Child And Adolescent Psychiatry edited by Sandra Sexson (Blackwell's Neurology and Psychiatry Access Series: Blackwell Publishing Professional) Traditional textbooks convey knowledge. It is the goal of this text in the Blackwell's Neurology and Psychiatry Access Series to convey not only essential knowledge but also the collected wisdom of its many highly regarded contributors. To achieve the goal of conveying not only knowledge but also wisdom, each book in this series is built on a structural framework that was well received by critics and readers alike in David: Pediatric Neurology for the Clinician and the first editions of Child and Adolescent Neurology, Adult Neurology, Child and Adolescent Psychiatry, and Adult Psychiatry (Mosby). Each volume is divided into three sections:
tools for diagnosis
diseases and disorders
Also included to facilitate a physician's use of this book are:
Nosologic diagnosis tables
'Pearls and perils' boxes
'Consider consultation when...' boxes
selected annotated bibliographies
a complete bibliography
and (new in this edition): 'Key clinical questions and what they unlock.'
The Nosologic diagnosis tables are based on a discriminator model to promote clearer understanding, and are superior to a criterion-based model and others that lack similar specificity.
Whoever having undertaken to speak or write hath first laid for themselves some [basis] to their argument such as hot or cold or moist or dry or whatever else they choose, thus reducing their subject within a narrow compass.
As Hippocrates has suggested, structure is the key to learning. Unless there is a structure onto which knowledge can be built, confusion and disorganization are the inevitable consequences.
Classification systems induce orderliness in thinking and enhance our ability to communicate effectively. A review of the most enduring hierarchical classification systems, particularly that of Linnaeus (that is, phyla, genera, species), makes clear the value of grouping according to discriminating features, as well as the value of simplicity, expandability, and dynamism.
The goal, whatever the classification system, is to seek the most powerful discriminating features that will produce the greatest diagnostic clarity. Discriminating features should avoid crossing domains. Much of the confusion that arises in diagnosis may be the result of the clinician who unwittingly crosses the anatomic, pathologic, pathophysiologic, phenomenologic, and etiologic classification domains used in medicine (for example, the inclusion of anatomically oriented 'temporal lobe seizures' in a phenomenologically based classification system that includes complex partial seizures). Some conditions, such as brain tumors, are classified according to their histopathology and lend themselves well to this classification system. Others, such as headaches and movement disorders, are classified phenomenologically and are therefore much less easily classified. In other cases, discriminators must encompass inclusionary, as well as, exclusionary features. At times, we can only use a criterion-based system or construct tables to compare features.
Arbitrarily, we label as consistent features those which occur more than 75% of the time. Features are considered variable when they occur less than 75% of the time. The diagnostic tables should be viewed, therefore, only as a beginning in the extremely difficult effort to make diagnosis more precise and biologically based. How well this book accomplishes the goals of identifying the most powerful discrimination features for maximum diagnostic clarity is limited by the current state of the art in child and adolescent neurology. In some areas, several features, when clustered together, serve to discriminate.
When Drs Dean X. Parmelee and Ron David first asked me to edit the Second Edition of Child and Adolescent Psychiatry, part of the four-volume Blackwell's Neurology and Psychiatry Access Series, citing Dr Parmelee's inability to take on the challenge at the time, I felt what almost seemed like an obligation to see this well renowned, practical and truly accessible text updated for the twenty-first century. After all, my entire academic and clinical career in child and adolescent psychiatry has been devoted to the very goals that Dr Parmelee ascribes to this teaching text in the Preface to the First Edition. The text is designed to make available in an extraordinarily user-friendly format information regarding child and adolescent psychiatry for the physician and other health care providers devoted to caring for the whole child, and those dedicated to early identification and interventions for mental health problems that arise in the lives of children, adolescents and their families. It is within this context of the vision of Drs Parmelee and David that I eagerly accepted the challenge to edit the Second Edition.
