ASSESSING AND FACILITATING CHILDRENS' COGNITIVE-DEVELOPMENT
Developmental Therapy and Counseling Practice
Mary Bradford Ivey
Amherst, Massachusetts Public Schools
Allen E. Ivey
University of Massachusetts, Amherst
Abstract
This article presents practical implications for assessing child cognitive-development and then
facilitating developmental growth. The concepts of developmental therapy are presented as a
systematic framework to integrate neo-Piagetian developmental theory into the interview.
Specific ideas are presented for assessment, designing systematic questioning sequences to
facilitate children's cognitive development, and overall treatment planning. A case example of
treatment of a case of child abuse illustrates the concepts in action.
* Portions of this article were presented by the senior author at the Christa McAuliffe
Conference, "Exemplary Programs and Practices in Elementary Guidance" held at Virginia
Technical University, Blacksburg, Virginia, May 1988.
Counseling is a verbal occupation. Most early elementary children simply don't have the
words or concepts for our traditional theories and methods. This article presents a practical
system which integrates developmental theory directly into interview to structure a brief contact
with a child, a full interview, or for planning long-term treatment. The concepts are based in
microcounseling practice (Ivey, 1971; Ivey, 1988; Ivey, Ivey, and Simek-Downing, 1987) and
neo-Piagetian developmental theory (Ivey, 1986; Ivey and Gonçalves, 1988).
Developmental concepts have long been prominent in the counseling literature (e.g.
Blocher, 1966, 1980; Haring-Hidore, in press; Morrill, Oetting, & Hurst, 1974; Miller-Tiedeman
& Tiedeman, 1985; Mosher and Sprinthall, 1971; Van Hesteren & Zingle, 1977). Most
counselors and therapists consider themselves as developmentally-oriented. Eriksonian life-span
theory (1973); Kohlberg's moral development (1981); and Haley's family life cycle (1963) are
but three examples of important developmental orientations which have enriched our
understanding. However useful developmental theory may be, it tends to remain a general
theory useful for case conceptualization, but with little specifics on how to use and translate the
theory into direct clinical interviewing practice.
Developmental therapy should be distinquished from life-span orientations to
development, although there are elements in common.
Developmental therapy specifically addresses the sequence and process of development as it
occurs in the natural language of the interview. Developmental therapy shows how to identify
and assess varying cognitive-developmental levels (sensori-motor, concrete, formal, post-formal)
as they appear in the here and now of the clinical interview. Developmental therapy is an
extension or reinterpretation of Piaget's basic concepts, applying these concepts to adult
cognitive development as well as child development.
Developmental therapy has identified specific Piagetian-type sequences of cognitive
progression in the interviews of therapists as varying as Rogers and Perls (Ivey, 1986). Another,
more systematic way to describe the developmental process which competent therapists use is
cognitive-developmental progressions. For example, in the case of Mrs. Oak (Rogers, 1961),
Rogers first works at the sensori-motor level bringing out feelings, then a concrete example, and
finally helps the client organize formal patterns of thought. This same systematic learning
sequence has been observed in widely varying populations including elementary and secondary
classrooms (A. Ivey & M. Ivey, 1987; Brodhead, 1988), group guidance (M. Ivey & A. Ivey,
1987), in interviews with inpatient depressives (Rigazio-DiGilio, 1988), and in counselor
supervision (Carey, 1988).
In a sense, developmental therapy is not new; rather it shows how effective therapists and
counselors unconsciously have always used key developmental sequences in their practice.
Developmental therapy argues that it is more helpful to use developmental concepts and
sequences in interviewing with conscious intent. Counseling is a learning process which can
benefit from use of the Piagetian developmental metaphor. There is now clear evidence that this
learning sequence is measureable. Rigazio-DiGilio (1988) has examined the reliability of the
assessment process of developmental therapy. She found raters could classify the cognitivedevelopmental level of clients in the first 50-100 words of an interview with .90 reliability.
Rigazio-DiGilio (1988) also found that clients all could move predictably through a
structured interview talking about their issues at the four distinct cognitive-developmental levels.
If the interviewer conducts a careful assessment of client cognitive-developmental level and
provides a structured environment, it is possible to enable most clients to discuss their issues in a
sensori-motor fashion, in concretes, or in formal and post-formal language.
Tamase (1988) is just completing an interesting study in which he combines
developmental concepts of Erik Erikson with those of developmental therapy (also see, Ivey,
1986, p. 314-316). Tamase's model of Introspective Developmental Counseling is particularly
striking as it illustrates concrete ways in which Eriksonian theory can utilize specific questioning
techniques to enable clients to examine their own developmental progressions over the life span.
