How Psychiatry Turns Kids Around

by Victor M. Fornari, MD

Psychotherapy can turn a child’s life around.  In a recent book written by Lenore Terr, M.D., Magical Moments of Change- How Psychotherapy Turns Kids Around, Dr. Terr eloquently describes the practice of the art of psychotherapy with children based on her years of clinical experience.  Although evidence based practices are becoming increasingly sought after, the role of psychotherapy with children and adolescents deserves attention.  

In 1991, a 29 month-old, highly abused and traumatized child was brought to the office of Lenore Terr, a leading child psychiatrist, and one of the world’s foremost experts on childhood trauma.  “More animal-like than human,” Terr writes, she growled rather than spoke, hissed, spat, hit, and seemed by all accounts- even to this seasoned child psychiatrist- to be beyond help.  Yet, 15 years of once-a-month sessions with a child proved, remarkably, otherwise. 

What causes a feral, neglected, and mistreated child to make such a dramatic change by adolescence?  For that matter, what causes a timid young girl to plunge into treatment after resisting for so long?  Or a boy to reframe a better self-image?  Or a traumatized kid who had been slogging away in therapy suddenly shows a rapid rate of improvement?  Are these turnarounds related to therapy?  And if so, how?  

Weaving into the book the story of the “wild child” she first encountered more than 15 years ago, in Magical Moments of Change, Terr seeks to answer these very questions, namely, How and when does therapy work, and what happens to make it work? 

To this end, she calls upon 33 of the nation’s premiere child and adolescent psychiatrists to share key moments of dramatic change that they have witnessed in their own patients, and to explain how these moments came about.  This book represents 48 such vignettes, carefully framed by her own clinical experiences and expert knowledge of the nature of child and adolescent trauma and the process of psychotherapy. 

Whether simple or inadvertent, or the results of an intense crescendo of therapy work, the moments of change that Terr shares provides all those who work with, care for, and love children valuable insight into just what can trigger their transformation.  What we are left with is a deeper understanding of the mechanisms of change in psychotherapy, and, by turn, powerful ideas for inducing turnarounds in our own children. 

Lenore Terr, M.D., Clinical Professor of Psychiatry at the University of California San Francisco and in private practice, is a pioneer in the filed of childhood trauma. 

(W.W. Norton & Company, Inc., New York, 2007)

ABOUT THE AUTHOR:
Victor Fornari, MD, is the Associate Chairman for Education and Training in the Department of Psychiatry at North Shore University Hospital. He is also Associate Professor of Clinical Psychiatry at New York University School of Medicine. Dr. Fornari is actively involved in research in eating disorders, and has collaborated on numerous published articles and textbook chapters on the subject. In 1994 he was awarded a National Institute of Mental Health grant to study the use of phototherapy for the treatment of Bulimia Nervosa.