For those who used the First Edition, the format of this text will be familiar. Many of the chapters bear the same titles, some the same authors, but all have been updated extensively. My section editors, Arden Dingle and Douglas Lee, and I have sought diligently to bring to this edition an integrated approach to the developmental, emotional and behavioral needs of children, adolescents, and their families that will provide the same utility and accessibility as that of the First Edition. It is directed primarily to the primary care physician, but should be useful to early career child and adolescent psychiatrists, general psychiatrists, and other child mental health providers. As before, contributors were chosen to share their significant clinically academic and practical expertise
The book is divided into three sections. Section One informs the diagnostic processes in child and adolescent psychiatry with an additional chapter that addresses the all-important aspects of treatment planning. Section Two again uses a DSMIV approach to diagnostic categories in child and adolescent psychiatry with some expansions in developmental disabilities to include mental retardation and in the schizophrenia chapter to look at a broader range of psychotic disorders. We also moved the chapters on substance abuse and aggression into this section and added a chapter that addresses mental health disorders that may present with physical symptoms, a common challenge for the primary care physician. Finally, Section Three again addresses common problems seen in everyday practice. Changes include an expansion of the suicide chapter to include other risk taking and dangerous behaviors, the addition of a chapter highlighting the physician's role in integrating the school into the care of children and adolescents, and a greatly expanded chapter on common behavioral problems. Finally, we decided to divide the child abuse chapter into one addressing attachment issues and another on responses to trauma.
Throughout the text the reader will find the tools common to this Series — diagnostic tables when appropriate, 'Key clinical questions and what they unlock' to guide the evaluation, 'Pearls and perils' to remind the reader of important aspects as well as common pitfalls, and finally 'Consider consultation when...' to assist the physician in deciding when a formal consultation to a child and adolescent psychiatrist is indicated. These consistent features throughout the text encapsulate the quick and easy access to practically relevant information.
It is my editorial goal to continue in this Second Edition the excellent tradition established by Dr Parmelee in providing a concise, clinically relevant, practical resource for those 'most involved on a daily basis with the comprehensive health needs of children and youth' (Parmelee, 1996, xi). I am grateful to Drs David and Parmelee for offering me this opportunity. And I want to thank my Section Editors, Arden Dingle and Douglas Lee, for their considerable wisdom and counsel as we have progressed along this journey together. And, finally, a very special thanks to my family — my husband, Bill, and my children, Kristen and Ryan — whose support and incredible insights always keep me well grounded in reality.
Adolescent Psychiatry: Developmental and Clinical Studies edited by Lois T. Flaherty (Adolescent Psychiatry, Vol 27: Analytic Press) Much of this volume of Adolescent Psychiatry focuses on trauma and violence. These are not new issues to psychiatrists, especially those who work with adolescents. Indeed, they are hardly new issues for the world. What is new is a growing awareness of the psychological, biological, and social impact of trauma on its victims, especially on the young. What awaits is the translation of this new knowledge into public policy, so that the effects of trauma can be mitigated and, ultimately, so that children and adolescents can be protected from harm.
The two Schonfeld Award papers in this volume deal with violence. Michael Kalogerakis has devoted much of his career to developing programs for violent youth in New York, where he served as Commissioner of Mental Health. He reviews the history of the pendulum swings in juvenile justice, revealing how far we have come from the original aims of the juvenile court. At the same time, the link between trauma and violence in adolescence is now firmly established, and there are programs that have good data for their effectiveness. My paper on terrorism attempts to show the appeal of ideologies that espouse violent revolution to young people.
Christopher Thomas et al. present a study from their groundbreaking work on youth violence in Galveston, Texas. The study links gang membership with serious violent crime, and by demonstrating the importance of the peer group, it points to ways that youth can be socialized away from gang membership.
The federal regulations on seclusion and restraint in inpatient settings that went into effect in 2001 were greeted with much apprehension. The study by Theodore Petti et al. shows that effective interventions can reduce the use of seclusion and restraint even with the most difficult state hospital adolescent populations. Most crucial to their findings is the importance of staff support.
Mani Pavuluri and colleagues present a comprehensive review of what we know about early-onset schizophrenia and bipolar disorders.
They discuss differential diagnosis and treatment strategies, with emphasis on newer pharmacological agents.
A series of papers by the Committee on Adolescence of the Group for the Advancement of Psychiatry deals with the nature, scope, and impact of trauma as well as implications of what we know for training and public policy. Freud's early discovery that histories of psychic trauma were prevalent among his patients—later put aside as he developed his theory of unconscious conflict—has been rediscovered as we have become aware of the appalling prevalence of child abuse and its lasting impact on its victims. Epidemiological studies have shown that traumatic stress is so prevalent in many societies and in subcultures of our own society that it can almost be considered a normative part of growing up. In areas as disparate as the inner cities of the United States and war-torn countries throughout the world, adolescents are traumatized by man-made violence. Natural disasters and disasters caused by human negligence take their toll everywhere.
