A Primer For Child Psychotherapists (Book Review)

Author:  Siskind, Diana
Publisher:  Jason Aronson, 2001
Reviewed By:  Abe Loebenstein, Spring 2003, p. 56

In A Primer for Child Psychotherapists, Diana Siskind provides an easy-to-read primer especially useful for a beginning child therapist in a private practice or clinic setting, where the therapist can set the tone for treatment. The book is written in a dialogue format with a hypothetical supervisee directing commonly asked questions which Siskind addresses.

Her responses not only guide the reader with what to do, but offer a way to critically think about what is being asked, keeping in line with what psychoanalytic tradition so richly offers the field of psychotherapy regardless of one’s theoretical orientation. Examples include her encouragement to examine one’s own countertranference reactions to either child or parent, and to examine what purpose a behavior might serve, before coming with a response. Intermediate therapists already established can use this book as a way of checking and challenging their assumptions and practices.

A useful philosophical stance Siskind provides is for “the child’s therapist to remain equidistant to child and parent (p.19).” The therapist has to build and be mindful of the relationships with both the caretaker and the child when doing child psychotherapy. Another point she stresses is gain an understanding as to what needs to be treated before proceeding with the treatment.

Siskind walks the reader through all the basics of treatment from why children may be brought to therapy, how to proceed, whom to see first, and the office setting, right down to when termination may be appropriate.

I will briefly describe some of the topics she addresses: The layout of the office, useful and distractible toys, issues of confidentiality, setting the tone for treatment, developmental considerations, setting limits and boundaries. Common problems addressed include how to handle a child wanting to keep a toy, gifts, handling the disruptive child, and the differences between kindness and over gratifying a patient. More difficult dilemmas are presented such as when parents divorce, and difficult problems such as dealing with suicidal patients, especially while handling confidentiality concerns.

The dilemmas are presented to her by the hypothetical supervisee, and then explored in a dialogue fashion. Siskind does provide answers and guidelines, but only after encouraging the supervisee to make the most of the question being asked including maintaining a professional attitude, exploring one’s own countertransference reactions. While the examples mentioned in the dialogue feel universal and have can be easily generalized, it is the critical way of thinking that she encourages that becomes the greatest source of learning, rather than the answer she ultimately gives. Still, I found myself wishing that Siskind had addressed even more common dilemmas such as handling child abuse issues, eating disorders, and substance abuse, as these dilemmas are complex and frequent.

I had some minor contentions with her guidelines of first meeting the parent prior to the initial contact with the child. I would argue that it many instances seeing the child first gives therapists a chance to evaluate a child in a less biased manner, and to assess if rapport with this child is possible. However, her points are well taken that building a therapeutic alliance with the parents, assessing parent’s motivation, and the appropriateness for treatment makes meeting the parents first preferable. More importantly, Siskind is not only writing a methodology for child treatment, but a way thinks about how we make our decisions. It’s not simply about who should be seen first but about how we come to this decision. In this regard, Siskind more than excels in imparting to the reader how to approach child psychotherapy, and makes A Primer for Child Psychotherapists a must-read for those entering the field of child psychotherapy.

Reviewer Note

Abraham Loebenstein has been in private practice for six years with a practice largely devoted to children and adolescents. He is a psychologist, a marriage and family therapist and a graduate of Alliant University: The California School of Professional Psychology.

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