In summary:
- Tania Kalkidis, clinical psychologist, explains how moving from symptom management to uncovering the unconscious mind can reduce clinical tension for both psychologists and their clients.
- Drawing on modern psychodynamic theory, this approach explores how repressed childhood experiences and unmet emotional needs can manifest as present-day behavioral conflicts.
- Psychologists can layer tools like art therapy, symbol work and role play onto existing frameworks to gain a broader context of a child or adolescent’s inner world.
- Explore these techniques in an upcoming two-part APS webinar; registrations close at 4pm on Friday, 17 April. APS members receive a discount.
Psychodynamic techniques can offer versatile entry points into the child and adolescent mind. Consider how to integrate these unconscious-focused tools into your current frameworks to foster more durable therapeutic outcomes.
Many psychologists find themselves at a common crossroads: working with a struggling child or teenager while managing the high expectations of a parent desperate for results.
While reducing presenting symptoms is a standard goal, focusing solely on behavioural change can create a high-pressure environment that risks burnout for the practitioner and creates tension for the client.
According to clinical psychologist Tania Kalkidis MAPS, there is a more sustainable path.
For those psychologists who don’t already use this approach, integrating psychodynamic techniques can uncover unmet emotional needs and unconscious conflicts driving behaviour.
In an upcoming APS webinar, Kalkidis will talk about how to move from symptom management to uncover the root cause of behaviour.
The key, she says, is accessing the unconscious mind.
"This can be done quickly and easily through various techniques, though the answers may take time to emerge – and that's okay."
Delving deeper into psychodynamic therapy
As a psychodynamic therapist, Kalkidis believes many struggles trace back to unmet emotional needs in early life.
Most psychologists would recall that Freud posited that problems in behaviour, emotion and relationships stem from unconscious conflicts – between primal urges (id), rational thought (ego) and moral standards (superego) – often stemming from adverse childhood experiences.
The field of psychoanalysis and psychodynamic therapy has evolved significantly since Freud's time. Contemporary psychodynamic therapy is shorter in duration and frequency and focuses on how past patterns and problems echo through present relationships (including between therapist and client).
Psychodynamic therapy – which is an evidence-based therapy with efficacy equivalent to or better than 'gold-standard' treatment such as CBT – still places weight on making the unconscious conscious, allowing the client to process and resolve their internal conflicts.
However, many psychologists remain unfamiliar with or avoid it, believing psychodynamic therapy to be to lengthy or difficult to practice, says Kalkidis
Accessing the subconscious
In her upcoming webinar, Kalkidis shares psychodynamic therapy techniques that psychologists can layer onto their existing practice tools to gain a broader context of their child or adolescent client's mind and understand their unconscious drives.
For example:
Using techniques from art therapy
Incorporating elements of art therapy into psychodynamic therapy is ideal for young children who naturally love to play and draw, says Kalkidis. Certain creative techniques can offer a clear window into the unconscious mind.
She shares a simple method: ask them to draw both a good and bad dream, then use open-ended prompts to ask what happens next until the story ends.
"Some children will just keep talking, so you end up with two very long storylines. It open the door to the unconscious; everything is right there."
To keep a child from feeling defensive or self-conscious, Kalkidis suggests framing the dream as someone else's.
Integrating play
Play therapy is spontaneous. Dolls' houses, toy kitchens and trains, for example, invite young children to dive in freely, while older kids or teens may prefer using clay or drawing.
"Watch how easily they play, what themes emerge – food shopping, for instance, can suggest not feeling 'fed' emotionally – and how much they engage with you," says Kalkidis. "Everything reflects their inner world. As I get to know the child, I start forming hypotheses and, eventually, interpretations."
Crafting stories
Stimulus cards, story prompts and third-person narratives can help wary or self-conscious children and teens tell their stories in a safe way, says Kalkidis.
"I hand them a deck of around 20 picture or word cards and ask them to pick the ones they like or that speak to them. These simple access points spark conversation and help build relational trust."
Symbol work
Symbol work suits children, teens and adults, helping them create a visual picture of how they see their family, says Kalkidis.
"I'll ask them to pick an object for each family member. Then I use Socratic questions – 'What's that? Tell me about the lion. What made you think of the lion when you thought of Dad?' – and their answers lead to more questions."
Next, she asks them to arrange the symbols by closeness.
"I might say, 'Mum and Dad are far apart, is that right? It looks like you feel closer to Dad than Mum?' They may agree or adjust. Then I ask, 'How would you like it to be?' Often, they pull the symbols closer together."
Kalkidis adds that Gestalt techniques – experiential methods that heighten present-moment awareness, such as the empty chair dialogue, body language exaggeration, role-playing and dreamwork – can deepen this work by inviting children to inhabit the symbols.
"Ask them to imagine being the lion. A teen [who is feeling depressed], for instance, might reconnect with the creative, strong and capable part of themselves. It gives them hope – and it gives me another way in."
Talking about their interests
Adolescents often shut down, making creative therapy less effective. That's when it helps to reach their unconscious through their own interests such as music, social media or gaming, says Kalkidis.
"The key is patience; building rapport with a teenager takes time."
She suggests joining them in whatever captures their attention.
"If they're on their phone, ask what's on their feed; the algorithm opens another door, which leads to more questions. If it's music or gaming, ask what they like and why. You're drilling down; every answer opens another question."
Role play
Role play is a powerful tool that helps children and adolescents build confidence in handling demanding or disengaged parents – or explore what it feels like to be a stuck, blocked adolescent.
"Role play helps clients manage resistance, defensiveness and anxiety," says Kalkidis. "It's also a way to normalise their feelings, which can be deeply validating – and for me to better understand them."
Easing the pressure
Psychodynamic theory turns everything into data for deeper understanding, says Kalkidis – from a client's clothes and body language, to where they sit in the waiting room, and whether or not they engage.
Viewing resistance as meaningful rather than problematic can be freeing for psychologists, she says.
"It can be a complete change in mindset. We don't need to push or panic. Adolescents and children generally don't talk much and that's fine; I sit calmly in the silence.
"We're building a trusting relationship that helps us understand them over time. Without that tension, it's easier to see them in a more positive light too."
She stresses that psychodynamic theory doesn't have to replace existing practice but often enhance it.
"It helps you support people in deeper, more lasting ways.”
Learn more from Kalkidis in this two-part webinar on psychodynamic psychotherapy for children, adolescents and families. Registrations close at 4pm on Friday 17th April, so don't miss your spot. Register now. APS members can access this learning at a discounted rate.