Thanks to developments in neurobiology, we now have compelling evidence that this impact is in part mediated by measurable changes in brain function, as Patricia Lester et al. discuss in their paper on neurobiology and trauma. Cultural and gender issues are equally important in understanding the impact of trauma, as Warren Gadpaille demonstrates. These new awarenesses are being translated into clinical practice, as Monica Green's paper on intervention discusses. Finally, in this section, Max Sugar looks at the vulnerability of a particular group—late adolescents—to combat-related posttraumatic stress disorder, linking their vulnerability to developmental features of this period. His findings have particular significance for public policy, as late adolescents and young adults make up most of the frontline troops in combat.
Saul Levine dissects a multitude of self-deceptions and myths that he sees as having infected the mental health professions. Some of these involve beliefs (or purported beliefs) on the part of policymakers and funding agencies, others have been accepted uncritically by professionals themselves. All, in his view, have led to neglect of appropriate therapeutic care for adolescents.
James Gilfoil discusses the importance of families' attitudes toward psychotherapy in the outcome of therapy with teenagers. His paper includes a series of illustrations that constitute clinical pearls for the adolescent psychiatrist.
The final section consists of a resource paper on youth violence written by Charles Huffine, chair of the ASAP Topical Studies Council. This paper, which discusses the contributions of societal attitudes about youth to the perpetuation of violence and lack of appropriate interventions, was adopted as an official American Society for Adolescent Psychiatry (ASAP) position paper.
Adolescence and Emerging Adulthood: A Cultural Approach, Revised (2nd
Edition) by Jeffrey Jensen Arnett (Pearson Prentice
Hall) Adolescence is a fascinating time of life, and for many students taking a
course in adolescent psychology, it is the time of life they have just completed
or are now passing through. Learning about development during this period is in
part for them a journey of self-discovery. Students who are beyond this period
often enjoy reflecting back on who they were then, and they come away with a new
understanding of their past and present selves. Jeffrey Arnett wrote
Adolescence and Emerging Adulthood to assist instructors and students
make connections of understanding on this dynamic and complex age period.
Arnett presents a fresh conception of adolescence, reflecting the most promising and exciting new currents in the field. There are four essential conceptual features guiding the book, and all of these features distinguish this text from others on adolescence:
(1) The Cultural Approach. In teaching courses on adolescence,
Arnett brings a considerable amount of research from other cultures. As a
postdoctoral student at the Committee on Human Development at the
Students learn not only that adolescent development can be
different depending on the culture, but how to think culturally—that is, how to
analyze all aspects of adolescent development for their cultural basis. This
includes learning how to critique research for the extent to which takes the
cultural basis of development into account.
Adulthood. Not only is adolescence an inherently fascinating period of
life, but we are currently in an especially interesting historical moment with
respect to this period. It is a distinguishing feature of adolescence in our
time in that it begins far earlier than it did a century ago. Yet, if we measure
the end of adolescence in terms of taking on adult roles such as marriage,
parenthood, and stable full-time work, adolescence also ends much later than it
has in the past, because these transitions are now postponed for many people
into at least the mid-twenties. Arnett’s research over the past few years has
focused on development among young Americans from their late teens through their
mid-twenties – including Asian Americans, African Americans, Latinos, and Whites
– has led to an understanding that this period is not really adolescence, but it
is not really adulthood either, even “young adulthood.” The transition to
adulthood has become so prolonged that by now it constitutes a separate period
of the life course in industrialized societies.
(3) The Historical
Context. Given the differences between adolescence now and adolescence in
the past, knowledge of the historical context of development is crucial to a
complete understanding of adolescent development. Students will have a richer
understanding of adolescent development if they are able to contrast the lives
of young people in the present with the lives of young people in other times.
Each chapter contains a Historical Focus box that describes some aspect of young
people’s development during a specific historical period—for example,
adolescents’ family lives during the Great Depression, the “Roaring Twenties”
and the rise of youth culture, and work among British adolescents in the 19th
century. Globalization is also brought into this section, and Arnett has made it
of the unifying themes of the book.
