Theory and research on parent-infant attachment and on adult representations of past relationships suggest several possible themes and approaches for therapeutic intervention with parent-infant dyads. These include strategies aimed at increasing the parent's insight into the connection between past and present relationships and enhancing the parent's understanding of the child's needs and feelings, as well as the use of the therapeutic alliance to help the parent move toward more positive working models of self and others. Project STEEP (Steps Toward Effective, Enjoyable Parenting), an ongoing study of the effectiveness of preventive intervention with new mothers, provides one model of therapeutic intervention built on attachment theory and research.

This paper presents a developmental and a clinical model for the treatment of conduct disorder through the strategy of preventive intervention. The theoretical principles and clinical strategies utilized in the FAST Track (Families and Schools Together) Program are described. We indicate how the clinical model is derived from both our developmental model and previous findings from prevention trials. The FAST Track Program integrates five intervention components designed to promote competence in the family, child, and school and thus prevent conduct problems, poor social relations, and school failure. It is our belief that testing the effects of such a comprehensive approach is a necessary step in developing new intervention models for this population.

This article describes the evolution of a psychosocial intervention, pairing, from its initial utilization as an interpersonally oriented therapy for severely emotionally disturbed pre- and early adolescents in a special needs school, to its current usage as a public school prevention technique for at-risk youngsters, both aggressive and withdrawn, who are living under conditions of poverty and limited community supports. The evolution of the intervention is described parallel to both the evolution of its theoretical foundations and its associated empirical analysis and evaluation. Given that our approach to both intervention and basic research is clinical-developmental (each part of the discipline influencing the other), the facilitation of greater social competence through the intervention provides the impetus for our research inquiry into the nature of psychosocial development. A generic evaluation model that integrates both outcome behavior and psychosocial development is described as it is applied to the evaluation of this specific intervention's effectiveness.

Infant-parent psychotherapy in the second year of life presents specific challenges related to the child's developmental characteristics. The concept of projective identification is discussed as a mechanism for understanding the toddler's specific contribution to attachment disorders with the parent. A versatile clinical format is recommended including joint parent-child sessions, individual work with the toddler and the parents, and the use of therapeutic modes of communication specifically geared to the toddler's needs (“toddlerese”). Clinical examples and research applications are given to illustrate these points.

This paper integrates the work of Stern on affect regulation, Ainsworth on quality of attachment, Piaget on cognitive development, Tulving on memory systems, and Bowlby on internal representational models around the issue of promoting secure attachment. It is proposed that procedural models of the self and attachment figures develop in infancy, are maintained throughout the life span, and are accessed preconsciously to regulate everyday behavior. In the preoperational period, semantic models of generalizations regarding the self and others are constructed (often from parents' words), encoded, and accessed linguistically when the expectations implied by procedural models are discrepant with outcomes; that is, semantic models are used for problem solving. Episodic models, encoded by multiple means (e.g., verbally, auditorially, visually) develop last and consist of episodes of experience that can be accessed unconsciously and regulate behavior when individuals are emotionally aroused. Of interest is the relation among these emerging models, the patterns of information processing contained in them, and the means of guiding their development in children experiencing distorted relationships. Treatment approaches drawn from social learning theory, family systems theory, cognitive therapy, and psychodynamic theory are associated with the memory systems and integrated into an approach to treatment.

Maltreatment can impact the earliest stages of development during which time patterns of emotion regulation and attachment begin to be established (Carlson, Cicchetti, Barnett, & Braunwald, 1989b; Cicchetti, Ganiban, & Barnett, 1991). These disruptive patterns are problematic for early moral development and are likely to play a role in the development of conduct disorders (Aber & Cicchetti, 1984). Thus, maltreated children are clearly in a high-risk situation. To examine emotion regulation, internal representations of relationships, and early moral development, the use of a play narrative story stem technique (Bretherton, Ridgeway, & Cassidy, 1990; Buchsbaum & Emde, 1990) with maltreated children and a nonmaltreated disadvantaged comparison group of children is described. Representative case examples from each group are used to illustrate the effectiveness of this technique for eliciting themes about family relationships, conflicts, and their resolution or lack thereof as well as defenses and coping styles. The potential usefulness of this paradigm for clinical assessment and intervention are discussed.

