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.
Table of 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.
"...[this book] will whet the appetite to learn more and see what these techniques offer for a rapid, deep understanding of patients."
"...offers clinicians a comprehensive paradigm for assessing object relations functioning in disturbed adolescents."
—Child Assessment News
"Filling a significant gap in the clinical assessment literature, Francis Kelly persuasively demonstrates the efficacy of object relations theory and of two object relations measures--the Mutuality of Autonomy Scale and the Social Cognition Object Relations Scale--for systematically understanding the inner life of disturbed and nondisturbed adolescents. Applying these theoretically-based, innovative measures both quantitatively and phenomenologically, Kelly convincingly argues that an assessment of object relations permits the clinician to move beyond actuarial measures with their narrow emphasis on manifest behavior to a more structural-dynamic assessment that can then be employed to inform and guide treatment. Those involved in the assessment and treatment of the adolescent will find this book a gold mine."
"Dr. Kelly has used his thorough knowledge of object relations theory and his extensive clinical experience in working with adolescents to produce a superb and exciting work. He demonstrates that knowledge of the adolescent's developmental level of object representation is critical for treatment planning; the benefit of this informed theoretical framework over a diagnosis based solely on behavioral symptoms is made clear. Through numerous case examples and clear explanations of how to assess object representations with projective techniques, Dr. Kelly provides a service to both clinicians and researchers in this important area of adolescent development."