Thus, he combines life-span theory with elements of developmental therapy.
The remainder of this article will focus on pragmatics. Children use the same language
as adults, although in a less complex fashion. The developmental therapy paradigm provides
specific methods for helping us enter the child's more concrete and sensori-motor world,
understanding that world, and then, as appropriate, facilitating expansion and development to
formal cognition.
Assessing Developmental Level: Theory Into Practice
Developmental therapy (DT) is a re-interpretation of Piaget. While drawing on Piaget,
some concepts have been extended to make them more immediately accessable to direct
counseling practice. DT suggests that children and adolescents and adults all manifest ways of
making meaning about their lives which can be anchored in basic Piagetian constructs. A key
idea of DT is that the Piagetian developental concepts recycle themselves again and again
throughout the lives of children, adolescents, and adults. There is no end to development and
these concepts are directly relevant to effective counseling and therapy practice. The key words
and concepts of DT for assessment and developing treatment strategies are the familiar concepts
of sensori-motor, concrete operations, and formal operations. To these DT adds the concept of
dialectic/systemic which some Piagetians term "post-formal operations." This later dimension is
particularly important to the child counselor who must work with the total system of the family
and school if interventions are to be effective.
Preoperational: An important example of how DT adapts Piagetian constructs is the
word preoperational which traditionally speaks to a developmental stage around the ages of 4-7.
(For that type of cognition, DT substitutes the words "late sensori-motor"). DT states that most
clients, whether adults or children, come to us because they indeed are preoperational. They are
not able to operate on the problem effectively. Children come to the school counselor because
they are not able to operate effectively in school (behavior problems, academic difficulties), at
home (divorce, alcoholism), or on the playground (friendship problems, fighting). In each case
the child is not able to act effectively ("operate") in the classroom and thus is preoperational.
Adults or families may be described as preoperational when they are depressed, in conflict, or
unable to achieve desired cognitive or behavioral goals.
Four ways to assess developmental level: Clients, whether children or adults, tend to
discuss their preoperational issues or problems in varying ways. Figure 1 presents in summary
form the key dimensions of developmental assessment. Also presented are specific counseling
strategies which the counselor might use in a single interview or as part of a larger treatment
plan.
---------------------------------------------------------------------Figure 1
Four Levels of Developmental Assessment and Counseling Strategies
Clients talk about their problems and developmental concerns from four perspectives.
Younger children will generally discuss their problems at the sensori-motor or concrete level.
Some fifth and sixth graders may be expected to operate at the formal level. Relatively few
individuals (children or adults) will talk about their issues at the post-formal dialectic/systemic
level.
Many clients, both children and adults, will discuss their issues at two or more levels. The
task of the counselor is to assess the child's cognitive-developmental level(s) on the particular
problem being examined. Then, the counselor can institute developmentally-appropriate
interventions which can change as the child develops.
Sensori-Motor
(What are the elements of experience?):
Assessment: The child presents concerns in a random fashion, topic jumps frequently, and may
show examples of magical or irrational thinking. Child behavior will tend to follow the same
pattern with a short attention span and frequent body movement.
Treatment: The counselor needs to provide a firm structure for exploration, but simultaneously
needs to listen to random elements of conversation. Later this will permit clearer organization of
the problem. In terms of interviewing techniques listening skills, closed questions to provide
structuring, frequent paraphrasing and summarization are useful. Direction is provided as
needed. Example treatments may involve play therapy and games, use of an exercise room and
breathing instruction, and behavioral management programs.
Concrete Operations
(Searching for situational descriptions):
Assessment: Most children talk in very concrete terms. They may either say very little in
response to questions (early concrete) or they may talk endlessly with small details of their
experience (middle concrete). Late concrete thinking occurs when children can exhibit "if . . .,
then . . . " causal thinking. The parallel between the counseling word "concreteness" and
concrete operations should be apparent.
Treatment: With the quiet child, well-placed closed questions are necessary to bring out the
concrete data. With the more verbal child, "Could you give me a specific example?" is the
classic concrete opening. The counselor acts more as a coach, alternating between direct action
and structuring and careful listening. The child needs help in further organizing thought and
behavioral patterns. Behavioral techniques and Glasser's reality therapy are particularly helpful.
When dealing with problems in causal thinking, Adlerian logical consequences may be useful.
