Manual of Regulation-Focused Psychotherapy for Children (RFP-C) with Externalizing Behaviors: A Psychodynamic Approach by Leon Hoffman, Timothy Rice, & Tracy Prout

As summarized by Nick Midgley of the Anna Freud Centre in the book’s foreword, the contribution of this manualized treatment approach for children with externalizing disorders is three-fold. First, it goes beyond a simple checklist of symptoms and focuses on implicit affect regulation as the key to understanding the many disruptive behaviors these children display. Second, and most important, the authors stress the children’s disruptiveness is not simply a set of behaviors but also a communication that needs to be understood. Therapeutic interventions toward understanding their behaviors are linked conceptually to the RFP-C theoretical model. Affect regulation for the child appears by the gradual emergence of a shared understanding of what the behaviors communicate. Third, the manual makes a major contribution by linking the psychodynamic concept of defense mechanisms, such as projection and denial, with the understanding of the hostile and at times violent behavior of these children. I agree with all of the comments by Midgley and would emphasize several additional observations. The inclusiveness of the theoretical model delineates clear theoretical connections between the newest concepts of neuroscience and developmental theory, placing psychodynamic concepts within a wider framework, highlighting commonalities and distinctive differences between parallel disciplines. Also, with this volume the authors’ intention was to provide a manualized road map for treatment of disruptive children that could be empirically replicated, measured, and assessed. The authors provide several rating scales for this purpose. In addition, the manual is inclusive in its attention to all aspects of the implicated therapeutic relationships, including meetings with the parents, consideration of transference and counter-transference feelings, and how these relationships might develop in the course of treatment. Clearly, for all of the above reasons this manual is a must-read for experienced clinicians as well as novices to the profession. For many readers, it will provide a new therapeutic approach. For others, it will illuminate what might be expected as treatment unfolds while, for other readers, it will challenge their current practice. RFP-C is an innovation certain to be empirically tested, discussed, and adapted to meet changing guidelines and attitudes. The next paragraphs will give a thumbnail sketch of the contents of the book, followed by a few remaining questions. The manual is divided into two sections: 1) Introduction and Theoretical Background and 2) Practice Manual. The overall style of the manual is concise and fully articulated. Occasional redundancy in content functions as an educational tool to clarify new material and emphasize important points. Each chapter is headed by a listing of subjects to be covered, similar to textbook formats. In addition, critically important definitions and comments are framed within boxes for emphasis, often summarizing content from the text. These boxes provide handy highlights for discussion and review. Lively and insightful clinical vignettes are integrated within the manualized presentation of prescribed therapeutic procedures. These illustrative glimpses give zest to the chapters and often render the occasional, somewhat stodgy procedural declarative imperatives lively and relevant. In chapter one, the authors state their definition of emotional regulation and the central hypothesis guiding their therapeutic approach. JOURNAL OF INFANT, CHILD, AND ADOLESCENT PSYCHOTHERAPY 2016, VOL. 15, NO. 2, 135–138 http://dx.doi. org/10.1080/15289168.2016. 1163203