Neither child nor adult: Applying integrative therapy to adolescents.

Abstract

Psychotherapy with adolescents with emotional and behavioral disorders is complicated by the physical, cognitive, emotional, and social changes occurring during this period. Developmental shifts, including those in identity, autonomy, intimacy, and sexuality, frame adolescents' needs and motivations. The authors propose that Assimilative Psychodynamic Psychotherapy (APP; Stricker & Gold, 1996), being a flexible multitiered approach, is well suited to adolescent psychotherapy. The authors examine the application of APP to adolescents with an increased emphasis on systems variables given their greater dependence on the world around them and the importance of "goodness of fit" with the environment. The authors review the application of APP to the needs of adolescents with particular attention to systems variables and developmental issues. In addition, the authors include case examples to illustrate how APP can be integrated into individual therapy with adolescents.

Adolescents’ reflections on successful outpatient treatment and how they may inform therapeutic decision making—A holistic approach.

“…In this study, the respondents also shared struggles arising from situations that were difficult to change as young people. According to Grehan and Freeman (2009), social contexts, such as those including family and friends, involve ongoing dependency relationships in which adolescents are less autonomous than adults. Coping abilities, social support, and positive life events may be effective tools for combating the vicious cycle of self-critical vulnerability and criticism from parents, best friends, and teachers (Shahar & Henrich, 2013).…”

“…Providing helpful mental health services to clients is a significant concern for therapists. The influence of client factors on therapeutic outcomes may contribute new knowledge to research on mental health services and inform therapeutic decision-making (Grehan & Freeman, 2009; Shirk, Karver, & Brown, 2011). Client factors are powerful determinants of therapeutic outcomes, and what a client, as a person, brings to therapy explains a high percentage of the variance in outcomes at the group level (Duncan, Miller, Wampold & Hubble, 2010; Lambert, 2010).…”

Unique beings undergoing standard evaluations—A qualitative study of adolescents’ experiences of the assessment processes in psychotherapy.

“…SDT suggests turning to social contexts to understand how a suffering person’s needs for competence, autonomy, and relatedness has been thwarted (Ryan & Deci, 2000). It is important to note that social contexts such as family and school constitute an ongoing dependency relationship in which the adolescent is less autonomous than an adult, a systemic variable that needs especial attention in adolescent therapies (Grehan & Freeman, 2009). We concur with this point, and also suggest that empirical research such as this study, together with clinical research on for example therapeutic presence (Geller & Greenberg, 2012), theoretical formulations from the relational tradition in psychoanalysis (Benjamin, 2004), and research on dyadic processes in the caregiver–infant relationship (Beebe & Lachmann, 2002), contribute to clinical understanding by detailing interpersonal processes pertaining to the issues of authenticity, relational togetherness and difference, and recognition, in relationships aimed to help such suffering.…”

Integrative psychotherapy for children and adolescents: A practice-oriented literature review.

“…More recent work extending and modifying adult treatment paradigms to children and adolescents also shows much promise. For instance, Grehan and Freeman's (2009) integrative model, combines cognitive-behavioral, psychodynamic, and family systems orientations, modifying and extending to adolescents the Assimilative Psychodynamic Psychotherapy model (APP; Strieker & Gold, 1996). While retaining APP's incorporation of psychodynamic concepts (e.g., unconscious processes, motives, conflicts, anxiety, and defenses) as well as utilization of cognitive-behavioral techniques, this adolescent modification includes an increased emphasis on developmental issues and environmental factors.…”