The Three Phases of CAPP

2018 ◽  
Author(s):  
Sabina E. Preter ◽  
Theodore Shapiro ◽  
Barbara Milrod
Keyword(s):  
Psychodynamic Psychotherapy ◽  
Separation Anxiety ◽  
Reflective Functioning ◽  
Anxiety Symptoms ◽  
Sexual Fantasies ◽  
Middle Phase ◽  
Adolescent Anxiety ◽  
Clinical Vignettes ◽  
Termination Phase ◽  
Opening Phase

Chapter 4 describes how to perform child and adolescent anxiety psychodynamic psychotherapy (CAPP) and includes clinical vignettes. Each phase is followed by a delineation of Tom’s treatment. The opening phase describes how the therapist’s listening and assessment of the material lead to a provisional psychodynamic formulation, which is verbalized to the youth. Typical dynamisms are separation anxiety; difficulties tolerating angry, aggressive, and ambivalent feelings; conflicted sexual fantasies; guilt; and ambivalence regarding independence. During the middle phase, therapist and patient collaboratively understand the central psychological conflicts identified and make adjustments to this formulation as needed. The goal is a deepening understanding of the meaning of the anxiety symptoms, with improvement in reflective functioning. The termination phase serves to review the recent changes and to revisit earlier symptoms, particularly if there is a rearousal of symptoms in which separation conflicts are experienced with the therapist. Adaptive and sensible autonomy-seeking is encouraged.

Time-Limited Psychodynamic Psychotherapy

2018 ◽  
Author(s):  
Sabina E. Preter ◽  
Theodore Shapiro ◽  
Barbara Milrod
Keyword(s):  
Selective Attention ◽  
Psychodynamic Psychotherapy ◽  
Reflective Functioning ◽  
Mental States ◽  
Anxiety Symptoms ◽  
The Unconscious ◽  
Adolescent Anxiety ◽  
Psychotherapeutic Technique ◽  
Important Mediator ◽  
Age Related

Child and adolescent anxiety psychodynamic psychotherapy (CAPP) follows psychoanalytic principles by addressing the unconscious meaning of the child’s symptoms, while employing a time-limited, twice-weekly frame, which affects technique. In Chapter 2, the authors illustrate how the therapist establishes a collaborative and empathic relationship with the child, identifies a central psychological dynamism early, and consistently refocuses on the presenting anxiety symptoms and the jointly identified psychological dynamisms. The authors describe variations in psychotherapeutic technique necessitated by the age-related capacities of the young patient. Important psychodynamic principles, such as transference, are described. Reflective functioning, which is the capacity to be reflective about one’s own mind and to envision mental states in others, is explained. Selective attention is paid to symptom-specific reflective functioning, which refers to the capacity to reflect on the specific anxiety symptoms and their meanings as an important mediator of change.

The Anxiety Disorders

2018 ◽  
Author(s):  
Sabina E. Preter ◽  
Theodore Shapiro ◽  
Barbara Milrod
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Psychodynamic Psychotherapy ◽  
Stress Disorder ◽  
Separation Anxiety ◽  
Treatment Strategies ◽  
Separation Anxiety Disorder ◽  
Adolescent Anxiety ◽  
Clinical Vignettes ◽  
Treatment Considerations

Chapter 6 consists of six subsections, describing the anxiety disorders treated with child and adolescent anxiety psychodynamic psychotherapy (CAPP). These include generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, panic disorder, agoraphobia and phobic avoidance, and (comorbid) posttraumatic stress disorder. Each section is organized as follows: the authors describe the phenomenology and diagnostic criteria, followed by the salient psychodynamic factors and conflicts. Each section concludes with treatment considerations, addressing transdiagnostic techniques, which apply to all anxiety disorders, and diagnosis-specific adaptations. Clinical vignettes are given for each anxiety disorder. A detailed table summarizes psychodynamic theory, target symptoms, and treatment strategies, followed by specific clinical approaches, rounding out variations of core fantasies and changes in techniques expected for each variant of the anxiety disorders.

