Corresponding Author Information: Julie Cradock O’Leary

Session Abstract: While the Thurston Cradock Test of Shame (TCTS) can be used with children, teens and adults, most evaluators only use it with adults. This case discussion begins with a brief review of the TCTS, to set the context for the cases presented. Test co­author Julie Cradock O'Leary will review special concerns when administering, scoring and interpreting the TCTS with children and teens. Actual child and teen protocols will be used to illustrate how shame dynamics are measured by the TCTS.

Next, three speakers will present child and adolescent assessment cases that used the TCTS to evaluate shame and other phenomena. In each case, the TCTS helped uncover the hiding places of strong defenses which caused difficulties for clients and their families.

The first case is a 17 year old girl who was referred for testing to better understand why she nearly failed 11th grade after 2 years of solid grades. The teen's impression was that she hadn't "felt great" and may have been anxious. While the TCTS clarified some ability to self-reflect, it also highlighted the teen's tendency to express vague affect and respond to shame and other uncomfortable affect with severe withdrawal into fantasy.

The second case is a 12 year old male who was referred for testing due to increasing irritability, manipulation, and self-harm behavior. The boy's therapist and parents wished to rule out Bipolar Disorder and narcissistic personality features as conditions that may be affecting his functioning. The evaluator wished to increase empathy regarding the child's narcissistic and aggressive behaviors, because his therapist and parents appeared overly focused on managing behaviors rather than understanding their root causes. The evaluator decided to use the TCTS to highlight likely feelings of shame underlying contemptuous/inflated and aggressive defenses to increase insight and understanding and shift the focus in treatment.

The third case involves a 11 year old girl who was referred by her parents because of declining school performance, social isolation, and aggressive behavior. Despite some behavioral progress in therapy, the therapist had diagnostic questions about the child's capacity for empathy and reciprocity. The TCTS was given to see if underlying shame was driving some of her aggressive behavior, and to better understand her view of self and other. Results were dramatic, revealed next to nothing about shame, and shed light on important aspects of the case that were previously opaque.

The discussant will provide insight into the shame dynamics present in each case, as well as common child and adolescent referrals. She will focus on shame defense “clues” that may be present in the referral or initial case material, as they are often the first sign that shame is an underlying issue. The discussant will also provide recommendations for therapeutically addressing shame, particularly when defenses against it are strong.

Chair Information: Julie Cradock O'Leary,PhD | Private practice, Anchorage. Alaska

Discussant Information: Julie Cradock O’Leary, PhD | Private practice, Anchorage, Alaska

Presentation 1 Title: Special Considerations when using the TCTS with Children and Adolescents

Presentation Abstract: While the Thurston Cradock Test of Shame (TCTS) can be used with children, teens and adults, most evaluators only use it with adults. This symposium begins with test co­author Julie Cradock O'Leary providing a brief review of the TCTS to explain how it evaluates shame, shame defenses, and a client’s ability to cope with and resolve shaming situations. Actual child and teen protocols will be used to illustrate how shame dynamics are measured by this test. Next, Dr. Cradock O’Leary will outline special concerns when administering, scoring and interpreting the TCTS with children and teens.

Presenters:

Julie Cradock O’Leary, PhD | Private practice, Anchorage, Alaska

Presentation 2 Title: Using the TCTS to Help Sort Out Diagnostic Questions in a Combined Neuropsychological/Personality Collaborative/Therapeutic Assessment

Presentation Abstract: A 17 year old girl was referred for testing to better understand why she nearly failed 11th grade after 2 years of solid grades. The teen's impression was that she hadn't "felt great" and may have been anxious. Neuropsychological testing revealed a nonverbal learning disorder, and projective measures, particularly the TCTS, helped clarify how the NVLD shaped her psyche. The projectives helped the assessor better understand the girl’s experience and emotional pain. While the TCTS clarified some ability to self-reflect, it also highlighted the teen's tendency to express vague affect and respond to shame and other uncomfortable affect with severe withdrawal into fantasy.

Presenters:

Melinda Kulish, PhD | Harvard Medical School, Cambridge, MA

Presentation 3 Title: "Tell me why my child is bad" - Using the TCTS to Foster Increased Emotional Attunement in Parents with Difficult Children

Presentation Abstract: The second case is a 12 year old male who was referred for testing due to increasing irritability, manipulation, and self-harm behavior. The boy's therapist and parents wished to rule out Bipolar Disorder and narcissistic personality features as conditions that may be affecting his functioning. The evaluator wished to increase empathy regarding the child's narcissistic and aggressive behaviors, because his therapist and parents appeared overly focused on managing behaviors rather than understanding their root causes. The evaluator decided to use the TCTS to highlight likely feelings of shame underlying contemptuous/inflated and aggressive defenses to increase insight and understanding and shift the focus in treatment.

