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"Ghost in the Graveyard! Run, run run!" - Discovering hiding places by using the TCTS (1.5 CEs)


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 co-author Julie Cradock O’Leary reviewing 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.

Time will be allotted for a question and answer period regarding the cases presented, as well as using the TCTS with these age groups.


Julie Cradock O'Leary | Private Practice 


Julie Cradock O'Leary | Private Practice

Goals & Objectives 
  1. List the three defenses again shame, measured by the TCTS
  2. Describe how the TCTS can illustrate patterns of defense again shame and other uncomfortable emotions.
  3. Identify at least three administration and scoring issues to keep in mind when administering the TCTS for children.

Special considerations when using the TCTS with children and adolescents

Julie Cradock O’Leary | Private Practice

Using the TCTS to help sort out diagnostic questions in a combined Neuropsychological/Personality Collaborative/Therapeutic Assessment

Melinda Kulish | Harvard Medical School, Cambridge, MA

“Tell me why my child is bad” - Using the TCTS to foster increased emotional attunement in parents with difficult children

Tara McKelvy Parker | Private practice, Dallas

No Shame in Sight: When the TCTS helps in unexpected ways

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



Non-Member Price: $109
Member Price: $49