Psychodynamic psychotherapy: When it helps people in recovery

You have almost never read about psychoanalysis or its less intense relative, psychodynamic psychotherapy, in these pages. It's because it doesn't work to treat active substance use disorders (SUDs). But psychodynamic psychotherapy, with all of the psychoanalytic underpinnings, can be very helpful to patients in recovery, because in fact many of these patients are self‐medicating a past trauma.     

Adolescent mourning: The sudden death of a peer

This paper examines adolescents who are mourning the traumatic death of peers. A psychodynamic model is employed in offering crisis intervention to individuals and groups of grieving adolescents within a school setting. Case vignettes highlight the psychological impact of the death of a peer on an adolescent's functioning and ego development.     

Behavior problems and attachment in adopted and non-adopted adolescents

Many studies have shown that adopted adolescents present more behavioral problems than non-adopted adolescents do. However, few studies have been published about national adoption in South America, even though this is the most common type of adoption in these countries. The goal of this study was to examine the differences in behavioral problems between nationally adopted and non-adopted adolescents (using Achenbach's Child Behavior Check-list (CBCL) and the Youth Self Report (YSR)), as well as to examine the relationship between behavioral problems and attachment style in adolescents. Participants: 25 adolescents adopted at the age of 6 months or older and 25 non-adopted adolescents. Results: No significant differences were found between groups in terms of behavioral problems. Adolescents adopted at a later age presented more “social problems” than those who were adopted earlier on. Even though the adopted adolescents presented more insecure attachment, there were no significant differences between groups in terms of behavioral problems and attachment style. There was a significant interaction between adoption and attachment on the Thought Problems scale of the YSR, with the non-adopted/insecure adolescents scoring higher. Possible interpretations of these results are presented in the discussion. In general, the adopted adolescents were not significantly different from the adolescents who grew up with their birth families. Furthermore, adoption within the first two years of life may represent a protective factor against “social problems” during adolescence. These findings may contribute to the de-stigmatization of adoption and a move away from the idea that adopted adolescents are “difficult”.     

Associations between discussions of racial and ethnic differences in internationally adoptive families and delinquent behavior among Korean adopted adolescents

Internationally adopted adolescents may have more delinquent behavior than non-adopted adolescents. One explanation is that these adolescents experience discrimination and loss of culture, and adoptive parents are not adequately addressing these experiences. However, studies have not examined the effects of family discussions of racial and ethnic differences within adoptive families on adopted adolescents' delinquent behavior. To test this relationship, this study utilized data from 111 U.S. internationally adoptive families with 185 South Korean adopted adolescents (55% female, M age = 17.75). During an observational assessment, families discussed the importance of their racial and ethnic differences, and adolescents completed a delinquent behavior questionnaire. Analysis of covariance showed differences in adolescent delinquent behavior across three ways adoptive families discussed racial and ethnic differences; adolescents whose families acknowledged differences had the fewest mean delinquent behaviors. There were no significant differences in delinquent behavior between adolescents whose families acknowledged or rejected the importance of racial and ethnic differences. However, adopted adolescents whose families held discrepant views of differences had significantly more problem behavior than adolescents whose families either acknowledged or rejected the importance of racial and ethnic differences. Clinicians, adoption professionals, and other parenting specialists should focus on building cohesive family identities about racial and ethnic differences, as discrepant views of differences are associated with the most adoptee delinquent behavior.     

Attachment to Parents and Aggressiveness in Adopted Adolescents: A Multi‐Sample Comparison Study

This study examined adopted adolescents’ levels of attachment security to parents and aggressiveness as compared to those of community nonadopted adolescents and of clinical nonadopted adolescents. Three different subsamples participated (n = 262): 101 community nonadopted adolescents (48.5% girls), 80 community adopted teens (65.0% girls), and 81 nonadopted counterparts (35.8% girls) who participated in a treatment program for youth with behavioral problems. There were no differences between community groups in attachment security or aggressiveness, whereas clinical nonadopted adolescents showed less attachment security and more aggressiveness than the other two groups. The implications of these results are discussed in terms of the potential healing impact that living with adoptive families could have on adopted teenagers’ risk of maladaptive outcomes.     