Child and Adolescent Anxiety Psychodynamic Psychotherapy

2018 ◽  
Author(s):  
Sabina E. Preter ◽  
Theodore Shapiro ◽  
Barbara Milrod
Keyword(s):  
Parent Involvement ◽  
Psychodynamic Psychotherapy ◽  
Child Psychotherapy ◽  
Reflective Functioning ◽  
Child And Adolescent ◽  
Anxiety Symptoms ◽  
Historical Background ◽  
Maladaptive Behaviors ◽  
Adolescent Anxiety ◽  
Psychodynamic Treatment

Child and adolescent anxiety psychodynamic psychotherapy (CAPP) is a new, manualized, tested, 24-session psychotherapy articulating psychodynamic treatment for youths with anxiety disorders. The book describes how clinicians intervene by collaboratively identifying the meanings of anxiety symptoms and maladaptive behaviors and communicating the emotional meanings of these symptoms to the child. The treatment is conducted from a developmental perspective, and the book contains clinical examples of how to approach youth of varying ages. The authors demonstrate that CAPP can help children and adolescents: • Reduce anxiety symptoms by developing an understanding of the emotional meanings of symptoms • Enhance the skill of reflection and self-observation of one’s own and others’ feelings and motivations (improvement in symptom-specific reflective functioning) • Diminish use of avoidance, dependence, and rigidity by recognizing how underlying emotions (e.g., guilt, shame, anger), as well as conflicted wishes can be tolerated and understood • Understand fantasies and personal emotional significance surrounding the anxiety symptoms to reduce symptoms’ magical, compelling qualities and impact on the child The manual provides a description of psychodynamic treatment principles and techniques and offers a guide to the opening, middle, and termination phases of this psychotherapy. The book contains chapters on the historical background of child psychodynamic psychotherapy, on developmental aspects of child psychotherapy, and on the nature of parent involvement in the treatment. This manual is intended to be used by clinicians from diverse therapy backgrounds, and it will appeal to the student reader as well as to the experienced clinician.

Mothers’ and fathers’ internalizing symptoms influence parental ratings of adolescent anxiety symptoms.

2017 ◽  
Vol 31 (7) ◽  
pp. 939-944 ◽  
Author(s):  
Krister W. Fjermestad ◽  
Wendy Nilsen ◽  
Tina D. Johannessen ◽  
Evalill B. Karevold
Keyword(s):  
Internalizing Symptoms ◽  
Anxiety Symptoms ◽  
Mothers And Fathers ◽  
Adolescent Anxiety ◽  
Parental Ratings

scholarly journals Working memory moderates the association between early institutional care and separation anxiety symptoms in late childhood and adolescence

2019 ◽  
Vol 31 (3) ◽  
pp. 989-997 ◽  
Author(s):  
Laura Alicia Alba ◽  
Jessica Flannery ◽  
Mor Shapiro ◽  
Nim Tottenham
Keyword(s):  
Working Memory ◽  
Emotion Dysregulation ◽  
Separation Anxiety ◽  
Institutional Care ◽  
Anxiety Symptoms ◽  
Late Childhood ◽  
Childhood And Adolescence ◽  
Significant Heterogeneity ◽  
Morning Cortisol ◽  
Cortisol Levels

AbstractAdverse caregiving, for example, previous institutionalization (PI), is often associated with emotion dysregulation that increases anxiety risk. However, the concept of developmental multifinality predicts heterogeneity in anxiety outcomes. Despite this well-known heterogeneity, more work is needed to identify sources of this heterogeneity and how these sources interact with environmental risk to influence mental health. Here, working memory (WM) was examined during late childhood/adolescence as an intra-individual factor to mitigate the risk for separation anxiety, which is particularly susceptible to caregiving adversities. A modified “object-in-place” task was administered to 110 youths (10–17 years old), with or without a history of PI. The PI youths had elevated separation anxiety scores, which were anticorrelated with morning cortisol levels, yet there were no group differences in WM. PI youths showed significant heterogeneity in separation anxiety symptoms and morning cortisol levels, and WM moderated the link between caregiving and separation anxiety and mediated the association between separation anxiety and morning cortisol in PI youth. Findings suggest that (a) institutional care exerts divergent developmental consequences on separation anxiety versus WM, (b) WM interacts with adversity-related emotion dysregulation, and (c) WM may be a therapeutic target for separation anxiety following early caregiving adversity.

