Adolescent Identity Treatment (eBook)

Pamela A. Foelsch, PhDWeill Cornell Medical College, New York-Presbyterian Hospital, Harrison, NY, USADr. Susanne Schlüter-MüllerPractice for Child- and Adolescent Psychiatry and Psychotherapy, Frankfurt, GermanyPsychiatric University Hospitals, Basel, SwitzerlandAnna E. Odom, PhDWeill Cornell Medical College, New York-Presbyterian Hospital, White Plains, NY, USAHelen T. Arena, PhDWeill Cornell Medical College, New York-Presbyterian Hospital, White Plains, NY, USAAndrés H. BorzutzkyInstituto Médico Schilkrut, Santiago, Las Condes, ChileProf. Dr. Klaus SchmeckPsychiatric University Hospitals, Basel, Switzerland

1 Introduction 2 Description of the Disorder2.1 Terminology and Definition2.1.2 Definition of Personality Disorders according to DSM--‐IV--‐TR2.1.3 Transition to DSM2.2 Epidemiology 2.3 Course and Prognosis2.4 Diagnostic Procedures and Differential Diagnosis 3 Theoretical Models and Rationale3.1 Models of the Disorder3.2 Neurobiological Vulnerability3.3 Sequence of Growth and Implications for Continued Development3.4 Theory Underlying the Individual Psychotherapy3.4.1 Object Relation Theory3.4.2 Developmental Theory3.4.3 Identity3.5 Theory Underlying the Environmental Interventions 4 Diagnosis and Treatment Indications4.1 Structure and Process of the Initial Patient Contact4.2 Diagnostic Process4.3 Diagnostic Procedures and Interviews4.3.1 Psychiatric Diagnosis4.3.2 Structural Diagnosis4.3.3 Identity Assessment4.3.4 Standard Assessment Battery Recommendations4.4 Treatment Indications and Contraindications4.4.1 Indications for Adjunctive Treatment4.4.2 Treatment Refusal4.4.3 Treatment Contraindications 5 Treatment5.1 Aims and Goals5.1.1 Specific Aim5.1.2 Planting seeds5.2 Therapist Variables, Stance, and Attitudes5.2.1 Considerations….the air within which the treatment thrives5.2.2 Therapist Characteristics and Attitudes5.2.3 Therapist Stance5.2.4 Maintaining Objectivity5.3 Preparatory Phase and Education5.3.1 Confidentiality5.3.2 Shift in Family Dynamic5.3.3 Treatment Limitations5.3.4 Role of Family in Treatment5.3.5 Psychoeducation5.3.6 Factors that may contribute to treatment interruptions5.3.7 General Parenting Strategies5.3.8 Tasks of Adolescence5.4 Contract Setting5.4.1 Contracting Phase5.4.2 Individual Contract5.4.3 Family Contract5.4.4 Threats to Treatment5.5. Strategies for the Treatment5.5.1 Session Frequency: Individual and Parent/Family5.5.2 Length of Treatment5.5.3 Direct Interventions5.5.4 Dual Treatment Focus: Acute/Focal and Long--‐Term (Structural Change)5.5.5 Patient Driven versus Model Driven5.6 Tactics5.6.1 Maintaining the Treatment Frame5.6.2 Selecting the Dominant Affect5.6.3 Regulating Affect in Sessions5.6.4 Intervention: Tactics5.6.5 Transference and Countertransference5.6.6 Modification of Transference Analysis with Adolescents5.7 Techniques5.7.1 Channels of Communication5.7.2 Clarification5.7.3 The Process of Clarification with Adolescents5.7.4 Confrontation5.7.5 InterpretationSummary of Adolescent Specific Techniques5.8 Working with the Families5.8.1 Practical issues around treatment5.8.2 Parent strategy for tolerating negative affect5.9 Direct Environmental Interventions5.9.1 Home Plan5.9.2 Additional Direct Environmental Interventions5.10 Adjunctive Psychopharmacological Treatment5.11 AIT Summary 6 Adolescent Identity Treatment (AIT) Case Illustration6.1 Initial Evaluation6.1.1 Structural Interview6.1.2 Parent/Family Assessment6.1.2.2 Collateral Sources6.2 Contracting6.2.1 Anna’s Motivation for Treatment6.2.2 Contracting Process6.3 Treatment:6.3.1 Anna’s Treatment Course6.3.2 Implementing Home Plan with Parents6.3.3 Working Through of Splitting in Self-Representation6.3.4 Individual Treatment Summary6.3.5 Parent’s Treatment Course 7Efficacy7.1 Empirical Support for Efficacy of AIT7.3 Modifications of Adult Treatment for Adolescents7.4 AIT in Adolescents7.4.1 Chart Review Study 8Training and Supervision8.1 Training