Presenters:

Tara McKelvy Parker, PhD | Private practice, Dallas, Texas

Presentation 4 Title: No Shame in Sight:  When the TCTS Helps in Unexpected Ways

Presentation Abstract: I will present a collaborative assessment case of a bright 11 year old girl who was referred by her parents because of declining school performance, social isolation, and aggressive behavior at home. Parents wondered, "Why is she so reactive and fighting with us over basic routines? Why does she talk 'at' us? Why is she more interested in our pet chickens than in other children?" While the family was making behavioral progress in therapy, the therapist had diagnostic questions about this child's capacity for empathy and reciprocity. The TCTS was given to see if underlying shame was driving some of her aggressive behavior and to better understand her view of self and others. Results were dramatic, revealed next to nothing about shame, and shed light on important aspects of the case that were previously opaque. As there was no shame in sight, this case also illustrates the versatility of the TCTS!

Presenters:

Diane Santas, PhD | Private practice, Oakland, CA and University of California, Berkeley

Dr. O'LearyDr. Julie Cradock O’Leary

Julie Cradock O’Leary, Ph.D. is a Licensed Clinical Psychologist in private practice in Anchorage, Alaska. She provides therapy and psychological assessments to children, adolescents and adults. Julie utilizes a psychodynamic approach, influenced by self psychology. She is co-author of the Thurston Cradock Test of Shame (TCTS), which was published by Western Psychological Services in 2009. Julie has studied shame for over 25 years, and still enjoys discovering the intricacies of how shame is at work in individuals and systems in cultures around the world. She regularly presents on shame and the TCTS at professional conferences, as well as clinical and academic settings in the United States and abroad. She conducts research with the TCTS, and especially enjoys working with graduate students completing masters projects and dissertations, or simply seeking research experience. Julie is coauthor of two TCTS case studies recently published in Rorschachiana. She provides in-person and tele-consultation for professionals seeking to better understand shame dynamics in their clients. Additionally, Julie provides TCTS scoring and interpretation services. Julie is a member of the American Psychological Association, International Society for the Rorschach and Projective Methods, Society for Personality Assessment, and Therapeutic Assessment Institute. She is a reviewer for several journals, including the Journal of Personality Assessment and Rorschachiana.


Dr. KulishDr. Melinda Kulish

Melinda Kulish, Ph.D. first became interested in psychological testing as an undergraduate at the University of Michigan, where she did research on The Early Memory Questionnaire with her first mentor, Dr. Martin Mayman. She went on to complete her doctorate in clinical psychology at Northwestern University. She completed her APA accredited internship at The Cambridge Hospital/Harvard Medical School. She went on to complete 2 years of post-doctoral training in adult neuropsychology through The Cambridge Hospital/Harvard Medical School.

She completed an additional 3rd and 4th year of post-doctoral training in adolescent neuropsychology through Tufts Medical School/The New England Medical Center in partnership with The Massachusetts Department of Youth Services. She has received advanced training in collaborative and therapeutic assessment through The Center for herapeutic assessment in Austin, Texas. She is also a psychoanalyst, having graduated from the Boston Psychoanalytic Society & Institute (BPSI) in 2016.

Dr. Kulish is an lecturer at The Cambridge Health Alliance/Harvard Medical School and is a member of the Harvard Medical School faculty, where she has taught and supervised students in psychological and neuropsychological assessment for many years. She has also supervised psychology interns in their psychotherapy training. Dr. Kulish has taught doctoral level classes at Boston College and UMass Boston, and taught a course entitled “Trauma, Affect and the Brain” at the Boston Institute for Psychotherapy. She was the director of the psychological and neuropsychological testing service at The Two Brattle Center from 2003-2008.

Dr. Kulish has been a practicing psychologist in the Cambridge area since 2000. Her private practice focuses on adult and adolescent psychotherapy. Recognizing the need for completely integrated neuropsychological and psychological testing, Dr. Kulish and her husband, Robert Sodergren, M.B.A., founded Integrated Assessment Services in the fall of 2012.


Dr. McKelvy ParkerDr. Tara McKelvy Parker

Dr. McKelvy Parker is a licensed counseling psychologist working in a predominately psychoanalytic group private practice in Dallas, TX. She considers herself an integrative therapist, with foundations in various psychodynamic therapies, cognitive behavior therapy, Eye Movement Desensitization and Reprocessing (EMDR) therapy, and child centered play therapy. Dr. McKelvy Parker specializes in assessment and child and adolescent psychotherapy, although she has skills and experience working with a variety of client populations, including adults and groups. Dr. McKelvy Parker has provided therapy and assessment to children, adolescents, and adults in private practice, community mental health, college counseling, and public-school settings. She has also worked in two separate children’s hospitals treating youths with eating disorders, diabetes, and other endocrine related illnesses. She is certified in group Positive Parenting Program, an empirically validated parenting skills group intervention. Dr. McKelvy Parker earned her doctorate in Counseling Psychology, with an emphasis in child and family therapy, from the University of North Texas in 2015.


Dr. SantasDr. Diane Santas

Dr. Santas is a licensed psychologist in independent practice in California, specializing in collaborative assessments and therapy with children, teens and adults for over 30 years. She has been trained in Stephen Finn’s six-step model of Therapeutic Assessment and integrates aspects of this more structured model into her own practice doing all types of assessments. Dr. Santas is also an Assistant Clinical Professor at UC Berkeley and an Adjunct Clinical Faculty member at The Wright Institute where she supervises graduate students in their assessment work and introduces students to a collaborative therapeutic assessment approach.

Leave a Reply