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-Child Work 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.
"This book is by far the most comprehensive and useful child therapy text. Amazingly well-written, it is both supremely helpful for new clinical graduate students and an outstanding, sophisticated review for clinicians and researchers. The second edition of this book is even more useful than the original text! The first edition filled a key gap by providing a broad array of useful and evidence based information to new child clinicians learning to conduct therapy with kids and teens. Because of its currency and clinical sophistication, it is also suited to busy practitioners who are looking for practical ways to integrate new, clinically relevant evidence and ideas. The writing engages the reader with a crisp style and clear real-world examples showing a deep understanding of evidenced based work with youth. The revised edition adds new material on mindfulness-based cognitive-behavioral therapies and motivational interviewing, and it weaves recent neuroscience research into discussions of clinical topics. To a unique degree, this book articulates the thought process of an experienced therapist as he or she integrates outcome research and clinical considerations to plan treatment strategy and decide what to do and say in work with clients. We use this textbook in our didactic practicum with new clinical graduate students at the University of North Carolina, and each fall, the students and I enjoy reading the combination of a broad perspective, specific techniques and logistical implementation ideas, as well as up to date references. Child and Adolescent Therapy: Science and Art is a helpful and detailed yet fun read for new and seasoned clinicians!" Jen Kogos Youngstrom, PhD, Professor of Clinical Psychology, Director of Child and Family Services and Assessment Clinic The University of North Carolina at Chapel Hill "This book combines clear, insightful explanations of the major theoretical orientations, rigorous summaries of outcome research, and the clinical wisdom of an experienced therapist in a unique synthesis that shows readers how to plan treatment and decide what to say when with clients. 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. I highly recommend this text to mental health professionals working with young people and to graduate students beginning their work in child and adolescent therapy." Sandra W. Russ, Distinguished University Professor Case Western Reserve University "As a researcher, clinician, and instructor in a school psychology graduate program, I appreciate books that offer breadth of content but also sufficient depth in evidence-based practices in order to best prepare future youth mental health professionals. After switching from other texts that were either overly broad and historical or too narrow, I adopted the first edition of this book as the required text for my introductory course in counseling and psychotherapeutic interventions. My graduate students and I have given this book the highest praise. We appreciate the clear, insightful explanations of theory and research and the detailed, vivid instructions for implementation that make the process of therapy come alive. Unlike edited books with chapters by different authors, this text presents psychotherapy as an integrated whole. The chapters cross-reference each other frequently to identify connections and contrasts among the major theories and to show how elements of different approaches can be woven together in customized therapy for each client. My students are particularly thankful for the numerous vignettes and example scripts that illustrate best practices and provide detailed demonstrations of effective therapy." Shannon Suldo, Professor, University of South Florida "This book is essential for courses covering child and family therapy. It is comprehensive, well-written, engaging, well-organized, and informative. When I used the first edition, my students told me they looked forward to reading each week's assignment and that this is the book they return to again and again throughout their career as a resource for the most up-to-date information on interventions for various disorders. The author not only provides background information about the theory and evidence base behind interventions but also practical illustrations for how to implement interventions effectively and stylistic suggestions that demonstrate the art of conducting therapy. This book is a wonderful addition to any therapist's library, whether a therapist in training or an experienced therapist who wants to stay current." Amy Przeworski, Ph.D. Assistant Professor Case Western Reserve University
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