Cognitive Developmental Therapy with Children

Article excerpt

Cognitive Developmental Therapy With Children Tammie Ronen. New York: John Wiley (www.wiley.com). 1997, 180 pp., $55.50 (hardcover).

Cognitive-behavior therapy with children is a growing clinical frontier. A crucial task for cognitive-behavioral researchers and clinicians is creating developmentally appropriate methods for working with children. Superimposing our adult templates for clinical work onto children risks adultomorphizing these youngsters. In order to maintain a developmentally sensitive approach to cognitive-behavioral therapy with children, a conceptually sound theory which integrates assessment and intervention is needed. Cognitive Developmental Therapy with Children by Tammie Ronen offers a promising approach.

In Cognitive Developmental Therapy with Children, Ronen proposes a comprehensive theory for understanding child behavior which seamlessly integrates assessment and treatment. She expertly uses Beck's cognitive therapy as a theoretical/clinical heuristic and then fluidly combines it with a developmental educational model as well as Rosenbaum's self-control model. Additionally, one of the more important goals in the book is the synthesis of scientific rigor, theoretical knowledge, clinical flexibility, and therapeutic artistry. Through this fruitful synthesis, Ronen attempts to engage children (and their therapists!) in cognitive-behavior therapy. Ronen is clearly trying to make cognitive therapy more accessible to youngsters. Indeed, she succeeds admirably in achieving all her stated goals in writing Cognitive Developmental Therapy with Children.

The book is divided into three cogent parts. The first section is entitled "Decision making in assessment for child psychotherapy." In this section, Ronen discusses the importance of diagnostic processes and the way diagnosis shapes treatment planning. Her integration of assessment procedures with intervention strategies is seamless. Ronen aptly embeds the diagnostic process in a developmental context. She also articulately explores the complicated issues inherent in child psychotherapy such as the rapid rate of developmental changes in childhood, developmental discontinuities, and the high rate of ostensibly spontaneous symptom remission. The decision-making guidelines that Ronen offers are clear and easy to follow. The case examples which accompany the guidelines are illustrative and nicely amplify her points.

In the chapter discussing ways to adapt cognitive therapy to children, Ronen compellingly writes, "I view behavioral and cognitive therapies not as techniques but as a way of life, as a theoretical approach, and as a way of looking at one's behavior and trying to change it." (p. 46). Ronen explicitly discusses the practice of cognitive therapy from both a content and process perspective. She thoughtfully presents direct and indirect approaches to cognitive therapy. Moreover, she includes intervention strategies which rely on verbal and nonverbal processes. Her work clearly transcends the traditional notions of cognitive-behavior therapy with children. Ronen nimbly stretches the theoretical boundaries without violating the fundamental assumptions of cognitive therapy. In this way, Ronen breaks new ground in the child psychotherapy literature and makes a convincing case for adopting a cognitive approach to treating childhood problems.

Part II of the book deals with developing a cognitive therapy approach with children. The cognitive content of common problems, recent advances in cognitivebehavioral therapy with children, and the rationale for using cognitive therapy with children are highlighted. Important issues such as obstacles to therapy, dropout rates, and generalization of treatment effects are addressed. Further, Ronen astutely notes that temporary regressions are the rules rather than the exceptions in childhood. …