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Block 1 Unit 4 Methods of Child Psychotherapy

1) Define the term ‘mentalise’?

Mentalisation is the capacity to understand that one’s own behaviour and that of others is motivated by internal states, such as thoughts and feelings. It also includes the understanding that one's perceptions of others are representations rather than the way reality actually is. In child development, mentalising is accomplished when the "equivalent modus" and the "pretend modus" can be integrated. The "equivalent modus" is when there are insufficient affect representations, and the "pretend modus" is when a child is capable of using symbolic representations.

2) What are the principles of Dyadic Developmental Psychotherapy?

The basic principles of Dyadic Developmental Psychotherapy are:

• Safety
• Self-regulation
• Self-reflective information processing
• Traumatic experiences integration
• Relational engagement
• Positive affect enhancement This therapy involves creating a "playful, accepting, curious, and empathic" environment where the therapist attunes to the child’s "subjective experiences" and reflects this back to the child.

3) What are the aims of play therapy?

The aims of play therapy include:

• To decrease behavioural and emotional difficulties that interfere significantly with a child’s normal functioning.
• To improve communication and understanding between the child and his parents.
• To improve verbal expression.
• To increase the ability for self-observation.
• To improve impulse control.
• To develop more adaptive ways of coping with anxiety and frustration.
• To improve the capacity to trust and to relate to others. In play therapy, the therapist uses an understanding of cognitive development and the different stages of emotional development, as well as the conflicts common to these stages, when treating the child. The therapist uses the child's fantasies and the symbolic meanings of play as a medium for understanding and communication with the child.

4) What is the aim of Child-Directed Interaction phase of PCIT?

The aim of the Child-Directed Interaction phase of PCIT (Parent Child Interaction Therapy) is to develop a loving and nurturing bond between the parent and child through a form of play therapy. During this phase, parents are taught a list of "Dos" and "Don'ts" to use while interacting with their child during a daily play period called Special Play Time.

5) Discuss DIR model. What is the goal of Developmental, Individual-Difference, Relationship-Based model?

The Developmental, Individual-Difference, Relationship-Based model (DIR) serves as a framework to understand the developmental profile of an infant or child and their family. It enables caregivers, educators, and clinicians to plan an assessment and intervention program tailored to the child’s and family’s profile. The DIR model is not an intervention itself, but rather a method of analysis and understanding that helps to organise the many intervention components into a comprehensive program. 

The goal of the model is to support the child's development of capacities related to:

• attention,
• engagement,
• purposeful emotional signalling and gesturing,
• preverbal and verbal problem-solving and
• imaginative interactions,
• thinking.

6) Discuss the psychoanalytical intervention methods for children?

Psychoanalytical intervention methods for children include:

• Parent-Infant Psychotherapy: This approach addresses problems with normal relationships between parent and child. In this therapy, the parent expresses their thoughts and feelings which are based on their own childhood experiences and their expectations for the child's future.
• Mentaliseren Bevorderende Kinder Therapie (MBKT): This therapy addresses problems with an infant’s ability to distinguish reality and fantasy. It aims to direct and focus the attention of the child to their inner world and to explore diffuse affects within the therapeutic relationship so that the child can recognise and form mental representations of their feelings.

7) Discuss in detail the different attachment based interventions?

Attachment-based interventions are aimed at infants or children who have developed or are at risk of developing less desirable, insecure attachment styles or an attachment disorder. The different attachment based interventions include:

• Dyadic Developmental Psychotherapy: This therapy is used for the treatment of attachment disorder, Complex Post Traumatic Stress Disorder, and reactive attachment disorder. It aims to help parents understand their child’s attachment disorder: how the child feels and thinks, and the child’s internal psychological dynamics. It also teaches parents about attachment facilitating parenting methods and the importance of attunement and responsive, sensitive parenting.
• 'Circle of Security': This is a parent education and psychotherapy intervention designed to shift problematic or 'at risk' patterns of attachment-caregiving interactions to a more appropriate developmental pathway.
• Attachment and Biobehavioural Catch-Up (ABC): This is an intervention programme aimed at infants who have experienced early adverse care and disruptions in care. It aims to provide specialised help for foster carers in recognition of the fact that a young child placed in foster care has to deal with the loss of attachment figures.

8) Write about play therapy?

Play therapy is a method of psychotherapy with children where a therapist uses a child’s fantasies and the symbolic meanings of play as a medium for understanding and communication with the child. The aim of play therapy is to decrease those behavioural and emotional difficulties that interfere significantly with a child’s normal functioning. It is also used with children who have experienced sexual or physical abuse, neglect, and the loss of a family. In play therapy, the therapist begins to recognise themes and patterns or ways of using the materials that are important to the child and helps the child make meaning out of the play.

9) Describe the process of parent child interaction therapy?

Parent Child Interaction Therapy (PCIT) is a therapy that combines behavioural therapy, play therapy and parent training to teach more effective discipline techniques and improve the parent-child relationship. PCIT is divided into two stages:

• Child Directed Interaction: This phase aims to develop a loving and nurturing bond between the parent and child through a form of play therapy.
• Parent Directed Interaction: This phase focuses on establishing a structured and predictable home environment. Here, parents learn to give clear commands and follow through with specific consequences for both compliance and non-compliance.