Problem Behavior and Heart Rate Reactivity in Adopted Adolescents: Longitudinal and Concurrent Relations

The present longitudinal study examined resting heart rate and heart rate variability and reactivity to a stressful gambling task in adopted adolescents with aggressive, delinquent, or internalizing behavior problems and adopted adolescents without behavior problems (total N=151). Early‐onset delinquent adolescents showed heart rate hyporeactivity to the stress‐eliciting gambling task compared to late‐onset delinquent adolescents and adolescents without behavior problems. Heart rate, heart rate variability, and reactivity to stress were not related to environmental factors such as early‐childhood parental sensitivity, parental socioeconomic status, or adoptee's health status at arrival. We conclude that the distinction between delinquency and aggression and between childhood‐onset and adolescence‐onset delinquency is important for the study of stress reactivity in adolescents.     

Adopted Adolescents' Preoccupation With Adoption: The Impact on Adoptive Family Relationships

This study examines the relationship between the intensity of adopted adolescents' thinking about their adoptions and their adoptive family relationships. Participants included 135 adopted adolescents involved in an ongoing study of openness in adoption. Adolescents who reported high levels of preoccupation with adoption reported greater alienation from their adoptive fathers than did adolescents who reported moderate or low levels of preoccupation. Adolescents with extremely high levels of preoccupation reported significantly higher levels of alienation and significantly lower levels of trust for their adoptive mothers and fathers than adolescents with extremely low levels of preoccupation. These findings, along with the divergences between adolescents' perceptions of dyadic and overall family relationships, are discussed in terms of how they relate to the process of adoptive identity exploration.     

Sense of School Membership and Associated Academic and Psychological Outcomes in Post-Institutionalized Adopted High School Students

Research highlights lasting cognitive and academic challenges in youth internationally adopted from institutional care. However, there is a lack of research examining internationally adopted students' sense of membership at school and associated academic and psychological outcomes. The current study measured sense of school membership and academic and psychological outcomes in post-institutionalized internationally adopted high school students (n = 29) compared to adolescents internationally adopted from foster care (n = 28) and non-adopted adolescents (n = 32). Post-institutionalized males had a lower sense of school membership than males adopted from foster care or non-adopted males. Group differences in school membership were mediated by academic achievement and psychological well-being.     

Prostitution of Young Persons

SUMMARY

Juvenile prostitution in the German welfare work is being interpreted as a peculiar behaviour which cannot be influenced by criminal law but by psychodynamic and social condition factors and motives. The public prostitution of adolescents largely takes place unaffected by criminal persecution. In view of the legislation in Germany, the regulations of criminal law have not had any decisive influence at juvenile prostitution. In Germany there exists a sufficient protection of children and adolescents. The current discussion about the expansion of the childhood definition of young people up to 18 years, and a de-legalization of agreed sexual actions between people under and over 18 years ignores a typical juvenile behaviour. A change in the situation of life of juvenile prostitutes by a legal intensification, as well as a change in behaviour through an anonymous sanction system like that of legislation, cannot be expected.     

Psychodynamic therapy for SUD: Counselor's view

First of all, psychodynamic psychotherapy as treatment for substance use disorder (SUD) works. Ian McLoone, lead therapist with the Alltyr Clinic in Minneapolis, knows that firsthand — he's in recovery from heroin addiction and is in it himself. And despite the fact that addiction therapists aren't taught psychodynamic theory or psychoanalytic psychotherapy in graduate school, where cognitive behavioral therapy (CBT), motivational interviewing (MI) and, to a lesser degree, 12‐Step facilitation are stressed, he became interested in it mainly because of his employer, Mark Willenbring, M.D., a psychiatrist and former medical director of the National Institute on Alcohol Abuse and Alcoholism. We talked to McLoone for this story as a follow‐up to our article on the self‐medication hypothesis of addiction, for which we interviewed its developer, Ed Khantzian, M.D. (see “Psychodynamic psychotherapy: When it helps people in recovery,” ADAW, June 22, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32756 ).     