Formal Operations
(What patterns of thought and action may be discerned?):
Assessment: Particularly in the 5th or 6th grade, children will start to be able to discuss their
concerns from a formal operational frame of reference. They can talk about themselves, their
feelings, and sometimes even from the perspectives of others ("I think it was Jane's fault, but
Jane think it was me." or later "I guess I need to think about my friend's feelings." The child
who recognizes commonalities in repeating behaviors or thoughts is moving toward formal
thinking.
Treatment: In helping the child describe self or situations, we may ask "Is that a pattern?" or
"Does that happen in other situations?" If the child can see the underlying structural repetitions,
he or she is showing signs of formal thinking. The elementary counselor often has difficulty
here as the treatment requires us to operate more as a consultant and we need to place more
power in the hands of the child. Too many teachers and counselors stay at only the concrete
level with children. If children are to develop more complex formal thinking patterns, they
require challenge and encouragement leading them toward self-examination. Formal operational
theories of the self and the pattern mode of thinking abound and include Rogerian, cognitivebehavior, psychodynamic, and many others. A variety of self-oriented program such as selfesteem workshops, "me-kits," and others faciliate the examination of self and patterns of selfconsistency.
Dialectic/Systemic
(How did that develop in a system or how is all this integrated?):
Assessment: Most children and adults do not ordinarily make sense of their worlds from this
frame of reference. In children dialectic/ systemic thinking will manifest itself most clearly
when young women (usually in the upper grades) start talking seriously about sexism or minority
students recognize that their difficulties may be caused by a racist system. Here the child is
operating on systems of knowledge and is learning how he or she is affected by the environment.
The locus of control changes from the individual child or teacher to larger systemic concerns.
As counselors, we should be aware that family and classrooms are two important systems
affecting the child which need more consideration and analysis.
Treatment: Systems thinking is manifested in family counseling and in classroom consultation.
We also use systems orientations when we help children deal individually or in groups with
issues of racism, sexism, and handicapism. When we conduct a case conference with our
colleagues and the family, we are utilizing our dialectic/systemic skills. In terms of individual
work, when we ask children how they integrate their sensori-motor, concrete, and formal
experiences, we are moving toward the dialectic/systemic frame of reference.
---------------------------------------------------------------------The first task of the child counselor is to understand and define the preoperational block
or problem. We get at the preoperational issue by simply listening to the child or by asking an
open question such as "Could you tell me about what just happened on the playground/in the
classroom/with your family?" Our goal to understand the problem as the child makes sense or
meaning out of it. Through careful listening to the unique child, it becomes possible to assess
the cognitive-developmental level of the child. Then, the counselor can choose appropriate
intervention to match the cognitive-developmental level of the child.
It is critical to remember that the developmental assessment is not simple matching of
counseling procedures with an overall child developmental level. In one interview the child may
present as sensori-motor (crying just after a fight on the playground or describing random details
of difficulty with a teacher), concrete (giving us the linear details of the argument or what
happened in class), and sometimes even formal (thinking about how this was a repeating pattern
of behavior).
Most children present in a random sensori-motor fashion or talk about their issues in a
highly concrete way, but DT has observed that even kindergarten children are capable of a form
of formal operational thinking and that even the most mature adult at times returns to sensorimotor confusion and experience (e.g. the teacher who comes to a school counselor's office to talk
about difficulties with her or his own divorce). As such, the counselor can expect any child,
parent, or teacher to present their concerns at any developmental level.
Expanding Horizontal and Vertical Development
Once having assessed cognitive-developmental level, it is possible for us to choose
whether we wish to expand development horizontally or vertically. For example, counselors
expand horizontal development when they help the concrete child develop a more detailed
concrete description of the problem on the playground. It is does little good to try to move
vertically to formal operations until a solid concrete foundation has been established.
Vertical development may occur as we help concrete children see cause and effect
relations (late sensori-motor), and then the patterns they are repeating. However, let us not
forget that many children need to return to the more experiential and affective base of sensori-
motor counseling. The trend in some developmental models has been to focus on moving
vertically to higher levels of cognitive functioning in the mistaken belief that "higher is better."
Piaget clearly indicated that children must have an adequate developmental foundation before we
can expect them to move to more complex forms of thought.
Figure 1 lists techniques which exemplify child counseling at each of the four levels.
These techniques and theories and their sequencing are common to those who work effectively
with children. Our experience reveals that these counselors and teachers immediately recognize
their own work style when the developmental concepts are presented. Less effective or
beginning teachers and counselors can benefit from learning more systematically how learning
sequences can be presented in the classrom and in the guidance office.