Findings of the few psychotherapy outcome studies with depressed children and adolescents raise questions about whether or not treatments are sufficiently sensitive to developmental factors. Here we review the outcome data, then survey potentially relevant research on the cognitions, competencies, and coping behavior of depressed youngsters. Much of the work in each domain is both procedurally and theoretically adevelopmental, and the psychotherapy research does not appear to be well informed by research in the other domains. To help remedy this situation, for each domain we suggest key developmental questions that need to be answered, and we discuss implications for psychotherapy. We also propose a three-way partnership involving basic developmental research linked with research on relations between depression and various cognitive and behavioral processes, with both lines of inquiry informing the development and refinement of interventions.

For more than a decade it has been reported that a significant proportion of youth referred for treatment come with aggressive problems that are difficult to treat and resistant to change. Concepts and research findings from the domains of body image, cognitive unconscious, and the new relational perspective in psychoanalysis are integrated to address this issue and construct a treatment model. It is proposed that body image schemas, representing early, interpersonal experiences and prescribing persistent aggressive behaviors, are cast in nonverbal, nonsymbolic forms. On the other hand, meanings of environmental rules are cast in symbolic/verbal forms. Therefore, little or no communication and conflict exist between these meanings. For the same reason, because verbal interpretation and discussions of beliefs and attitudes, emphasized by both cognitive-behavioral and psychodynamic therapies, are cast in symbolic-conceptual forms, they might not effectively influence embodied meanings that prescribe aggression. Accordingly, the goal of the proposed approach is to facilitate the translation of embodied meanings that underly aggression into symbolic form in order to promote communication between these meanings and those of expectations and interpretations. This translation is accomplished as the youth and therapist (paralleling infant-caretaker transactions) interact and negotiate an evolving series of ritualized activities within which the youth projects various unrepaired, developmental interferences (interpersonal dilemmas), and their associated embodied meanings, onto the therapist who enacts the roles of the projected dilemmas, using action symbols as solutions whenever possible. As the youth identifies with and internalizes the therapist's efforts and solutions, the embodied meanings become translated into symbols that communicate with those of rules at higher cognitive levels, resulting in mental conflict available to awareness and discussions. To illustrate the heuristic value of the model, a treatment case is described and new research directions discussed.

This paper introduces a new, clinical-developmental approach to research, theory and intervention. A line of research is described exploring the relationship between developmental organizations of meaning and symptom expression in adolescence. These cross-sectional and longitudinal studies demonstrate needed distinctions between self-complexity and self-maturity/integration—concepts that are described in the context of an overarching framework. In the final section of the paper, clinical methods are introduced for different adolescent developmental worlds and are exemplified with two cases.

A brief treatment protocol for pediatric psychogenic pain conditions is presented, based on attachment and family systems theories and on the following principles of developmental psychopathology: commonality of developmental principles, developmental pathways, continuity and change in disorders of development, and disorders of development as reflecting competence-based strategies. Some principles of intervention based on this integrated model are presented, followed by an outline of the treatment protocol. Of 19 families who participated in the 4-day program, 17 had children who remained symptom-free on 6-month follow-up. Alternative family developmental pathways for pediatric psychogenic pain conditions are proposed as well as some directions for future research.

Despite substantial interest in the therapeutic relationship by child clinicians, relationship processes in child therapy have been neglected by clinical researchers. In this paper, clinical and empirical perspectives on the therapeutic relationship in child treatment were reviewed. Initial findings indicated that the quality of the child's affective relationship with the therapist is associated with collaboration on therapy tasks. Given the recurrent finding of links between treatment collaboration and treatment outcome, research on factors that influence children's ability to form therapeutic relationships is recommended. To this end, a developmental social cognitive model of therapeutic alliance formation is proposed.