Mental Health Knowledge Gaps in the Child Protection Work with Parents: A Narrative Review of the Social Work Literature

This is a narrative review of the latest peer-reviewed social work literature on the child protection work with parents. Aiming to identify knowledge gaps, the study researches the mental health aspects of the implicit or explicit theoretical perspectives underpinning the assessment and intervention with parents. An electronic database search extracted 38 peer-reviewed journal articles. It was found that the theoretical perspectives the publications adopted were the managerial, the critical, the humanistic, the psychodynamic and the behavioural. The study identified mental health knowledge gaps in the assessment and intervention work with parents across all theoretical perspectives and stressed the need for process and effectiveness studies on the work with parents, under explicit theoretical perspectives. The study finally highlights the need for the social work profession to increase its mental health literacy through mental health education for students and practitioners alike.     

Do Preparation for Bias and Cultural Socialization Protect Against Discrimination for Transracially Adopted Adolescents?

This study of transracially adopted adolescents and their White parents examines the role of two types of parental racial socialization, preparation for bias and cultural socialization, in protecting adoptees from the impact of discrimination. Sixty-six transracially adopted adolescent–parent dyads in the United States completed an online questionnaire. Preparation for bias, and not cultural socialization, protected transracial adoptees from discrimination-related stress, in particular when experiencing high levels of racism. The importance of parents talking to their transracially adopted adolescents about racism and how to cope with it and the value of researchers examining types of racial socialization separately as opposed to broadly are discussed.     

Social Skills in Children Adopted From Socially-Emotionally Depriving Institutions

This study assessed social skills in post-institutionalized (PI) children with respect to age at adoption, age at assessment, and gender. Parent ratings of social skills (Social Skills Rating System) and behavior problems (Child Behavior Checklist) were obtained for 214 children and 127 adolescents who were adopted from socially-emotionally depriving Russian institutions. Results showed that children adopted before 18 months of age have better social skills than those adopted after this age; those assessed in childhood demonstrate better social skills than those assessed in adolescence. PI females, especially later-adopted adolescents, have particularly poor social skills. Children with poor social skills tend to have higher rates of behavior problems.     

Psychodynamic theory within the politics of social work theory

Abstract

It is argued that social work theory has a politics in which supporters of theoretical perspectives are in discourse. The political position of psychodynamic theory has varied in each of three phases of social work theoretical development: the pre-influence, dominance and alternatives phases. In the dominance phase social work theories usually derived from psychoanalysis, psychodynamic ideas permeated basic social work practices and non-psychodynamic perspectives were influenced by it. In the alternatives phase, these influences continued, psychodynamic theory became a player in a wider discourse, was incorporated into or incorporated other perspectives and continued its dominance in specific settings. However, intensity of criticism of it, non-therapeutic approaches in much of social work, restricted training programmes, poor media of professional communication, the novelty of newer perspectives and poor transfer of new developments in psychodynamic theory have implied an insecure position for psychodynamic theory. But many of these problems are shared by alternative perspectives and its historical strength, strength in related occupations its adaptiveness and inclusiveness and the development of post-qualifying training offer continuing avenues to strengthen its political position within social work theory     

Manifestations of the therapeutic alliance in children and adolescents

Building the therapeutic alliance is a creative process and is a central issue for all age groups. In the absence of an alliance, there can be no therapy. The alliance contains many primitive sources for collaboration with the therapist. It is a combination of both rational and irrational elements. The therapist's awareness of developmental issues and defense mechanisms are utilized to guide one along the pathway of productive therapy. In addition, the unique psychodynamic factors are considered when working with children and adolescents. The clinical examples distinguish pitfalls which are destructive and could be avoided, in contrast with understanding and responding appropriately to the verbal and nonverbal communications of the young patient.This paper was presented to the International Conference for the Advancement of Private Practice of Clinical Social Work, Rio de Janeiro, Brazil, August 1987. Ms. Marcus is in private practice in New Orleans.     

