Abstract
The current paper is a theoretical proposal that interfaces the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and its emphasis on interpersonal consequences with the structured order of a Play Therapy Model for troubled 3 - 8-year-old children. This proposal is not a research paper or a review of literature; instead, it is a treatment proposal that is novel and untested. CBASP psychotherapy, an empirically validated treatment, was developed originally to treat the persistently depressed adult. CBASP’s major focus of interpersonal consequation will be interfaced with a Play Therapy structured model to rectify the maladaptive preoperational functioning of five interpersonal types of problem-children. The types are classified interpersonally using D.J. Kiesler’s Interpersonal Message Inventory (IMI). Kiesler’s IMI is employed in this proposal as an ongoing assessment modality, a source of information to make treatment strategy consequation decisions, and thirdly as an evaluative outcome variable. The troubled child types described herein frequently become candidates for early-onset Persistent Depressive Disorder (PDD) unless rescued by successful treatment. The origins of early-onset PDD arise in dysfunctional households where toxic interpersonal relationships predominate: where “survival from abuse,” not growth, describes the child’s modal developmental experiences. These children are often exposed to either serious traumas (e.g., sexual abuse, loss of a parent, physical abuse, physical or emotional neglect) or psychological insults (e.g., continuous, and chronic verbal and nonverbal abuse). The result, in the most serious cases, is a maturational stunting at the preoperational stage of development which, as noted above, if not successfully resolved, thrusts the child into early-onset PDD.
Highlights
Healthy, nurturing relationships within the family unit are the most effective means to prevent mental disorders and decrease suicidal rates
If the diagnosis of early-onset chronic depression (PDD) is made for a child applying for Play Therapy treatment, a diagnostic determination of the present disorder is required; that is, is the individual currently reporting a Depression (MD) or Dysthymia (DD)- or an Major Depression (MD)-level disorder?
The structural process of Cognitive Behavioral Analysis System of Psychotherapy (CBASP)-Play Therapy consists of two stages: 1) Stage One occurs in sessions 1 - 3 and consists of two parts: a) creating a safe dyadic relationship with heavy weighting placed on the therapist’s reactions to the patient (CBASP therapist’s Goal 1 is to communicate: “I will not hurt you.”); and b) assessing the patient’s interpersonal style and constructing a remedial interpersonal strategy to resolve the stylistic problems [i.e. determining through play if the child is controlling-dominant, hostile-sarcastic, generally distant, fearful-withdrawn, or passive-compliant]; 2) In Stage Two the therapist administers a remedial interpersonal strategy to resolve the stylistic problems and shapes in more appropriate interpersonal behaviors
Summary
Healthy, nurturing relationships within the family unit are the most effective means to prevent mental disorders and decrease suicidal rates. A child comes into the world seeking someone “looking for them” and, in finding that person, becomes aware that they are loved [3] Such caregivers are attuned to the child’s needs and initiate the developmental-rhythmic dance of secure attachment. Daniel Siegel writes, “If you had a difficult childhood but have come to make sense of those experiences, you are not bound to re-create the same negative interactions with your own children Without such self-understanding, research has shown that history will likely repeat itself, as negative patterns of family interactions are passed down through the generations.” [4]. Many parents have experienced neglect and a lack of nurture during their own critical, developmental years As a result, their attachments to their own children will be insecure and their “road map” for raising children will necessarily repeat earlier toxic experiences.
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