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The Psychological Assessment of Abused and Traumatized Children (Paperback)
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The Psychological Assessment of Abused and Traumatized Children (Paperback)
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The past decade has seen more and more clinicians involved in the
assessment and treatment of abused and traumatized children. They
have contributed to an impressively large body of literature on the
impact of abuse and trauma at all ages, the focus of which has been
the short and long-term sequelae apparent in the child's behavior,
emotional experience, and social interaction. But there have been
few efforts to investigate the ways in which abuse and trauma
damage the intrapsychic systems and structures that often guide,
direct, and inform the child's manifest adjustment and functioning.
The need to redress the balance was the major impetus for this
book. Kelly offers a clinical paradigm for the personality
assessment of abused or traumatized children via projective
instruments--the TAT and Rorschach--and shows how various
projective measures and indices can be utilized as sensitive
barometers of changes in self, object, and ego functioning
following therapeutic interventions and other corrective
experiences. But further, integrating the tenets of trauma theory
and those of psychoanalytic theory, he sets this clinical paradigm
in a meaningful theoretical context, and draws on both theory and
clinical experience to develop a comprehensive psychological
composite of the child who has been maltreated. Part I provides an
overview of theoretical models relevant to the assessment and
diagnosis of the maltreated child. Contemporary psychoanalytic
theory serves as one frame and is discussed first, with particular
emphasis on object relations and ego functions. Equal attention is
devoted to developmental psychology as another frame. Part II
reviews relevant research. The Mutality of Autonomy Scale (MOA) and
the Social Cognition and Object Relations Scale (SCORS) are
introduced as examples of reliable and valid instruments readily
employed to assess the impact of abuse or trauma on a child's
object relations functioning. Additional Rorschach
indices--boundary disturbance measures, thought disorder indices,
trauma markers, and defensive functions measures--are discussed as
measures of the impact on different facets of ego functioning.
These various projective measures can be utilized as sensitive
barometers of changes in self, object, and ego functioning
following therapeutic interventions and other corrective
experiences. Part III includes a variety of extended clinical
illustrations. Seven cases of boys and girls subjected to varying
degrees of abuse and trauma are presented to demonstrate the
clinical utility of projective material for assessment, diagnosis,
and treatment planning. For the clinician who takes the
idiographical-phenomenological approach, appropriate given the
uniqueness of each situation of abuse or trauma and the frequent
brevity and barrenness of the protocol, such material can open a
window onto a rich vista of the child's psychological terrain. The
resulting map can point the way to wise decisions about type,
timing, and level of therapeutic intervention, the resolution of
such process issues as transference and countertransference, plus
additional questions. Two cases of adult women who were abused as
children and find themselves continuing to struggle with enduring
unresolved issues vis a vis their own children are also presented.
These cases underscore the value of TAT and Rorschach material, and
object relations measures, in assessing and understanding the
abusive and potentially abusive parent.
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