Psychoanalysis and psychoanalytic psychotherapy in Dublin

Child and Adolescent Psychotherapy is that area of psychotherapy with a particular focus on those clients under the age of eighteen.

The primary difference between psychotherapy with these younger clients and psychotherapy with adults is that these younger clients are brought by others: their parents, teachers, doctors. The first one to recognise that a child or adolescent is having a problem with their emotions or behaviour is usually the parent because the child is unable to diagnose that for themselves. The decision to seek professional help can be a difficult one and usually is considered after other avenues have been considered, such as extended family, teacher, family physician, school counsellor. A consultation with the Child & Adolescent psychotherapist offers objective assessment and a treatment plan or interventions that help the child and the whole family understand and cope in a better fashion.

The child and adolescent psychotherapist specialises in the treatment of disorders of thinking, feeling and or behaviour in young clients aged between three years old and eighteen years old. Typical problems in these age groups which may benefit from psychotherapeutic intervention include: addictions (including internet and texting), anger, anxiety, attention and attachment disorders, autism spectrum disorders, bullying, conduct and mood disorders, depression, eating disorders, grief/ bereavement counselling, night terrors, obsessions and compulsions, panic attacks, phobias (including school phobia), post-traumatic stress disorder, relationship problems, self-harm, sexual confusion or acting-out, substance abuse, suicidal ideation, temper tantrums and trauma counselling.

In their training, therapists will have studied normal child and family development, psychopathology, and the treatment of typical disorders of childhood and adolescence. Early intervention prevents further complications such as social isolation, poor academic functioning, stress reactions, relationship problems, low self-esteem.

Psychotherapeutic treatment for anxiety and depression in children and adolescents are based primarily on communication but the particular treatment offered may be a combination of individual psychotherapy, family therapy, behavioural interventions and skills coaching. The therapist may use art materials as well as techniques such as play and pretend-games to communicate with the child but essentially the therapy is based on speech, even with selective mutism. It is important not to discount psychological problems at this age and parents should bear in mind that psychological problems in young people usually respond well to treatment.

The therapist will expect that the parents attend together with the child for the first consultation. The ongoing support and cooperation of the parents are essential to the overall success of the therapy. Therapy is called ʻworkʼ because it is rewarding but the process can be difficult and painful to sustain. The familyʼs commitment to the therapy encourages the childʼs engagement with the work, as does the establishment of a regular weekly time and consistent attendance.

Psychotherapy helps children and adolescents by offering objective emotional support. It assists them to resolve conflicts with people, to understand confused or overwhelming feelings and problems, and to explore or develop alternative solutions to old problems. Goals for therapy may be specific (change in behavior, improved relations with friends or family), or more general (less anxiety, better self-esteem). The length of psychotherapy depends on the complexity and severity of the problems.

Therapeutic Approaches:

The aim of therapeutic work is to promote personal change, reflected in changes in thinking, emotional functioning, and behaviour. The therapist will recommend an approach built around the specific needs of the young person, with a view to reducing personal distress; promoting recovery from mental health difficulties; improving personal functioning; and acquiring age-appropriate self-management and coping skills.

Psychodynamic Psychotherapy:

  • emphasizes understanding the issues that motivate and influence a childʼs behavior, thoughts, and feelings. It can help identify a childʼs typical behavior patterns, defenses, and responses to inner conflicts and struggles. Psychodynamic psychotherapies are based on the assumption that a childʼs behavior and feelings will improve once the inner struggles are brought to light.

Cognitive Behavior Therapy (CBT):

  • helps improve a childʼs moods and behavior by examining confused or distorted patterns of thinking. During CBT the child learns that thoughts cause feelings and moods which can influence behavior. For example, if a child is experiencing unwanted feelings or has problematic behaviors, the therapist works to identify the underlying thinking that is causing them. The therapist then helps the child replace this thinking with thoughts that result in more appropriate feelings and behaviors.

Play Therapy:

  • involves the use of toys, blocks, dolls, puppets, drawings and games to help the child recognize, identify, and verbalize feelings. The psychotherapist observes how the child uses play materials and identifies themes or patterns to understand and interpret the childʼs problems. Through a combination of talk and play the child has an opportunity to better understand and manage their conflicts, feelings, and behavior.

Family Therapy:

  • focuses on helping the family function in more positive and constructive ways by exploring patterns of communication and providing support and education, e.g. parent-coaching. Family therapy sessions can include the child or adolescent along with parents, siblings, and grandparents. Family therapy may include parent-coaching or a family conference to consider intervention with, or on behalf of, a difficult family member.