Interdisciplinary Approach. The cultural approach and the emphasis on
historical context are related to a distinguishing feature of the conception
offered in this book—the interdisciplinary approach to theories and research.
Psychology and education are of course represented abundantly, because these are
the disciplines in which most research on adolescent development takes place.
However, Arnett also integrates materials from a wide range of other fields:
anthropology, sociology, history, psychiatry, medicine, and family studies.
The integration of materials across disciplines means
drawing on a variety of research methods. The reader will find many different
research methods represented here, from questionnaires and interviews to
ethnographic research to biological measurements. Each chapter contains a
Research Focus box, in which the methods used in a specific study are described
Chapter Topics. Arnett’s goal of presenting a fresh conception of young people’s development has resulted in chapters on topics not as strongly represented in most other textbooks. Most textbooks have a discussion of moral development, but Adolescence and Emerging Adulthood has a chapter on cultural beliefs, including moral development, religious beliefs, political beliefs, and a discussion of individualistic and collectivistic beliefs in various cultures. Most texts include a discussion of gender issues at various points, and some include a separate chapter on gender, but in this one there is a chapter on gender that focuses on cultural variations and historical changes in gender roles, in addition to discussions of gender issues in other chapters.
Adolescence and Emerging Adulthood also has an entire chapter on work,
which is central to the lives of adolescents in developing countries because a
high proportion of them are not in school. In industrialized societies, the
transition from school to work is an important part of emerging adulthood for
most people, and that transition receives special attention in this chapter. An
entire chapter on media is included, with sections on computer games and the
Internet. Finally, this text closes with a chapter on adolescence and emerging
adulthood in the 2lst century, in which the futures awaiting voting people
around the world are considered.
Supplements to the text, prepared by Sandra Jarvis and
Helen Novak of the Department of Education,
Arnett also edited a book of readings, Readings on Adolescence aid Emerging Adulthood to parallel the chapters in the text so that the two books complement one another. These readings are from a variety of cultures, on emerging adulthood as well as adolescence, and drawn from a variety of disciplines, and they will be helpful in using the text to teach upper level undergraduate courses.
This Second Edition of Adolescence and Emerging Adulthood includes new material that will enhance students’ understanding of cultural similarities and differences and how the development of adolescents and emerging adults is influenced by the culture they live in. Chapters have been revised to include the most up-to-date theory and research related to emerging adulthood. Arnett succeeds in making the book not only highly informative but also lively and fun to read. His fresh conception of adolescence provides students a broad perspective from which to view their lives.
The Social Psychology of Adolescence by Patrick C. L. Heaven (Palgrave) How does the family influence adolescent behavior? Why do some young people become delinquents? What role do peers play in shaping the way adolescents act? These and many other questions are answered in this book. The Social Psychology of Adolescence introduces and reviews major themes in adolescent development, including such topics as sexuality and the risk of HIV/AIDS, school life, teenagers in the work place, mental health issues, and others. It is an up-to-date review of the latest scientific evidence of the factors that help shape adolescent behaviors. It deliberately reviews studies from as wide a range of different cultures as possible.
Author summary: It has been well established that personality factors are implicated in the psychological well‑being of teenagers. Thus, it is possible to make predictions about an adolescent's level of suicide ideation or the likelihood of their participation in delinquent and criminal activities based, in part, on their particular personality traits.
The study of personality traits is now well advanced and there seems to be general agreement among many personality theorists as to their structure and, with respect to some traits, their origin. Trait theorists appear unanimous in suggesting that traits are important in predicting a wide range of social behaviours. But, just what are personality traits? McCrae and Costa have suggested the following: 1. Traits are not merely summaries of behaviour. In fact, they are able to predict and do account for one's thoughts, feelings and actions. 2. Personality traits are not explained by such factors as cultural norms or learned responses. Indeed, the pattern of personality traits appears to be reliably present across cultures and may even have a genetic basis, as evidenced in twin studies. 3. We can use personality traits to predict unseen or unobservable behaviours. 4. Some personality traits have an identifiable and discernible biological basis. 5. Traits can interact with the environment so as to produce unique adaptations to effect attitudes, relationships, and so on. 6. These unique adaptations interact with the situation and have an indirect effect on behaviours.
