Transference-Focused Psychotherapy for Adolescents With Severe
Personality Disorders offers clinicians a comprehensive,
compassionate presentation of this specialized psychodynamic
psychotherapy. Like the transference-focused psychotherapy model
developed for borderline personality disorder (BPD) in adults, the
version for adolescents is based on contemporary psychoanalytic
object relations theory as developed by the leading thinker in the
field, Otto Kernberg, one of the authors of this insightful manual.
The book fills an acute need: Currently, there is relatively little
research on promising treatments for adolescents with PDs, in part
because clinicians hesitate to diagnose PD in patients so young
(because of stigma and other factors), although it is evident that
a constellation of symptoms can be observed in children and
adolescents. However, these personality issues are unlikely to
resolve without interventions developed explicitly to treat
adolescents. In TFP-A, the psychotherapist provides patients with a
safe space to examine emotions, relationships, and past trauma,
with the focus on helping them gain better behavioral control;
increase affect regulation; develop more intimate and gratifying
relationships with family, peers, or close friends; and engage in a
productive life aimed at realizing current and future goals.
Noteworthy themes and features of the text include: * Emphasis on
the therapist as "third voice," acting as interpreter and mediator
between the adolescent, the parental couple, and conventional
society and its values, with the ultimate goal of fostering ego
integration sufficient to allow the adolescent to proceed under his
own agency.* Detailed coverage of the techniques of TFP-A,
including creating a holding environment, assuming an active
stance, engaging in the interpretive process, analyzing
transference and countertransference, achieving technical
neutrality, and ensuring interventions are developmentally
informed.* Practical and accessible review of TFP-A "tactics,"
including establishing the treatment frame, collaborating with
parents, and other interventions that maintain the conditions
necessary for working effectively with the adolescent and for
protecting treatment integrity.* Thoughtful review of the
attributes that make a clinician a good "fit" for
transference-focused psychotherapy. For example, therapists must
have their own lives "together," because they will have to use
countertransference reactions to identity and understand what is
projected onto them.* A rich and useful repository of assessment
scales and forms in the Appendices, as well as extended and
illustrative patient interviews. Navigating adolescence is fraught
under the best of circumstances, but patients with PDs are hampered
in their quest for individuation. Transference-Focused
Psychotherapy for Adolescents With Severe Personality Disorders
fills a critical gap in the treatment literature and is an
eminently useful guide for clinicians serving this vulnerable
population.
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