Integrating Narrative Approaches into Clinical Curricula: Addressing Diversity through Understanding

Abstract

Academic programs in clinical social work often focus on either psychodynamic or systemic approaches. Narrative approaches grounded in postmodern theory also merit attention, as they are well suited for the diverse populations served by social workers. In narrative approaches, practitioners help clients to deconstruct and reconstruct their own life stories, and thereby to empower themselves. This paper compares narrative approaches with psychodynamic and systemic approaches, and suggests ways to integrate their coverage into curricula built around the dominant traditional approaches.     

Validating the Scale Measuring Dysfunctional Parenting with Hong Kong Adolescents

Dysfunctional parenting in situations requiring discipline is an important issue in Hong Kong. However, few scales for measuring dysfunctional parenting have been validated in the local context. The current study validated, with a sample of Hong Kong adolescents, a dysfunctional parenting scale that has been widely adopted in the West. A total of 965 adolescent students (males 43.3%, mean age 14.6, and range 12–18) were recruited for this study. Principal component analysis with varimax rotations and Tucker’s congruence coefficient were adopted to examine the factor structure of the scale and its stability. Cronbach’s alpha and correlation analysis were used to assess the internal consistency and the convergent and divergent validity of the scale and of each subscale identified. Three stable factors (laxness, overreactivity, and verbosity) were extracted, and their individual items demonstrated good internal consistency. The convergent and divergent validity of the scale (and subscales) were confirmed by its positive association with the material hardship of the families, the parental stress, and the antisocial behavior of the adolescents, their haughtiness and loneliness, and by its negative association with the adolescents’ social skills. Unlike previous studies that investigated parents’ rearing of young children, where verbosity was not detected as a significant factor, in adolescents, verbosity was detected as a factor affecting discipline. For adolescents in Hong Kong, verbosity is shown to be a dysfunctional parenting behavior; this is also true of Western adolescents but differs from traditional Chinese cultural beliefs.     

Cultural Identity and Acculturation Preferences Among South Asian Adolescents in Britain: An Exploratory Study

The study reported in this article is part of a wider research project on the adaptation of South Asians in Britain. It examines and compares the acculturation attitudes and cultural identity of Indian and Pakistani second‐generation adolescents Indian (Punjabi Sikh and Gujarati Hindu) and Pakistani (Muslim) in Britain. The research project integrates a social psychological approach to ethnic identity, Berry’s (Cross‐cultural Perspectives. Nebraska Symposium on Motivation, 1990) acculturation strategy and stress models, and Phinney’s (Journal of Early Adolescence, 9 , 1989:34) model of ethnic identification. There were 240 adolescents, aged 13–18 years, with an even split between the genders. Results from this study suggested that the majority of Indian youth adopted integration strategies as opposed to Pakistani Muslims who adopted a separation strategy. Cultural identity is a term used to include both ethnic and national identities. Ethnic identity scores were high for Indian and Pakistani adolescents. National identity was more important for Indian adolescents but ethnic identity was more important than national identity for all groups. Perceived discrimination was related to acculturation strategies.     

Into the Wilderness—A Case Study: The Psychodynamics of Adolescent Depression and the Need for a Holistic Intervention

Adolescent depression has become epidemic in the United States, with statistics showing that one in five adolescents may suffer from depression (Brent and Birmaher in N Engl J Med 347(9), 2002). This article examines adolescent depression from a psychodynamic perspective, and identifies the psychodynamics of adolescent depression as the affective correlates that stem from unresolved developmental conflicts, issues of separation/individuation, the search for identity and the development of the true self. This article presents wilderness therapy as a holistic intervention which can be used to address the intrapsychic, developmental and relational factors that give rise to adolescent depression. Wilderness therapy is a modality of mental health treatment that takes place outdoors and utilizes challenge and adventure, group work and other structured clinical interventions. A clinical case study presents wilderness therapy as an effective intervention for adolescent depression that can promote positive self-image and enhanced coping skills, and discusses limitations and implications for social work practice.