Clinical Problem Solving: The Case of John, Part II: Excerpts From Sessions 2-7

This article is part two of the three part series of articles entitled "Clinical Problem Solving: The Case of John," with excerpts from Sessions 2-7. In this article, the authors give their responses to sessions 2-7. One author talks about psychodynamic issues and developmental issues, as well as family interaction and intrapsychic problems in response to the sessions. Another author points out that asking the adolescent to give a brief facilitated and clinically guided lifetime narrative serves several important aims, including the following: (1) It actively engages the adolescent in the therapeutic process by telling his or her story; (2) The process enormously enhances the therapeutic alliance in that it offers numerous opportunities for the therapist to empathetically respond to the adolescents' narrative and to demonstrate a nonjudgmental, nonshaming approach to interpretation; (3) The process not only enables the therapist to obtain necessary developmental and historical clinical information but also reveals the adolescent's primary defenses, cognitive style (and distortions), perceptions, self-efficacy, self-esteem, self-awareness, skills, and skill deficits; (4) The process also enables the therapist to inquire about the onset and progression of psychiatric symptoms, behavior problems, and substance use across the life span; and (5) The process enables the adolescent to be "known and understood" as it provides assurance that the therapist realizes that it is impossible to understand current problems and issues without understanding the history and context from which they arose. [For Part I, see EJ754676; For Part III, see EJ754682.]