testable forms of psychodynamic psychotherapy in anxiety and post-traumatic stress disorders. She has served as Principal Investigator on a number of randomized controlled clinical trials, and has worked on three clinical trials that demonstrated efficacy for psychodynamic psychotherapy for panic disorder. Theodore Shapiro is Professor at the Weill-Cornell Medical College and a practicing Psychoanalyst and Adult and Child and Adolescent Psychiatrist . He is a co principle; investigator on a study of psychodynamic psychotherapy for children and adolescents with anxiety disorders. He has more than 250 scholarly and research publications and is author of 7 books and edited the JAPA from 1983-94. He has received the Rado, Brill ,Hartmann and Philip Wilson awards and is a training/supervising analyst at the NYPSI.

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