Opening moves and sequential strategies in child psychotherapy.

Abstract

This model of sequential psychotherapy seems to indicate a reasonable and rational approach for planning opening moves and later strategies during therapy with many different types of children. After the initial diagnostic evaluation there is a period of contractual negotiation, followed by a second stage of behavioural, interactional and affectual rehearsal, which leads into a final stage of exploration into more involved intrapsychic, environmental and intrafamilial issues. Although the complexities of the case will often suggest very complicated psychodynamic possibilities, the initial strategies are often couched in rather simple behavioural terms, and even though they become more complex as therapy progresses they still maintain their inner consistency. As the child achieves greater skills he internalizes increasing self-esteem, and is therefore able to attack the more buried, and sometimes very frightening historical instinctual and other material which then emerges in therapy. Even when such material emerges, behaviourally-based approaches often provide the best inroads into these complex interactional and intrapsychic problems.