Cycles of Understanding and Hope: Toward an Integrative Model of Therapeutic Change in Child Psychotherapy*

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ABSTRACTThis article presents an integrative theory of pathological development in childhood and an inclusive model of therapeutic change, based on a contemporary understanding of children's emotions. In this model, effective therapies for children and adolescents, whether through empathy and understanding or through active efforts to change patterns of thought and behavior, arrest malignant emotional processes, especially vicious cycles of painful emotions and pathogenic family interactions. Our most successful interventions then set in motion positive cycles of healthy emotional and interpersonal experiences - increased confidence and engagement in life and more affirming interactions between parents and children. Over time, successful therapy strengthens in children and adolescents a more encouraging, less critical inner voice and, perhaps most profoundly, more positive expectations for their future - a new sense of what is possible in their lives.