A Developmental Approach to Children’s Communications

2018 ◽  
Author(s):  
Sabina E. Preter ◽  
Theodore Shapiro ◽  
Barbara Milrod
Keyword(s):  
Language Development ◽  
Developmental Stage ◽  
Psychodynamic Psychotherapy ◽  
Child And Adolescent ◽  
Story Telling ◽  
Developmental Approach ◽  
Adolescent Anxiety ◽  
School Aged Children ◽  
Communicative Abilities ◽  
Theoretical Overview

Chapter 3 addresses the implications of age and developmental stage of the youth on the therapist’s behavior and how the therapist conducts treatment. The authors provide a theoretical overview across development as it relates to child and adolescent anxiety psychodynamic psychotherapy (CAPP) (Piaget, Bowlby, Erikson, Mahler, Winnicott, among others), and the authors explain how making therapeutic contact is adjusted to the stage related competence for understanding. Particular attention is paid to language, development of communicative abilities in general, and the capacity to treat nonverbal play as well as verbal story telling symbolically, by providing a framework built on the most prominent developmental theorists and researchers (Vygostky, Bowlby, Stern, Fonagy, Nelson, among others). The capacity for empathy and reflection across the developmental span is explored. Examples of encounters with children of all ages, school-aged children, preteens, and teenagers are offered and prefaced by comments about their respective developmental uniqueness and how this affects communication between child and therapist.

Integrating Positive Psychology and Elements of Music Therapy to Alleviate Adolescent Anxiety

2018 ◽  
Vol 29 (6) ◽  
pp. 663-676 ◽  
Author(s):  
Sylvia Y. C. L. Kwok
Keyword(s):  
Positive Psychology ◽  
Music Therapy ◽  
Emotional Competence ◽  
Controlled Trial ◽  
Well Being ◽  
Anxiety Symptoms ◽  
Subjective Happiness ◽  
Adolescent Anxiety ◽  
The Relationship ◽  
Significant Mediator

Purpose: Incorporating the resource-oriented music therapy framework, the present study aims to examine the effectiveness of a designed protocol, integrating positive psychology, and elements of music therapy, in increasing the sense of hope and enhancing emotional competence, hence decreasing anxiety and increasing subjective happiness of the adolescents with anxiety symptoms. Method: Adopting a two-arm randomized controlled trial, 106 Grade 8 to Grade 9 students were recruited from three secondary schools in Hong Kong and randomized into experimental groups and no-treatment control groups. Results: Students in the experimental groups had significant increases in scores of hope, emotional competence, subjective happiness, and significant decrease in anxiety symptoms. Changes in hope were a significant mediator in the relationship between the intervention and decrease in anxiety symptoms and increase in subjective happiness. Discussion: The study provides evidence that integrating positive psychology and music therapy is effective in alleviating psychopathology and enhancing well-being of adolescents.

scholarly journals Co-reminiscing with a caregiver about a devastating tornado: Association with adolescent anxiety symptoms.

2020 ◽  
Vol 34 (7) ◽  
pp. 846-856
Author(s):  
Madelaine R. Abel ◽  
Eric M. Vernberg ◽  
John E. Lochman ◽  
Kristina L. McDonald ◽  
Matthew A. Jarrett ◽  
...  
Keyword(s):  
Anxiety Symptoms ◽  
Adolescent Anxiety
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