When counseling adults, do not always expect clear formal thought. For example, in a
parent conference, it may do little good to talk about patterns of child behavior in a formal way
("Letti has difficulties with peers"). Rather, provide the parents with concrete information and
examples of behavior so that a clearer understanding of the problem is possible. Once a concrete
example is provided, understanding form of formal patterns comes more easily.
When we work with teachers as consultants or have a parent meeting, we often use the
dialectic/systemic forms of treatment. Child behavior does not occur in a vacuum. School
counselors and private child therapists often have their most effective interventions when they
work with the family system, the network of helping agencies in the community, and in helping
the teacher understand and work with the child daily.
As we view the above treatment alternatives, it can be seen that the child counselor needs
to be skilled in many perspectives. In one ten-minute contact with a fourth grader whose parents
have just separated, the counselor may need to use changing modes of listening and action. In
developing a treatment plan over a three-month period or more, the counselor needs to expand
development at all levels.
Specific Developmental Strategies to Facilitate Growth
DT also offers specific strategies to help counselors organize their child contacts in a
meaningful developmental sequence. Specific goals, questions, and techniques for expanding
client horizontal and vertical development in the interview may be found in Figure 2. A specific
set of questions have been found useful in helping children talk about their developmental blocks
and concerns. If we as counselors ask children certain types of questions, we are more likely to
obtain answers at specific developmental levels.
Rigazio-DiGilio (1988) tested a more elaborate eight level version of this questioning
sequence (Ivey, Rigazio-DiGilio, & Ivey, 1987) with adult clients to determine if indeed they
would respond as predicted to the varying interventions. She found that 89% of client responses
followed the predicted pattern. If a question or intervention is at a specific cognitivedevelopmental level, then it may be predicted that the client will respond at that level. Clinical
work with children and adolescents again and again reveals that it is possible to match specific
types of counseling leads which then facilitates different levels of talk about the problem.
Furthermore, when a child talks about a difficulty from two or more cognitive-developmental
levels, this itself seems to be helpful because the child is learning to take new perspectives on old
data.
---------------------------------------------------------------------Figure 2
Developmental Goals and Questioning Skills for Children
The following are examples of goals and specific questions which the counselor can use to: 1)
assess cognitive-developmental level of children; 2) expand the foundation of development
through extensive elaboration of the concepts at each level; or 3) move children to alternative
levels of thinking through changing the style of questioning.
Cognitive Assessment of Present Level:
Goal: Obtain child or client's story - aim for a minimum of 50 words. Use these data for
assessment of overall cognitive-developmental functioning on this particular issue or problem.
Example questioning skills: Could you tell me about what just happened on the playground/in
the classroom/with your family? Could you tell me what you'd like to talk about? In a short
time, it is possible to obtain a rough indication of level of cognitive-developmental functioning.
Sensori-motor
Goal: Elaboration of the problem in a random fashion with special emphasis on what was
seen/heard/felt.
We need to listen carefully to get the data out before we seek to organize the information in a
concrete sequence or formal pattern.
Example skills: What do/did you see? Hear? Feel? At issue is to draw out the random
elements of experience without the need for organization. Summarize paraphrase at end to
anchor in the feelings and images.
Concrete operations
Goal: A linear description of the event in the early stages with "If... then..." thinking
around causation as the later goal.
Example skills: Could you give me specific example? What happened? What happened next?
What did he/she do? What did he/she say? What happened before? What happened next?
Possibly: "If he/she did X, then what happened?" (Late concrete operations with emphasis on
causation.) Summarize data before moving on.
Formal operations
Goal: To talk about repeating patterns/situations.
Example skills: Does this happen in other situations? Is this a pattern? Does that happen a lot?
What were you saying to yourself when that happened? Have you felt like that in other
situations? Again summarize this level accurately before moving on.
Dialectic/systemic
Goal: To see how the child puts concepts together.
You may want to focus on action rather than thought. In a few rare cases you may wish to help
the child see how the situation evolved in a systemic context (e.g., sexism, racism). In family or
teacher consultation, the goal is to enable them not to blame the child, but to see the total context
of the problem.
Example skills: Begin by summarizing all that has been said so far in the session(s). How do
you put together/organize all that you told me? What one thing stands out for you most? What
did you learn? What might you want to do about it? (For older children, it may be possible for
them to discuss how their pattern of being evolved in their family of origin.) What rule did your
family operate under? With teachers or family members, "How is what is going on in
class/home related to the behavioral problem?," "How can we coordinate school and family for
the benefit of the child?"