`How do young people acquire their personality traits?' and `Can I teach my child acceptable traits?', are reasonable questions to ask. It now seems to be generally accepted that the heritability rates of some of the basic personality traits are quite high. In other words, researchers have concluded that the basic personality traits such as extraversion have a substantial genetic basis to them, while other traits like psychoticism may be linked to hormonal influences. Note that traits are not totally due to genetic and hormonal influences, but the effect does appear to be significant. Thus, for example, it has been estimated that the heritabilitics for extraversion range between 0.60 and 0.70. Interestingly, the heritability estimates of aggressive behaviours in young people tend to be higher (0.60) than that of delinquent behaviours (0.35).
Considerable scientific research has been conducted into the biological bases of personality. Space does not allow a detailed discussion of this body of work, suffice to say that the evidence is quite compelling. For example, Eysenck has argued that a distinguishing feature of introversion-extraversion can be found in the functioning of the ascending reticular activating system, a structure in the brain that determines cortical arousal. Typically, extraverts are under‑aroused such that they tend to be stimulus-hungry. Thus, they seek out `arousal jags' and tend to score higher on measures of sensation‑seeking. Because introverts are over‑aroused, they are stimulus‑shy. One consequence of this difference is that extraverted teenagers are more likely to study successfully while distracted (for example, while having the television on), than are introverts who are much more easily distracted.
Personality has also been shown to have hormonal and psychophysiological bases. For example, both extraversion and Eysenckian psychoticism (both predicted to be related to high delinquency levels in adolescents), are said to have links with gonadal hormones (testosterone) and dopamine. It therefore seems to be highly likely that anti‑social and delinquent teenage behaviours, while no doubt influenced by family and socioeconomic circumstances, may also be due to biological factors beyond one's control. This would have important implications for policy development, which would have to shift from a strongly economic perspective (for instance, alleviating poverty) to how best to manage innate behaviour.
In conclusion, there can be no question that the role of personality factors in shaping adolescent behaviours is important. As our review has made clear, it is not the only influence. This brings us to the role of the family.
As has already been made clear, the family is an important socialising influence on young people. There can be no doubt that the psychological well‑being of young people is, in part, determined by the quality of family communication, parental personalities, parental styles, family cohesion and friction, and parental discipline styles. Each of these factors has been shown to be related to a wide range of behavioural outcomes including, for example, delinquency, whether a young teenage mother decides to keep her baby or not, whether a young person is likely to complete school and attend university, and so forth. It is clear that the family sets the `tone' for how teenagers will interact with others and how they will accommodate and deal with their many varied experiences. The individual's first experience of others occurs within the family home. This suggests that one's family experiences have a crucial impact on the behaviours, perceptions, and expectations of the child, an experience that the child carries into adolescence.
Earlier sections of this book discussed the evidence that shows strong links between parental psychopathology and the behaviours of their teenage children. Of considerable interest and importance is the fact that there is a common genetic influence that accounts for many parent-children linkages. In a noteworthy study, Pike and colleagues showed that there is a sizeable and common genetic thread that predicts levels of negativity in mothers and depression in their children. In addition, these genetic threads have been traced and found to be influential in the lives of children who have been adopted out. Thus, Ge and colleagues noted that it is possible to predict the behaviour of adoptees as well as of adoptive parents based on the behaviour of biological parents. For instance, adoptive parents' behaviours toward their adopted children was a function of whether the children's biological parents had a psychiatric disorder or not (Ge et al., 1996).
In summary, the influence of the family is not simply limited to environmental influences. Indeed, the impact of the family appears to be far‑reaching and complete. The evidence suggests that there are also strong cross‑generational genetic threads that help shape adolescent well‑being.
The influence of family life and personality traits on adolescent behaviours is complex indeed and much has yet to be learned about the intricate ways that these factors co‑determine behaviour. Much research needs to be done to understand how personality factors interact with unique environmental and common genetic influences in determining adolescent adjustment. It is doubtful that the last word has been written on this topic. One way to better understand these issues would be to use longitudinal research designs incorporating twins and other siblings.
