Psychodynamic With

ChildrenMichelle Wendel, Michielle Garcia &

Yesenia Castillo

ObjectivesIncreases self-understandingIncreases acceptance of feelings and wishesReplacement of (unconscious) defense mechanisms with (conscious) coping strategiesDevelopment of realistically complex and positive schemas for relationships between self and others (Shapiro, Friedberg & Bardenstein, 2006, p. 117).

Overview Psychodynamic emphasizes early attachments with caregivers due to its influence on present personality and behavior“The word dynamic, in ‘psychodynamic,’ refers to interactions between different aspects of the mind” (Shapiro, Friedberg & Bardenstein, 2006, p. 102).“In dynamic theory, feelings and impulses are viewed as morally neutral; they are either good nor bad” (Shapiro, Friedberg & Bardenstein, 2006, p. 129).

OverviewIt “provides education, ego

support, and therapist activity in experiencing

interventions, establishing a common space for

language and emotional communication, and/or

provides acute empathy” (Bromfield, 1989, p. 447).

Overview• “A client’s wishes, fears, and

object relations are manifested in their experience and behavior during sessions” (Shapiro, Friedberg & Bardenstein, 2006, p. 133).

• Common defense mechanisms:• Denial, repression,

devaluation, displacement, projection, reaction formation and splitting

OverviewThe goal of psychodynamic with children is to “develop a framework in which the child can become more psychologically minded” (Rosegrant, 2012, p. 377-379).The structure of the mind contains the id, the superego, and the ego

Id: concerned with what we want and desireSupergo: concerned with what is right Ego: concerned with what will work

OverviewDuring play with children,

“their unconscious material is brought into

consciousness so that the child’s ego is able to resolve unconscious

psychic conflicts” (Seligman & Reichenberg,

2012, p. 46)

OverviewThe psychodynamic therapist’s duty is to interpret the symbolism in play

A therapeutic alliance promotes the child’s sense of security, “which allows unacceptable, psychically dangerous feelings to emerge and to be addressed in more productive ways” (Schaefer, 2011, p. 53).

Strengths“Children’s symptoms tend to improve in the course of dynamic therapy” (Shapiro, Friedberg & Bardenstein, 2006, p. 121).

Its focus on motivational conflicts helps children with their competing desires, ambivalence and confusion about what he/she wants (Shapiro, Friedberg & Bardenstein, 2006).

Psychodynamic provides space for unstructured play, emotion-dominated thinking and magical fantasies that encompass much of life for young children (Shapiro, Friedberg & Bardenstein, 2006).

LimitationsThe unstructured play provides an “accepting environment, but not necessarily a “warm” interaction in that their task is to understand, not to gratify, the client’s needs” (Shapiro, Friedberg & Bardenstein, 2006, p. 123)Trainees find psychodynamic psychotherapy as a “daunting task” due to the dichotomy of the patient to be ‘protected and feared” (Cohen & Hatcher, 2008).“An exclusively interpretative approach does not facilitate a therapeutic alliance”

Ex: Dennis complained to his mother that his therapist continued to ask the same ‘boring’ questions about his feelings every session (Goodman, 2013, p. 438-455).

Target PopulationsChildren with high-functioning autism

Psychodynamic allows the child to create a unique therapeutic world, which assisted in addressing social skills, cognitive development, and self-care (Bromfield,1989, p. 452)

Children diagnosed with Encopresis

“Over time, Maverick became skillful at deactivating unpleasant feeling states through these symptoms” (Goodman, 2013)

Target PopulationsTraumatized children

Psychodynamic helps reduce traumatic symptoms plus an improvement in relationships (Foa, 2009, p. 588)

Children ages 3 to 12 with anxiety, depression, PTSD, internalizing disorders, externalizing disorders, developmental character difficulties, maladaptive, internal responses to life events, and sleep disorders

ReferencesBromfield, R. (1989). Psychodynamic play therapy with a high-functioning autistic child. Psychoanalytic Psychology, 6(4), 439-453. Cohen, Z., Hatcher, S. (2008). The experiences of trainee psychiatrists learning a psychodynamic psychotherapy model: a grounded theory. Australasian Psychiatry, 16(6), 438-441. Foa, E. (2009). Psychodynamic therapy for child trauma. Effective Treatments for PTSD, 586-588. Goodman, G. (2013). Encopresis happens: Theoretical and treatment considerations from an attachment perspective. Psychoanalytic Psychology, 30(3), 438-455.Medicus, J. (2012). Practice parameter for psychodynamic psychotherapy with children. Journal American Academy Child Adolescent Psychiatry, 51(5), 541-547.

ReferencesMedicus, J. (2012). Practice parameter for psychodynamic psychotherapy with children. Journal American Academy Child Adolescent Psychiatry, 51(5),

541-547.

Rosegrant, J. (2012). Review of 'Starting treatment with children and adolescents'. Psychoanalytic Psychology, 29(3), 377-379. 

Schaefer, C. (2011). Foundations of play therapy. (2nd ed.). Hoboken, New Jersey: John Wiley & Sons.

Seligman, L and Reichenberg, L. (2012). Selecting effective treatments. (4th ed.). Hoboken, New Jersey: John Wiley & Sons.

Shapiro, J. P., Friedberg, R. D., & Bardenstein, K. K. (2006). Child and adolescent therapy. (pp. v-605). Hoboken, New Jersey: John Wiley & Sons.

Professional Videohttp://www.youtube.com/watch?v=S1qSvv3bzIk