---------------------------------------------------------------------Figure 2 indicates that the first task of the counselor is to assess the cognitive-developmental
level of the child. By either listening to the child's spontaneous conversation or by asking an
open question ("What's troubling you?" "What's happening?"), we can access the child's general
frame of thinking about the problem. This will enable us to place the child in one or more of the
four cognitive-developmental levels. At this point, we can match our interventions and treatment
style with the cognitive-developmental level of the child. A major interviewing question is
whether we should: a) match our questioning and intervention with the child's presenting
cognitive level; b) drop back a level (e.g., from concrete to sensori-motor) to develop a more
solid foundation; or c) help the child to a more complex form of cognition. Developmental
therapy argues that all of the above are useful at varying times in the session. DT also points out
the limitations of remaining only at one level (for example, with a concrete child). Staying at
one level can result in a repetitious counseling style which leads to little growth and change for
the child and to boredom and frustration for the counselor.
A comprehensive, developmentally-appropriate treatment plan is required for work with
any client, but especially with children. The following case example illustrates how concepts of
developmental therapy may be used to organize both interviews and longer-term issues in a
broad-based intervention program.
Issues of Abuse: Developmental Therapy Treatment Planning
In addition, to their value with normal concerns, DT and microskills have been useful in
bringing out and working with issues of past child abuse. Brassard, Germain, and Hart (1987)
provide a helpful overview and the many possible areas of psychological maltreatment which
children might experience ranging from sexual and physical abuse through economic deprivation
and racism. The framework of the case discussion below could be used for many different types
of abuse situations. (The case discussed below has been thoroughly disguised.)
The four levels of developmental therapy provide a framework for interventions. First in
each interview, whether with the child, parents, or with state workers, we find it helpful we
match our conversation with the changing cognitive developmental level of others. Secondly,
the developmental therapy model helps ensure that all levels of treatment are considered for the
child and the family. There is a need to expand sensori-motor experience, concrete skills and
action, abstract formal thought about repeating patterns, and action at the systemic level through
family and classroom intervention. Unless all four levels are working together in a unified plan,
change will be slowed.
The presenting problem was fighting on the playground. The "difficult child" was an
eight-year-old boy who was identified as primarily concrete in thinking, but moved often to
random sensori-motor expression. Typical verbalizations in the interview included "He hit me
first." followed by stubborn silence, then they might be followed by impulsive anger or by
attention-seeking behavior.
At first he had difficulty in trusting the counselor, but as the relationship developed, he
discussed his problems in the classroom in a random sensori-motor fashion. The first task of the
counselor was to increase the portion of the interview in concrete operations. Rather than
demanding clear concrete operational operational conversation, the counselor encouraged
random talk about a variety of issues, many of which had little to do with the problem at hand.
Rapport was gradually developed with the boy. He was particularly fond of the game
"Blockbusters" and while playing the game, he gradually moved from random talk to concrete
and specific examples of his difficulties on the classroom and on the playground. During the
first four 20-minute sessions, the counselor used the DT questioning sequence to facilitate the
boy's movement, but the emphasis was on expansion of concretes. Particularly important for
trust building was the identification of specific strengths and positives within the child.
The suspected problem of abuse was addressed in interview five. This session began
with a careful reconstruction of the presenting problem of fighting in the classroom and
playground. At the start of the discussion, his talk returned to defensive, random, angry
language typical of children who experience abuse. Listening and paraphrasing eventually
brought out a linear, concrete picture of the original presenting situation - a particularly violent
fight on the playground. The child presented a detailed concrete operational description of one
this specific instance of fighting. As with most early concrete children, the child often wandered
to other topics -mostly with concrete description, but with elements of sensori-motor and random
meaning making.
Through this discussion, it was important that the counselor maintain a focus on the
primary topic of fighting, but still maintain a solid foundation of trust. With this foundation, the
counselor turned the focus to sensori-motor functioning, but with a new perspective. In
summarized form, the exchange went as follows:
"What did you see just before you hit him? Can you see him now?"
"I see his red ugly face. He is panting and shouting."
"What are you feeling right now in your body?"
"My stomach feels queasy, like I want to throw up."
"Where have you had the same feeling before?"
"When my Dad came in drunk last week and threw the dog
against the wall and then he hit me."