In conclusion, there are many different factors that have an impact on adolescent behaviours, but two pervading and consistent ones appear to be individual differences and family life, factors that permeate nearly every aspect of adolescent life. Notwithstanding the importance of these two broad factors, one must not lose sight of the fact that others such as one's cultural background and specific life experiences will also be implicated in determining adolescent well‑being.
Beyond Appearance: A New Look at Adolescent Girls by Norine G. Johnson, Michael C. Roberts, Judith Worell (American Psychological Association) presents a balanced view of adolescent girls, emphasizing their strengths and weaknesses. Reviews research on girls from a variety of ethnic, racial, socioeconomic backgrounds, and ages. Explores gender roles, body image, family and peer relationships, sexual decision-making, and experiences at school and in the community. For researchers and practitioners.
Beyond Appearance is an important survey of research and treatment strategies about adolescent girls. It helps orient clinicians to current research, providing realistic descriptions and useful theoretical models from which to design interventions and therapy. Highly recommended.
Manual of Adolescent Substance Abuse Treatment by Todd Wilk, M.D. Estroff (American Psychiatric Publishing) Manual provides a mix of scientific findings, literature review, clinical wisdom, and case material. Practical text for students, program managers, practitioners, evaluators, and policy makers. Comprising 17 chapters by psychiatrists, program directors, and researchers, this handbook provides an overview of adolescent substance abuse and treatment. Drawing from research, theory, and actual practice, it discusses topics like epidemiology, predisposing factors, diagnosis, co-morbidity, evaluation, treatment planning, medication, spirituality, family treatment, relapse, adolescent development, and untreatable patients. The book offers guidance for practitioners, program managers, evaluators, and policy makers.
Candor, Connection, and Enterprise in Adolescent Therapy by Janet Sasson Edgette (W.W. Norton) Strategies for working with the reluctant adolescent client. Helping reluctant adolescent clients and their overwhelmed family members is made easier by this book which describes a different way of relating and talking to young people who are uncomfortable accepting the guidance they want, or who have found therapy in the past to be meaningless, patronizing, or just plain boring.
Therapists trying too hard to appeal to their uncooperative adolescent clients risk losing cases before they are even underway. These kids are quick to pick up on the therapist who struggles to be helpful, be liked, make conversation, and not upset. So worried is the therapist about saying the "wrong" thing, he or she may wind up saying too little that is useful. The client withdraws into silence, becomes sarcastic, or makes fun to show disinterest, or even contempt, and the therapist finds him‑ or herself getting frustrated and blaming the adolescent for the treatment's failure, attributing the problem to "resistance."
Candor, Connection, and Enterprise in Adolescent Therapy explores a unique new approach to relating to adolescents in therapy. Focusing on establishing relationships between therapists and adolescents that are genuine and unaffected, and on bringing about conversation that is candid, forthright, and emotionally moving, this book offers therapists techniques for engaging and connecting with their teenaged clients to help them and their family members find dignified, face‑saving ways out of their problems. Case examples and stories from the author's own practice illustrate how therapists can successfully navigate difficult therapeutic encounters and avert the power struggles and "going nowhere" dialogues that stall treatment and bore their young clients.Thorough and lucidly written, this much needed guide gives therapists invaluable tips on how to become partners with their adolescent clients, how to draw them out into comfortable conversation, and how to read their body language and expressions to convey understanding and respect during treatment. All therapists, whether seasoned in adolescent therapy or just starting out, will find vital methods for improving their practices and making the transition from adult to adolescent therapy a smooth one.
Learning Disorders & Disorders of the Self in Children & Adolescents by Joseph Palombo (W.W. Norton) Demonstrates the impact of learning disorders on the development of the self and discusses the treatment process. When a child has a learning disorder, it affects not only school success, but also relationships and sense of self. Addressing the concerns of psychotherapists working with children and adolescents, this book explores five main disorders and how each impacts the self, including dyslexia, ADD, executive dysfunction disorder, nonverbal learning disability, and Asperger's disorder.
Author’s Summary: This book addresses the concerns of two audiences: psychotherapists who treat children and adolescents with learning disorders and professionals, such as clinical psychologists, neuropsychologists, school psychologists, and learning disabilities specialists, who are involved in the assessment or remediation of children's learning disorders.
