Chapter 10 A Self-Psychological Approach to Child Therapy: A Case Study

“I don't know how you did it, but you sure got rid of my fears.” Keith, almost 10 years old, said this to me one month before we terminated a biweekly therapy lasting four and a half years. His words illustrate the creative nature of a self-psychological therapy. The purpose of the case material is to illustrate how self psychology as a theory is appropriate as a model of treatment for children. The case presented demonstrates the process of the patient's individual therapy, which utilized play therapy, verbal interactions and interpretations, and shared experiences, along with a combined treatment approach that included collaborative parental involvement.1 The work with the parents demonstrates the inherent value in mobilizing a different set of responses within the child's environment to facilitate age-appropriate growth and development. The work with the patient was based on an empathic attunement and treatment ambience which allowed for the emergence of fluctuating idealizing, mirroring and alter-ego selfobject transferences and responses. Through transmuting internalization in an optimally responsive environment,