Mentalizing in Child Therapy: Guidelines for Clinical Practitioners PDF
Preview Mentalizing in Child Therapy: Guidelines for Clinical Practitioners
MENTALIZINC IN CHILD THERAPY Guidelines for Clinical Practitioners Edited by Annelies J. E. Verheugt-P leiter, lolien Zevalkink, & Marcel C. ). Schmeets Foreword by Peter Fonagy KARNAC First published in 2008 by Kamac Books 118 Finchley Road London NW3 5HT Copyright O 2008 by Annelies J. E. Verheugt-Pleiter, Jolien Zevalkink, & Marcel G. J. Schmeets The rights of the editors and contributors to be identified as the authors of this work have been asserted in accordance with 77 and 78 of the Copyright Design and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, eledronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Dutch edition: Mentaliseren in de kinderthempie, copyright O 2005, Koninklijke Van Gomm BV, Assen, The Netherlands. British Library Cataloguing in Publication Data A C.1.P for this book is available from the British Library ISBN: 978-1-85575-581-9 Edited, designed, and produced by Communication Crafts Printed in Great Britain www.k arnacbooks.com MENTALIZINC IN CHILD THERAPY Developments in Psychoanalysis Series Peter Fonagy, Mary Target, & Liz Allison (Series Editors) Published and distributed by Karnac Books Other title in the Series Developmental Science and Psychoanalysis: Integration and Innovation. Celebrating the Renewal of the Collaboration of theYale Child Study Center and the Anna Freud Centre in Promoting Psychoanalytic Developmental Research Edited by Linda Mayes, Peter Fonagy, & Mary Target Orden Tel: +44 (0)20 7431 1075; Fax: +44 (0)20 7435 9076 Email: [email protected] www. kamacbooks.com CONTENTS xi ACKNOWLEDGEMENTS xiii SERIES FOREWORD xvi i ABOUT THE EDITORS AND CONTRIBUTORS FOREWORD Peter Fonagy xxi CHAPTER ONE lntroduction Marcel C./. Schmeets, Annelies 1. E. Verheugt-Pleiter,l olien Zevalkink 1 CHAPTER TWO Theoretical concepts Marcel C.1 . Schmeets Introduction Developmental tasks of the infant Cergely and Watson's social biofeedback theory of parental affect mirroring: the representation loop vi CONTENTS Limitations in the capacity to mentalize Actual mode, pretend mode, and integrative mode Manifestations of the inability to mentalize In conclusion CHAPTER THREE Assessment of mentalizing problems in children lolien Zevalkink Target population Theoreticala nd psychiatric description of the target population Indicator criteria for mentalization-based child therapy Standardized diagnostics ln troduction Attachment representation Personality dynamics Cognitive function Questionnaires for anxiety and depression Behaviouralproblems according to parents and teacher In conclusion CHAPTER FOUR Treatment strategy Annelies 1. E. Verheugt-Pleiter Introduction Backgrounds Framework of the treatment Working with the adults in the child's life The representational mismatch Setting of child therapy The therapist as development object Working "in" the transference Principles behind the technique of mentalization-basedc hild therapy Workingi n the here and now of the relationship Recognizing the child's level of mental functioning and meeting at the same level Giving reality value to inner experiences Playing with reality The process is more important than the technique Ending the treatment Notes CONTENTS vi i CHAPTER FIVE Helping parents to promote mentalization Marja J. Rexwinkel and Annelies I. E. Verheugt-Pleiter Introduction General aspects of guidance for parents Helping parents to promote rnentalization The parent guidance framework Mentalizing techniques Giving reality value to the inner experience of the parents with their child Learning to observe and read the child's inner world Working in the here and now Repairing misattunement Parent guidance: one, two, or more parents Collaboration with other therapists In conclusion CHAPTER SIX Observation method Jolien Zevalkink Identifying intervention techniques: a brief history Working method for the observation of interventions in mentalization-basedc hild therapy Introduction Selection of suitable cases Agreements prior to data collection Reactions of children to the observer and the video recorder Systematic collection of the observations Discussing interventions in peer review meetings In conclusion Note CHAPTER SEVEN Intervention techniques: attention regulation Annelies 1. E. Verheugt-Pleiter Introduction What is attention regulation? Accepting the child's regulation profile and attuning to the same level viii CONTENTS Attention to the content of the child's play or activity/ introducing structure in play or story Naming/describing physical states Naming/describing behaviour aimed at the naming of mental content (cognitions and feelings) Naming/describing anxiety and feeling threatened Naming/describing a state of animosity Working on the ability to make contact Maintaining contact and introducing continuity in contact Creating a sak environment Naming/describhg explicit interactions Working on the basis for intentional behaviour Joining into the child's activities visually and/or in gestures Giving reality value to preverbal interactions by taking the child's own style seriously Directing attention at describing behaviour Focusing on the child's qualities In conclusion CHAPTER EIGHT Intervention techniques: affect regulation Annelies 1. E. Verheugt-Pleiter Introduction Playing within boundaries Introduction of fantasy to facilitate the pretend mode Focus on separating fantasy and reality Setting boundaries loining in the pretend mode Giving reality value to affect states Giving reality value to an affect state of a play figure Giving reality value to an affect state of a child Deducing second-order affect representations Guiding and differentiating affect Looking for your own share in enactments In conclusion CHAPTER NINE Intervention techniques: mentalization Annelies 1. E. Verheugt-Pleiter Introduction CONTENTS ix Comments on mental contents Making comments on mental content in pretend mode Discussing thoughts and feelings with respect to attachment figures Comments on mental content of the child Additions ofpositive content Comments on mental processes of the child Making comments on mental processes of the child such as remembering, asking, wanting, fantasizing, and making connections Verbalization of wish and/or intention in the pretend mode Verbalization of wish and/or intention of the child Verbalization of thoughts about the mental life of others/objects Stressing the individual character of the child's mental world Comments on interactive mental processes In conclusion CHAPTER TEN Treatment in practice Introduction The setting The frequency The therapy room, the toys Playing The first therapy session The initial stages The therapeutic relationship Midway Transference, development object, and countertransference Setting boundaries Interruptions Shifting the level of interventions The final stages Criteria for termination CHAPTER ELEVEN Research strategy lolien Zevalkink Research in child and adolescent psychotherapy Step I: Theory and research on the nature of the clinical disorder
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