The major thesis is that neuropsychological deficits or weaknesses play a critical role in the development of the sense of self and in the creation of a self narrative. Psychopathology, in the form of a disorder of the self, may arise as a result of the presence of a learning disorder. Three areas are opened for exploration from the child's subjective perspective:
• How do these children experience their learning disorder and how does that experience affect their interactions with others?
• What factors contribute to the development of disorders of the self in some children but not in others?
• How does the knowledge of the presence of a learning disorder affect the treatment process?
The book is not intended as a manual on how to treat patients with learning disorders. As I emphasize in the chapters that follow, the treatment methods used with these patients in many ways are no different from those used with any other type of patient. What is different is the therapist's perspective as to the origins and nature of the patient's difficulties. Situating the origins of those difficulties within the context in which the patient developed helps therapists appreciate the contributions of both endowment and the environment. This perspective not only highlights what the patient, as a child, brings to the interaction with caregivers but also underscores the reasons for caregivers' responses to the patient.
I hope educators concerned with the training of professionals involved with this population will also take an interest in this work. Few programs that train psychotherapists include courses on this topic. This gap has serious consequences for the welfare of our patients. By the same token, few programs that prepare specialists who deal with this population emphasize sufficiently the contribution made by learning disorders to the child's subjective responses and nonacademic problems. Students alerted early in their training to the impact of neuropsychological deficits on development win be in a better position to assist those whom they are charged to help.The book is divided into three sections. Following the introductory chapter that sets the theoretical and historical setting of the problems, Section I details the conceptual framework I use. Psychoanalytic self psychology, as proposed by Heinz Kohut, provides a perspective that starts with self‑experience. By focusing on the child's sense of self, the empathic/ introspective perspective provides an approach to understanding the child's subjective experience as it is filtered through his or her particular neuropsychological deficits. The child's self‑narrative supplements this subjective view by addressing the meanings the child assigns to those experiences. The juxtaposition of the two perspectives provides insights into the patient's world and provides clues as to why some children develop a disorder of the self while others do not. Because of the special problems that this population presents, the section includes a chapter on adolescence. Section II deals with the five specific disorders I have chosen as exemplars of the range of actual learning disorders. These are dyslexia, attention‑deficit/hyperactivity disorder, executive function disorder, nonverbal learning disability, and Asperger's disorder. Compared to other learning disorders, more is known about the disorders highlighted here and they are more likely to be encountered by clinicians. I have excluded disorders such as autism and mental retardation, as well as disorders that have their origins in acquired brain changes, such as those resulting from strokes, closed head injuries, or brain lesions. All of these require special treatment. Section III provides a framework for applying the information in Sections I and II to the therapeutic process.
Empowering Adolescent Girls: Examining the Present and Building Skills for the Future with the "Go Girls" Program by Craig Winston Lecroy and Janice Daley (W.W. Norton) contains a wealth of practical information on how to help real girls with a plethora of specific strategies for working with major behavior and self-image issues of adolescence. The curriculum lays out exactly how to conduct group meetings A method to help adolescent girls in today's culture successfully navigate the transition to adulthood. Mary Pipher's Reviving Ophelia awakened us to the need for gender-specific programs tailored to the unique issues girls face. In this book, LeCroy and Daley outline the issues, review the research, and offer specific strategies for working with adolescent girls. One copy of the The Go Grrrls Workbook is included with the text (and is also available separately). At adolescence, says Mary Pipher, "girls become 'female impersonators' who fit their whole selves into small, crowded spaces." Many lose spark, interest, and even IQ points as a "girl-poisoning" society forces a choice between being shunned for staying true to oneself and struggling to stay within a narrow definition of female. Pipher's alarming tales of a generation swamped by pain may be partly informed by her role as a therapist who sees troubled children and teens, but her sketch of a tougher, more menacing world for girls often hits the mark. She offers some prescriptions for changing society and helping girls resist. Empowering Adolescent Girls even has evaluation tools and a companion parent curriculum to use. It's like getting three books in one. The workbook is a perfect tool to use with girls. It incorporates fun and informative activities in an interactive format that I know my clients will love. I'll be using this as a reference for years to come, and expect to order several more workbooks for clients to use. The Go Grrrls Workbook by Craig Winston Lecroy and Janice Daley (W.W. Norton) A workbook to accompany the book Empowering Adolescent Girls, a method to help adolescent girls in today's culture successfully navigate the transition to adulthood.
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