The psychotherapeutic intervention in childhood and adolescence

The psychotherapeutic intervention in childhood and adolescence


  • 1 Reasons usual demand in therapy with children and adolescents
  • 2 Cognitive Psychotherapy
  • 3 The Psychology of Personal Constructs (PCP)
  • 4 Narrative Psychotherapy: the outsourcing conversation

Common demand reasons in therapy with children and adolescents

  • Difficulties in school (learning / relationship)
  • Nightmares and / or night terrors
  • Eating and eating behavior disorders
  • Elimination disorders (enuresis / encopresis)
  • Psychological problems of the child arising from the relationship between the parents and with the parents.
  • Challenging Negativist Disorder
  • Attention deficit hyperactivity disorder (ADHD) or without hyperactivity
  • Sad or irritable mood (sometimes diagnosable as depression)
  • Anxiety disorders (especially separation anxiety, social phobia and school phobia)

Cognitive Psychotherapy

As in psychotherapy with adult clients, in working with children and adolescents the cognitive therapy It has proven effective, for example, for the treatment of depression. Its main objective is the exchange of negative thoughts for more adaptive ones.

Usually the therapeutic procedure is carried out from the following sequence:

Emotional education

  • Teach the child to differentiate different types of emotions and recognize that a person can experience two different and / or contradictory emotions simultaneously.
  • Teach the child that different situations cause different emotions.
  • Teach the child that the intensity of emotions varies depending on the situations.

Cognitive restructuring

  • Teach the child that thoughts are responsible for emotions.
  • Teach the child to identify cognitive distortions and discuss depressive thoughts.
    • Help the child to be more tolerant of his own mistakes.
    • Help the child develop his capacity for social perspective.
    • Help the child to acquire more adaptive social behaviors.
    • Help the child to develop pleasant activities.

As in the case of therapy with adults, to address these goals in cognitive therapy with children and adolescents, it is usually intervened through the use of work sheets and self-records. Therefore, it adapts the format and presentation of the worksheets and records to the child's evolutionary level and personal interests.

The Psychology of Personal Constructs (PCP)

The greatest exponent of working with children and adolescents since the PCP is Tom Ravanette (1999), who has worked and researched especially in the field of Psychology of the education. When George A. Kelly (1955) developed the PCP from the philosophical postulate according to which the meaning of the experience is a personal construction and is not revealed directly to us with the simple observation of external reality. In this way, new interpretations of the experience are always possible. Following these premises, the main objectives of working with children and adolescents since the PCP they would be the following:

  • Evaluate the constructions through which the child makes sense of himself and others.
  • Make it easier for the child to discover new personal meanings that are more useful and that make him feel better.

These objectives are pursued by exploring different aspects of the child's life:

  • Self-sense exploration
  • Self exploration in relation
  • Exploring the child's problems
  • Feeling Elaboration

Techniques designed to address therapeutic goals are invitations to that the child think about himself and his way of giving meaning to life; they are characterized by having a minimal structure and inciting a maximum freedom of expression. In addition, each exercise contains the possibility of generating new construction alternatives.

Narrative Psychotherapy: the outsourcing conversation

Since narrative psychotherapy is considered narrative as the central element of knowledge building. That is, we organize knowledge about ourselves and what we live in stories or narratives. Since there is always more than one way to explain the story itself, narrative psychotherapy has two main objectives:

  • The child is helped to find more satisfying ways to tell his own story.
  • It is intended that the child's identity is not defined by his problem. As Freeman, Epston and Lobovits (2001, p. 29) state, "the problem is the problem, the person is not the problem." It is in this sense that we speak Outsourcing of the problem: the problem is the entity itself, it is reified or personified, and the child and his family are invited to provide it as something external to themselves. Thus, based on the knowledge of the child's abilities and interests, the exceptions to the influence of the problem and the co-creation of new functional relationship possibilities (solutions) between the child and the problem will be emphasized.

But how does an outsourcing conversation take place? Below we will see some types of intervention useful to outsource the problem:

Questions of relative influence (White, 1986): they are useful so that the child does not identify with the problem and feels that he has or may have some control over it.

  1. Questions about the influence of the problem on the child's life / relationships, for example: "How does anger get you mad at your mother? What makes you do?".
  2. Questions that incite the description of the child's influence on the life of the problem, for example: "What do you do to make the anger go away?".

Invitational Questions: they are useful to generate experience of preferred relationships with the problem, not only to get information:

  1. Questions about interests (hobbies, favorite TV characters and cartoons, games they prefer, etc.), special skills (intuition, imagination, magic games, playing music, being a good athlete, etc.) and other particular characteristics of the child, which you can use to deal with the problem, just as you have used them to overcome other problems.
  2. Questions to generate experience of preferred relationships with the problem: invite the consideration of the effect of seeing the problem from several more advantageous points of view, for example: "Can you think of something that worked for you in the past to get something you wanted?" .

Use of metaphor: It is useful to describe the relationship between a person (or more) and a problem. Thus, we can talk, for example, about the wall of rage, turn our backs on the problem, tame it, destroy it, throw it away, etc. The metaphor changes as the relationship with the problem changes. You choose with the client, using your own language; meaning is always negotiated.

We can also personify the problem in order to negotiate: for example, ask the child to give him a name, draw him, write letters, etc..


Freeman, J., Epston, D., and Lobovits, D. (1997). Narrative therapy for children. Barcelona: Paidós, 2001.

Ezpeleta, L. (2001). The diagnostic interview with children and adolescents. Madrid: Ed. Synthesis (Technical Guides Series).

Méndez, FX (2000). Fears and fears in childhood: Help children overcome them (2nd ed.). Madrid: Pyramid.

Méndez, FX (2001). The child who does not smile: Strategies to overcome sadness and childhood depression (2nd ed.). Madrid: Pyramid.

Pacheco, M. and Botella, L. (2001). Relational constructivism in psychotherapy with children and adolescents: a proposal for the liberation of new dialogic spaces. Journal of Psychotherapy, 44, 5-26.

White, M., and Epston, D. (1993). Narrative means for therapeutic purposes. Barcelona: Paidós.