Child Psychotherapy Research Research Articles

Use of a reference group in researching children’s views of psychotherapy in Malta

ABSTRACTThis paper explores the process and outcomes of a children’s reference group within the context of child psychotherapy research in residential care. The reference group was set up to consult children about the design of a research project which seeks to evoke, represent and understand children’s views of psychotherapy. No work to date has explored the experience of reference groups in the context of child psychotherapy in residential care in Malta. The paper contextualises the research within the literature on reference groups in child research, which identifies the potential of reference groups as a participative and co-reflexive activity which can inform research design. The paper critically examines the nature and conduct of the reference group by acknowledging the specific context of this work rather than assuming this is necessarily positive. It does so by specifying and evaluating the outcomes of the reference group in line with its aims. The paper draws on the recordings of the reference group meetings and reference group field notes taken by the researcher as key data which were thematically analysed. The main outcomes of the reference group include children’s contribution to the design of data collection methods especially in terms of not relying only on words during data collection. Children also identified key ethical issues from the point of view of young psychotherapy service users, especially in relation to issues of trust within a residential care context. Children also reviewed and appraised research information material. The reference group process drew from the researcher’s and participants’ contexts and contributed significantly to the researcher’s reflexive process especially in terms of acknowledging his power and positioning as an adult and his dual role as a practitioner/researcher.

Grounded Theory methods in child psychotherapy research

This article considers the place of qualitative research in psychoanalysis and child psychotherapy. It discusses why research methodology for many years occupied so small a place in these fields, and examines the cultural and social developments since the 1960s which have changed this situation, giving formal but also qualitative methods of research much greater significance. It reflects on the different pressures to develop explicit research methods which arise both from outside the psychoanalytic field, as a condition of its continued professional survival, and from within it, where its main aim is the development of fundamental psychoanalytic knowledge. It suggests that the conduct of mainly quantitative research into treatment outcomes is largely a response to these external pressures, whilst the main benefits to be gained from the development of qualitative research methods, such as Grounded Theory, are in facilitating the knowledge-generating capacities and achievements of child psychotherapists themselves. The paper describes Grounded Theory methods, and explains how they can be valuable in the recognition of hitherto unrecognised meanings and patterns as these are made visible in clinical practice. Finally, it briefly describes three examples of completed doctoral studies, all of which have added significantly to the knowledge-base of child psychotherapy, and which demonstrate how much can be accomplished using this method of research.

Storied images of psychotherapeutic change: approaching children's voices through drawings

Introduction: In the field of child psychotherapy research it is common to evaluate psychotherapeutic change through the perspective of adults, such as the child’s parents or designated therapist. Research that actively includes children’s perspectives of psychotherapy generally turn to verbal methods of gathering information, such as interviews. It is important, however, to take into account non-verbal resources that better facilitate expression among children. Aim: This article explores the use of drawings in order to better understand how children view psychotherapy and psychotherapeutic change. It aims to contribute to child and adolescent psychotherapy research by proposing a new methodology. Method: This study presents a single case analysis of the “before and after psychotherapy” drawing of an eight year-old boy who was sexually abused and successfully completed the psychotherapeutic process due to this experience. Data collection methods include soliciting a drawing and carrying out an in-depth interview, both of which were examined using thematic and visual narrative analysis. Results: Participant drawing provided crucial insight into the psychotherapy process, such as perceived changes in emotional states and personal growth and empowerment, all of which allowed the child to make sense of the abusive experience. Meanings that emerged when analyzing the drawing complement verbal narratives. Discussion: The implications of these results are discussed, highlighting the importance of non-traditional research methodologies that are sensitive to children’s developmental needs. Methodologies that consider the developmental characteristics of children allow them to express themselves fully, articulate their narratives and voices, and allow us to reach an understanding of their meanings of their psychotherapeutic processes.

Sense and sensibility in infant observation: a response to Margot Waddell

This response to Margot Waddell's paper welcomes its argument, and draws attention to a number of issues which it raises. One of these is the origin of the theory of container-contained relations, and the possible links between the work of Esther Bick and Wilfred Bion, in its development. A second issue is the relation between infant observation as a form of learning, and a method of research. It argues that infant observation has given rise to significant discoveries, and also that it makes a significant implicit contribution to clinical research in child psychotherapy. Finally the paper notes the distinctive sensibility nurtured by observational experience, and agrees with Waddell that the value of infant observation lies as much in this sphere as in more theoretical and empirical domains.

