“Why Won't My Parents Help Me?”: Therapeutic Assessment of a Child and Her Family

Abstract

We present a case study of a child's psychological assessment using the methods of Therapeutic Assessment (TA). The case illustrates how TA can help assessors understand the process and structure of a family by highlighting how maladaptive family processes and interactions impact a child's development. It also illustrates how TA with a child can serve as a family intervention. In this case, it became apparent that the child's social difficulties were significant, not minor as initially reported by the parents, and were rooted in an insecure attachment, underlying depression, an idiosyncratic view of the world, and longing for attention, all of which were hidden or expressed in grandiose, expansive, and off-putting behaviors. In addition, the familial hierarchy was inverted; the parents felt ineffective and the child felt too powerful, leading to enhanced anxiety for the child. Intervention throughout, punctuated by the family session and feedback sessions, allowed the parents to develop a new "story" about their child and for the child to experience a new sense of safety. Following the TA, the parents and child indicated high satisfaction, enhanced family functioning, and decreased child symptomatology. Subsequent family therapy sessions allowed the family to further implement the interventions introduced in the TA.

Training Assessors in Therapeutic Assessment

“…One aspect that differentiates TA from traditional assessment with children is that parents are encouraged to observe the standardized testing sessions to help the parents or caregivers better understand the child's functioning (Finn, 2007;Hamilton et al, 2009;Tharinger, Finn, Wilkinson, & Schaber 2007). This can occur by the assessor, child, and clinicians working with the parent or caregiver (the mother in our case) being in the same room.…”

An Updated Statement for the Clinical Case Applications Section: Suggestions for Clinical and Empirical Case Reports

“…This can be seen in the now numerous articles covering various aspects of CTA, with a number of excellent clinical case examples (e.g., Austin, Krumholz, & Tharinger, in press; Finn, 2003, 2011a; Guerrero, Lipkind, & Rosenberg, 2010; Hamilton et al, 2009; Haydel, Mercer, & Rosenblatt, 2010; Peters, Handler, White, & Winkel, 2008; Smith & Handler, 2009), quasi-experimental case studies (e.g., Aschieri & Smith, 2012; Smith & George, 2012; Smith, Nicholas, Handler, & Nash, 2011; Smith et al, 2009), and papers describing and illustrating CTA techniques with rich case material (e.g., Tharinger et al, 2012; Tharinger et al, 2008). We certainly encourage continued submission of manuscripts about CTA, but we also hope that prospective authors do not conclude that submissions to the CCA must be about this topic.…”

Therapeutic Assessment with Children in Family Therapy

“…With appropriate modifications, the TA model has been applied to and researched with different types of clients, such as adults, couples (Aschieri, 2013), and families with children and adolescents (Finn, Fischer & Handler, 2012). This paper draws on this work and Tharinger et al (2009) and Hamilton et al Filippo Aschieri, Francesca Fantini and Paolo Bertrando (2009) to describe and illustrate therapeutic assessment for families with children (TA-C).…”

“…The TA-C Approach TA-C involves a series of steps developed to best meet the need of parents to find meaningful and transformative answers to questions and puzzles about their child's problems. The assessor engages the parents as co-evaluators and co-observers of their child and co-constructs with them new understandings of the presenting problems (Tharinger et al, 2009). The new narrative that results from this collaborative process represents the basis for long-lasting ways of interacting within the family (Byng-Hall, 1995).…”