Psychotherapy in children and adolescents
Clinical psychotherapy for children and adolescence exists at the intersection of social, psychological, medical and pedagogical directions. The basis of a variety of methods and techniques of therapeutic intervention is developmentally oriented approach.
The conceptual foundations of children’s and adolescent psychotherapy is the fact that the physical appearance of the child, unlike an adult, is changed qualitatively in a short time, and the faster, the younger the age. Return to previous, mobilesmania state of mind can not serve as the optimal goal in working with the child in the process of rapid growth and development. It is therefore important that mental state by the end of psychotherapy characterized by the patient before the disease, and was in keeping with the level of development of the psyche, which would be created by this time, while maintaining the favorable external and internal conditions of ripening. Based ontogenetically oriented approach is evolutionary biology the concept of mental illness, and in particular the doctrine of mental dysontogenesis G. E. Sukharev, G. K. Ushakov, V. V. Kovalev. Learner-centered psychotherapy psychodynamic, humanistic, behavioural trends in children and adolescence corresponds ontogenetically adapted version of it, called Y. S. Shevchenko et al. ontogenetically oriented (reconstructive-conductive) psychotherapy”. In accordance with the concept of developmentally oriented psychotherapy developed practical methods of group family treatment and corrective works, integrating various techniques of Gestalt therapy, behavioral approaches, suggestions and autosuggestion, games and collective psychotherapy, psychogenetic, play therapy and other clinical and psychological areas.
Unlike adults, the decision to start psychotherapy in children adopted parents. In addition, no other is necessary for psychotherapy in adults components: the consciousness of the illness, voluntary decision and will to recovery. Often the symptom is the child carries the “message to adults” or is a means of dealing with them, and thus with its help the child recaptures its place. The need to consider and to adjust the family situation, social environment (kindergarten, school) child makes a child psychotherapist to some extent always systemic (family or group) psychotherapy.
The suggestion is present in all types of psychotherapy. It can be in reality. And then it is divided into direct and indirect. In young children mechanism is used imprinting (imprinting), which consists in uttering short phrases during the game without interruption to induce estimated effects and imprinting. The suggestion may even be a shock. Direct suggestion during sleep can be used not only by the therapist but also the parents. The optimal phase for direct suggestion during sleep phase REM sleep, as in deep sleep suggestion not perceived, and in the phase of dreams suggestion may come in unpredictable combination with the content of dreams. Parents can use this kind of suggestion after training therapist, including taped. Direct suggestion effectively with neurotic reactions, neuroses, psychosomatic and behavioral symptoms. With indirect suggestion intermediaries are used: parents, games, toys, custodial and therapeutic moments and procedures, medicines. In the parent indirect message is used peripheral hearing. Parents in the conversation between them, in the field of hearing distance of the child, use suggestive formulas positive value (“I know that she will be able to”) or say something informing or convincing (the story of what someone already did). The indirect message is associated and the placebo effect from the appointment of indifferent substances with information about its positive effect. Parental placebo effect is particularly important when working with young children who cannot give direct installation. The most effective suggestion is made in a state of hypnosis.
Hypnosis, especially his soft, “non-prescriptive options, widely used in pediatric practice. Children are susceptible to hypnosis easier than adults. Currently it is believed that hypnosis is possible from the time when “the child may listen to the tale”. Widely used special type of hypnosis – Ericksonian hypnosis, which consists in a special non-prescriptive technique hypnotization using the language of images. Hypnocatrice proposed in the late nineteenth century that uses the ability of hypnosis to cause Anisimovna traumatic experiences.
Hypnosis in children can be used to treat phobias, enuresis, encopresis, mutism, stuttering, thumb-sucking, hair pulling, obgrizannie nails, ticks. He finds the use of hypnosis in the treatment of psychosomatic and somatoform disorders in children and adolescents, as eczema, asthma, uncomplicated form of diabetes, vomiting, psychogenic pain and the pain of physical origin, emotional breakdowns, conversion reactions. A hypnotic trance can have a striking effect on the pain. Especially it is often used in patients with burns, cancer, surgery of the dentist and before the first gynecological examination in girls. Hypnosis can help reduce the severity of post-traumatic stress disorders, eliminate difficulty in falling asleep, night fears and nightmares.
Self-hypnosis, using many of the techniques are addressed primarily to the resources of the psyche, not the problem. It is possible in children 7-8 years of age, psychomotor enough stable and motivated for treatment. Autogenic training offered j.Schultz, the most effective in functional and psychosomatic disorders. In expanded form is applicable not earlier than adolescence, although its elements a child can be trained much earlier.
Play therapy builds on the basic functions of the children’s game. It is widely used in, children in the treatment of a large range of mental disorders, behavioral disturbances and social adaptation, especially in the neuroses in children. Play therapy allows by means of symbolization and mechanism of fantasy “wish fulfillment” to respond and resolve intrapersonal conflicts. Being played in the game, the traumatic obey the “master of game”. Thus, the child subjugates a situation where in reality he feels powerless. In addition, during the game the child learns to reach of separating yourself from your mother or the person, its replacing. This is especially important for children with emotional disorders. In addition, during the game the child learns the necessary social skills to make contact, to part, to share toys, etc.). He learns welcome to try on adult roles, adapting to the environment of people, it decreases the fear of death. Play therapy is used in children and adolescents in individual, family and group forms. Can be performed as an outpatient or in the hospital, in the school work of a psychologist.