Regulation-focused psychotherapy for children
Regulation-Focused Psychotherapy for Children is a short-term, time-limited psychodynamic treatment approach for children with disruptive behavior disorders, including oppositional defiant disorder, conduct disorder, attention deficit/hyperactivity disorder, and disruptive mood dysregulation disorder. RFP-C consists of 16 individual play therapy sessions plus 4 sessions with the child's caregiver only. The basis for the therapeutic process in RFP-C is that all behavior has meaning and that some children engage in disruptive behaviors as a way to avoid experiencing painful or threatening emotions such as guilt, shame, and sadness. RFP-C is an alternative to traditional cognitive-behavioral strategies used in the treatment of disruptive behavior, which employ principles of behavior modification as tools to manage behavior. Instead, RFP-C is affect-oriented, and clinicians using RFP-C focus on understanding the child's inner world and subjective experience and communicating this inner experience to the child in a developmentally appropriate way. RFP-C conceptualizes aggressive and antisocial behaviors as products of emotional dysregulation. The goals of the child sessions are to: identify which of the child's emotions are being avoided, understand how the emotion is being avoided and explore why the emotion is being avoided in a maladaptive way. The goals of the caregiver sessions are to obtain clinical background information, develop the therapeutic alliance, and provide psycho-education to aid in caregivers’ understanding of the child's difficulties. The ultimate goal of RFP-C is to help the caregiver and child understand that all behavior, even disruptive behavior, has meaning in the service of emotional and behavioral regulation. This insight leads to a decreased need to act on the distressing emotions and an increased ability to tolerate, work through, and talk about the feelings that previously needed to be warded off. RFP-C utilizes a modified version of the Malan triangle of conflict in case conceptualization and in parent work to help support the child's development of more adaptive implicit emotion regulation capacities.
RFP-C was codified in 2016 with the publication of the Manual Of Regulation-Focused Psychotherapy for Children With Externalizing Behaviors: A Psychodynamic Approach. This short-term psychodynamic psychotherapy has demonstrated evidence in a pilot study, a randomized controlled trial, and an online, school-based program during the COVID-19 pandemic.
Ongoing education and research related to RFP-C is supported by the non-profit, which offers online training and consultation, as well as research grants.