Short-term Psychoanalytic Psychotherapy (STPP) is a manualized, time-limited model of psychoanalytic psychotherapy comprising twenty-eight weekly sessions for the adolescent patient and seven sessions for parents or carers, designed so that it can be delivered within a public mental health system, such as Child and Adolescent Mental Health Services in the UK. It has its origins in psychoanalytic theoretical principles, clinical experience, and empirical research suggesting that psychoanalytic treatment of this duration can be effective for a range of disorders, including depression, in children and young people. The manual explicitly focuses on the treatment of moderate to severe depression, both by detailing the psychoanalytic understanding of depression in young people and through careful consideration of clinical work with this group. It is the first treatment manual to describe psychoanalytic psychotherapy for adolescents with depression. The treatment approach described in this manual has been used in a multi-site randomized controlled trial in the UK, "Improving Mood with Psychoanalytic and Cognitive Therapies" (IMPACT) and internationally. It is presented here as a treatment to be used in routine clinical practice and will be of interest to child psychotherapists, multi-disciplinary professionals in young people’s mental health, service providers, and researchers alike. After describing theoretical models of depression and presenting an overview of STPP as a treatment model, the manual details the specific stages of the STPP process for the therapist and adolescent patient. It then describes the nature and scope of parallel work with parents and gives a detailed account of the function of supervision. Reviews and Endorsements: “This research-informed and comprehensive treatment manual covers not only the principles, aims, and techniques of STPP, but also theories of adolescent depression and developmental perspectives, the empirical evidence for psychoanalytic therapy, and a thorough description of the stages of treatment. This treatment is designed for young persons with clinical depression, including the severely depressed with long-standing complex relational difficulties. Reading the manual, I was struck by the tone of compassion and hopefulness also for “hopeless patients” that have lost almost all faith in the adult world. How therapists can use their own feelings as a source for better understanding their patients is masterfully described. I endorse this book with the highest level of enthusiasm.” - Per Haglend, Professor of Psychiatry, Institute of Clinical Medicine , University of Osio “This manual is extraordinary. It manages to tackle eloquently the controversy over the danger of reductionist narrowing of the art of psychoanalysis versus the free, abundant, and creative intuiting of the nuances of transference and countertransference. Thus it is more than a manual – it is an important contribution to what Schore calls the ‘science of the art’ of psychotherapy. Importantly, it begins by distinguishing depression in adolescence from that in childhood and in adulthood. The authors insist that psychoanalytic work with severely depressed adolescents must take account not only the pathology, but also of the developing an adult identity and maintaining appreciation of parental figures. We are left in no doubt of the necessity for finely detailed calibration of the differing and changing states of mind of both patient and his or her family, the skill required to carry this out, the urgency for such treatment to prevent the well-known relapses, and of course the research required to validate its effectiveness. For all the detail, it is also highly readable.” - Anne Alvarez, PhD, MACP, Consultant Child and Adolescent Psychotherapist “This book is a very welcome and timely addition to the canon of psychoanalytic practice. The structured articulation of the psychoanalytic approach, which made this approach amenable to testing in the modern state-of-the-art randomized controlled trial (RCT), is timely and necessary. This treatment manual manages to combine theory with compassionate and practical everyday NHS clinical practice. It carries the psychoanalytic tradition forwards, and I wholeheartedly commend it to trainees and experienced practitioners alike.” - Raphael Kelvin, Consultant and Associate Lecturer in Child and Adolescent Psychiatry, Cambridge University, and National Clinical Lead for MindEd Table of Contents: About The Editor and Authors Acknowledgements Series Editors’ Preface Foreword Introduction • Depression in adolescence • Treatment of adolescent depression • STPP and the IMPACT trial • The manual: STPP in practice 1) Psychoanalytic views of adolescent depression • Psychoanalytic theories of depression • Developmental considerations • Towards a psychoanalytic formulation of depression for adolescents 2) Psychoanalytic child psychotherapy: principles and evidence • Psychoanalytic psychotherapy with children and young people • The evidence for psychoanalytic psychotherapy with children and young people 3) Short-Term Psychoanalytic Psychotherapy for adolescent depression: framework and process • Principles, aims, and techniques of STPP • Case management, collaborative working, and psychiatric issues • Referral for STPP 4) The stages of treatment in Short-Term Psychoanalytic Psychotherapy • The early stages of STPP • The middle stages of STPP • The ending stages of STPP • Post-treatment contact 5) Work with parents and carers • Principles of psychoanalytic work with parents and carers • Parent work in STPP • Setting-up, reviews, communication,and routine outcome monitoring • The process of parent work in STPP • Common themes, difficulties, and variations • Working with adopted and looked-after children and their carers 6) Supervision of Short-Term Psychoanalytic Psychotherapy • Principles and aims of psychoanalytic supervision • STPP supervision: the framework and process • Dealing with risk • Problems of management in STPP supervision • Supporting therapists’ management of countertransference • Parallel process in supervision • Supervision of parent work 7) Short-Term Psychoanalytic Psychotherapy in clinical practice • Managing psychiatric difficulties and risk • Some common problems Afterword About the Association of Child Psychotherapists References Index About the Editor: Jocelyn Catty, MA (Oxon), DPhil, is a Child and Adolescent Psychotherapist working with adolescents in a Child and Adolescent Mental Health Service in South London, and an adult psychotherapist in independent practice. She is Research Lead for the doctoral training in child psychotherapy at the Tavistock Centre and co-editor of the Tavistock Clinic Series. She was previously Senior Research Fellow in Mental Health at St George’s, University of London, with a special interest in the therapeutic alliance, and has published in social psychiatry, psychotherapy, and English literature. |