“Attachment Disorder behavior in early and middle childhood: associations with children’s self-concept and observed signs of negative internal working models.” By Peter Zimmermann and Alexandra Iwanski; published 2019 in Attachment & Human Development.

• ABSTRACT: Most research on attachment in childhood is based on observation. In contrast, research on reactive attachment disorder (RAD) is mainly based on caregiver reports. Moreover, little is known about self-concept or internal working models (IWMs) of self and others in children with RAD. The present study examined whether caregiver reports and the frequency of observed signs of RAD reveal differences between children at risk for developing RAD symptoms and healthy controls in middle childhood. In addition, children’s self-concept, observable signs of negative IWMs, and mental health were assessed. Results revealed that the RAD risk group showed increased reported and observed signs of RAD, a more negative self-concept, and more signs of negative IWMs compared to healthy controls. Signs of RAD in middle childhood were expressed trans-relational to both caregivers and strangers. Moreover, RAD symptoms were associated with negative self-concept, observed signs of negative IWMs, and poor mental health.

Back to Normal: Why Ordinary Childhood Behavior Is Mistaken for ADHD, Bipolar Disorder, and Autism Spectrum Disorder. By Enrico Gnaulati; published 2014 by Beacon Press.

• OVERVIEW: In recent years there has been an alarming rise in the number of American children and youth assigned a mental health diagnosis. Current data from the Centers for Disease Control reveal a 41 percent increase in rates of ADHD diagnoses over the past decade and a forty-fold spike in bipolar disorder diagnoses. Similarly, diagnoses of autism spectrum disorder, once considered, has increased by 78 percent since 2002. Dr. Enrico Gnaulati, a clinical psychologist specializing in childhood and adolescent therapy and assessment, has witnessed firsthand the push to diagnose these disorders in youngsters. Drawing both on his own clinical experience and on cutting-edge research, with Back to Normal he has written the definitive account of why our kids are being dramatically overdiagnosed—and how parents and professionals can distinguish between true psychiatric disorders and normal childhood reactions to stressful life situations.

“Mentalization-based Interventions in Child Psychiatry and Youth Protection Services II: A Model Founded on the Child’s Prementalizing Mode of Psychic Functioning.” By Vincent Domon-Archambault, Miguel M. Terradas, Didier Drieu, and Natalie Mikic; published 2020 in the Journal of Infant, Child, and Adolescent Psychotherapy.

• ABSTRACT: The systematic and rigorous observations of children in child psychiatry and Youth Protection Services in Quebec revealed that most of these children presented multiple, complex and often severe problems, and did not seem to benefit much from classic psychodynamic psychotherapy. Owing to a poorly developed mentalizing capacity, many of these children did not use symbolic play as a means of expressing their intrapsychic conflicts and relational difficulties and did not communicate much verbally with clinicians. It was noted also that these children’s inner world was dominated by prementalizing modes of thinking, namely, the teleological mode, the psychic equivalence mode, and the pretend mode. This article is the last in a series of three. The first concerns the clinical assessment of prementalizing modes of psychic functioning in children and their parents. The second lays out the general objectives, principles and interventions of a mentalization-based treatment for children. This third article presents specific intervention strategies adapted to children’s predominant mode of thinking. The objectives and techniques regarding each mode are discussed. Three clinical examples serve to illustrate the interventions. The authors suggest that these children must develop a certain degree of mentalizing capacity before they can benefit from classic psychodynamic psychotherapy.

The Mother-Infant Interaction Picture Book: Origins of Attachment. By Beatrice Beebe, Frank Lachmann, and Phyllis Cohen; illustrated by Dillon Yothers; published 2016 by W. W. Norton & Company.

• OVERVIEW: Using video microanalysis—which captures moment-to-moment sequences of interactions—Beatrice Beebe and her colleagues have turned their lens on the most primary of relationships, mother and infant. This process becomes a “social microscope,” enabling readers to see subtle details of interactions which are too rapid and complex to grasp in real time with the naked eye. These moment-to-moment sequences teach us to see how both infant and mother affect each other. We see that infants at four months are already extraordinarily communicative and responsive to the movements and emotions of the partner. These interactions can be used to predict a range of future attachment styles. They enable researchers to translate infants’ nonverbal language and provide a unique and rare window into child development. Lushly illustrated by Dillon Yothers, these drawings reveal the emotions, but conceal the identities, of the mothers and infants.

Relational Treatment of Trauma: Stories of loss and hope. By Toni Heineman; published 2015 by Routledge.

• OVERVIEW: Relational Treatment of Trauma: Stories of loss and hope is the culmination of over 35 years of psychotherapy with children and adults, many of whom have suffered the effects of physical, emotional, or sexual abuse. It addresses a gap in the literature on the treatment of trauma and chronic loss that are ubiquitous parts of life in foster care. While "trauma-informed care" has received considerable attention recently, there is little that focuses on the consequences of repeated, unexpected, and unexplained or unexplainable losses of caregivers. Relational Treatment of Trauma explores the ways in which those experiences arise in the therapeutic relationship and shows how to help clients build the trust necessary for establishing healthier, and more satisfying and hopeful relationships.

The Thinking Heart: Three levels of psychoanalytic therapy with disturbed children. By Anne Alvarez; published 2012 by Routledge.

• OVERVIEW: How do we talk about feelings to children who are cut off from feeling? How do we raise hope and a sense of safety in despairing and terrified children without offering false hope? How do we reach the unreachable child and interest the hardened child? The Thinking Heart is a natural sequel to Live Company, Anne Alvarez' highly influential and now classic book about working with severely disturbed and damaged children. Building on 50 years experience as a child and adolescent psychotherapist, Alvarez uses detailed and vivid clinical examples of different interactions between therapist and client, and explores the reasons why one type of therapeutic understanding can work rather than another. She also addresses what happens when the therapist gets it wrong.

“Traumatic and stressful events in early childhood: Can treatment help those at highest risk?” By Chandra Ghosh Ippen, William W. Harris, Patricia Van Horn, and Alicia F. Lieberman; published 2011 in Child Abuse & Neglect.

• ABRIDGED ABSTRACT: Objective: This study involves a reanalysis of data from a randomized controlled trial to examine whether child–parent psychotherapy (CPP), an empirically based treatment focusing on the parent–child relationship as the vehicle for child improvement, is efficacious for children who experienced multiple traumatic and stressful life events (TSEs). Conclusions: The data provide evidence that CPP is effective in improving outcomes for children who experienced four or more TSEs and had positive effects for their mothers as well.