The sequence to the discovery of abuse contained the following elements: 1) accepting
and listening to the random events of the argument and fight on the playground; 2) organizing
these events in a concrete, linear sequence; 3) returning to the sensori-motor level with an
emphasis on what is seen, heard, and felt coupled with a free association exercise based on the
expectation that that feeling occured in some other situation. Here the counselor expects a
pattern, but introduces conditions so that the child can bring out the information. We have found
that basing counseling more solidly on a sensori-motor and concrete foundation is particularly
important as we seek to understand the complexities of childhood cognitions.
For counseling, the next task was drawing out more of the sensori-motor images and
linear concretes of the abusive situation and then searching for patterns of how the abuse
repeated itself. Needless to say, an 8-year-old boy is not expected to draw together the patterns
at this time. It is here that the counselor broadened treatment plan to include a variety of social
agencies and school authorities.
The child was referred for individual treatment. In terms of treatment planning for the
therapist who worked with the child, developmental therapy suggests the importance of working
through emotional sensori-motor elements relating to the abuse. The child needs to learn to deal
with important emotional dimensions of abuse. The child also needs to develop concrete
behaviors and coping strategies to deal more effectively with the school. Similarly, in working
with the family, it is important to consider all four levels of intervention.
The counselor worked as a therapeutic supportive agent to help achieve agreed-on
therapeutic goals. Experience reveals that children cannot maintain long-term change unless
they have systemic support both individually and in the classroom. Thus, the counselor spent a
good deal of time in consultation with the boy's teacher and suggested a behavioral program to
facilitate classroom and playground controls. Group guidance activities were also organized in
the classroom to help generate a better peer group for the boy. Supportive individual guidance in
consultation with the case manager from youth services helped the boy maintain the important
relationship with the counselor. Contact with the referral therapist was maintained. The youth
services worker visited the home and initiated necessary legal and treatment steps.
No case of child abuse is simple. Experience reveals that referral to state agencies is not
enough. A comprehensive developmental plan is needed in which case workers, individual
therapists, and the school work together with the child and the family. As often happens, in the
long-term, the counselor ended up doing most of the direct work with the child, but maintained
supervision and consultation with the school psychiatrist. Fortunately youth services were able
to provide financial assistance and referral services leading to a more stable home situation.
A subsequent divorce resulted in a second set of counseling sessions with the boy, whose
behavior again regressed. But the foundation had been established for developmental growth
and an adapted developmental treatment plan similar to the one just described again proved
useful.
Summary
The developmental therapy model provides a baseline for
counselors to analyze the complexity of each child. Does this child (or parent or teacher) need to
talk about his or her problem at the sensori-motor, concrete, formal, or dialectic/systemic level?
What treatment plan and interview plan is most likely to be helpful? What is important here is
that an array of techniques and theories can be assembled to help children work through the
difficult issues they face. At the same time, normal developmental concerns may be facilitated
and understood via the developmental therapy model.
Counselors at the elementary school and those who work with children are often overcommitted people. Do they have time to assess cognitive-developmental level, expand thinking
at each level, and simultaneously work toward behavior change? Our clinical experience and
preliminary research findings indicate that this developmental model is useful and learning it
saves time in the long run. The assessment procedures bring a precision to counseling which
seems unique and enables practical integration of many theories thus enriching the possibilities
of facilitate child development.
These developmental concepts need not be used only in long-term treatment planning.
Once mastered, it is possible to use these ideas in brief contacts so common in work with
children. One does not have to conduct deep therapy to find developmental constructs useful in
the interview. Furthermore, the same theory and methods which are used with children can be
immediately applied successfully with adults such as in parent and teacher consultation.
It now seems possible to integrate a neo-Piagetian developmental framework into the
individual interview with children and with adults. Recent work has expanded the framework
into group counseling and into the consultation process (Ivey and Ivey, 1987). The
developmental model has proven effective with adult clinical patients as varying as agoraphobics
(Gonçalves, 1988) and inpatient depressives (Rigazio-DiGilio, 1988). As noted earlier, the
cognitive-developmental sequences may be observed in the work of many well-known therapists
and counselors, in classroom interactions, and in many varying types of instructional procedures.
Carey (1988) has recently expanded the model in his cognitive-developmental supervision
process. Research on the framework is in its infancy, but early work shows considerable
promise. It appears possible to integrate developmental constructs fully into the clinical
counseling interview at all levels of our practice, treatment and supervision. Furthermore, the
developmental therapy model seems to be compatible with existing theory and method.
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