The child as identified patient: Integrating contextual therapy and EMDR


It is estimated that as many as 2% of children under age 12 and from 5% to 18% of adolescents suffer from a depressive disorder (Birmaher et al., 1996; Northey, Wells, Silverman, & Bailey, 2003) that will likely persist into adulthood (Northey et al., 2003; Wagner & Ambrosini, 2001). Contextual Therapy is a differentiation-based (e.g., Kerr & Bowen, 1988; Schnarch, 1991) approach in that it promotes self-determination in the face of family pressure for compliance, reliance on internal resources for self-validation rather than dependence on others for approval, and the overcoming of emotional discomfort in the interests of responsible action (Boszormenyi-Nagy & Krasner, 1986). Both the contextual approach and the Adaptive Information Processing (AIP) model predict that formative childhood experiences affect both psychological health and relational functioning. With its systemic paradigm and its ethical dimension of relationship, the contextual approach is complementary and additive to Shapiro's (2001) AIP model. The contextual approach shows the clinician where to look for the targets, and Eye Movement Desensitization and Reprocessing (EMDR) provides the potency to transform the experience. A general structure of phase-oriented therapy can be described that accounts for most, if not all, referrals for treatment. An assessment phase, a contracting phase, and an intervention phase characterize the main tasks of the therapist. In practice, these phases may overlap, coincide, or repeat themselves over the course of minutes, weeks, or months. This chapter describes only those practices that are unique to the integrated approach.


Book Section




Barry Litt

Original Work Citation

Litt, B. (2007). The child as identified patient: Integrating contextual therapy and EMDR. In F. Shapiro, F. W. Kaslow, & L. Maxfield (Eds.), Handbook of EMDR and family therapy processes (pp. 306-324). Hoboken, NJ: John Wiley & Sons Inc



“The child as identified patient: Integrating contextual therapy and EMDR,” Francine Shapiro Library, accessed October 20, 2021,

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