Full Description
This book offers clinicians a long-awaited comprehensive paradigm for assessing object relations functioning in disturbed younger and older adolescents. It gives a clear sense of how object relations functioning is manifest in different disorders, and illuminates how scores on object relations measures are converted into a therapeutically relevant diagnostic matrix and formulation.
Outlining the process of object relations assessment, Kelly presents vividly detailed cases of a range of disorders including anorexia nervosa, borderline states, depressive disorders, and trauma. The cases portray the vicissitudes of object relations functioning and disruption that result in a unique structural developmental composite for a given adolescent.
A major concern is demonstrating the utility and validity of two object representation measures--The Mutuality of Autonomy Scale (MOA) and The Social Cognition Object Relations Scale (SCORS)--that are the main ones employed in the assessment of adolescents. MOA and SCORS scores facilitate a multidimensional understanding of the nuances of an adolescent's object relations functioning, and provide clinicians with organized, theory-based data leading to clear, specific treatment directions and guidelines and appropriate therapeutic programming. The book addresses the following questions:
* Is individual psychotherapy indicated--will this adolescent benefit from an insight-oriented approach?
* What are the likely directions that transference parameters will take in the treatment?
* What types of countertransference reactions are likely to be anticipated in a given patient?
* Is medication likely to be helpful in making this adolescent more accessible for treatment?
Focusing only on adolescents, covering both the TAT and the Rorschach, and utilizing object relations theory as its major interpretive foundation, the book offers practitioners an alternative to general references based on a more actuarial, nomothetic, and atheoretical interpretive approach. It reflects one school of contemporary thought in projective assessment--one that advocates a more phenomenological, theory-based approach to test application and interpretation.
Contents
Contents: Preface. Introduction. Diagnostic Difficulties in Adolescent Psychiatry: Limitations of DSM-IV and the Role of Projective Tests in Developmental Assessment. Object Relations Assessment and Functioning in Adolescence: Theoretical and Clinical Considerations. Object Representation Assessment in Adolescence: TAT and Rorschach in Relation to Different Clinical Populations. Object Representation Scales. The Assessment of Object Representation in Normal Adolescents. Introduction to Clinical Case Illustrations. Pathways of Trauma: The Impact of Chronic, Complex Abuse and Neglect Experiences on Object Representations and Relatedness. From Assessment to Treatment Planning: The Development of the Psychodynamic Formulation. Object Representation and Changes in Clinical Functioning: Positive and Negative Therapeutic Sequelae in Adolescence. Concluding Observations and Remarks.