Clinical facts, turning points and complexity theory

In this paper, I explore how we might link ideas about clinical facts to current issues in child psychotherapy research. I consider what our understanding of clinical facts might contribute to our research methods and how our research methods might better represent the clinical facts. The paper introduces a selection of psychoanalytic writers' formulations of the concept and describes some of the debates about the shortcomings of the traditional style of case reporting. The importance of keeping emotional experience central in our research is discussed. I describe a research method that I believe has the potential to capture and describe some of the complicated processes of change in psychotherapy. This is the concept of the ‘turning point’ session. Introducing the paradigm of complexity theory, I briefly explore how we might think about and understand the relationship between processes revealed through detailed analysis of a single session and change over a longer period of therapy.

Investigação em psicoterapia com crianças: uma revisão

O objetivo deste estudo foi realizar uma revisão bibliográfica sobre as pesquisas mais recentes em psicoterapia com crianças, com ênfase na psicoterapia psicanalítica infantil. Procedeu-se à revisão de todos os trabalhos encontrados na consulta às publicações científicas indexadas de acesso on-line e aos livros-textos das áreas de avaliação de resultados de psicoterapia psicanalítica com crianças, avaliando e discutindo os aspectos metodológicos. Os resultados demonstraram que, apesar dos avanços alcançados, ainda existe uma escassez de pesquisas na área, principalmente no que diz respeito às pesquisas que comprovem a efetividade das psicoterapias de orientação psicanalítica com crianças. Por último, conclui-se que existe uma necessidade de desenvolver estudos com metodologias mais sofisticadas para avaliar os resultados de psicoterapia com crianças.

Hard science, thin air and unexpected guests: a pluralistic model of rationality, knowledge and conjecture in child psychotherapy research

Psychoanalysis and child psychotherapy have traditionally sought to describe their relationship to science in a variety of ways. As a consequence, different strands of the research programme are underpinned by divergent methodological and epistemic assumptions. The perceived incommensurability of these positions sometimes hinders the development of an integrated research programme. This paper examines possibilities for redescribing child psychotherapy research in terms of a broad and pluralistic framework where clinical, empirical, conceptual and interdisciplinary research are aspects of a dynamic whole, and where rationality emerges from discursive processes that take place not only within but between traditions of investigation. The potential merits of this redescription are discussed with reference to the truth status of psychoanalytic knowledge, the characteristics of the child psychotherapy research terrain, the role of metaphor in a creative research culture, and the nature of grounds for theory choice.

Research on Day Treatment Programs for Preschoolers With Disruptive Behavior Disorders

Research on Day Treatment Programs for Preschoolers With Disruptive Behavior Disorders

Outcomes for Children and Adolescents After Residential Treatment: A Review of Research from 1993 to 2003

The focus of this research review is to determine what factors increase the likelihood that positive individual and systemic changes occur for children and adolescents following discharge from residential treatment. Residential treatment outcome studies from 1993 to 2003 that fulfilled predetermined criteria were located through 4 on-line databases using key word combinations. The research selected was: (a) 7 studies that measured outcome immediately upon completion of treatment and discharge, and (b) 11 studies where outcome progress was assessed at one or more follow-up dates after discharge. Results showed that children and adolescents with severe emotional and behaviour disorders can benefit and sustain positive outcomes from residential treatment that is multi-modal, holistic and ecological in its approach. Similar to the clinical child psychotherapy research, conclusions must be tempered due to the limited number of studies and methodological weaknesses. Future considerations highlight how research results can more realistically reflect intervention effectiveness when elements of the ecological and systemic landscape of care are addressed.

Sailing between Scylla and Charybdis1: Incorporating qualitative approaches into child psychotherapy research

Starting from the acknowledged gap between research and practice in child psychotherapy, this paper offers an historical perspective on the relation between these two activities, and suggests that qualitative approaches to research may offer new ways of bringing them together. After introducing the fundamental concepts of qualitative analysis, three areas where qualitative forms of research may be useful to child psychotherapists are explored: relevant but non-psychotherapy research; accounts of therapy research; and therapy process research. Examples of all of these types of research are presented, and some of the challenges to incorporating qualitative approaches into child psychotherapy research are discussed.

The research agenda: the vital need for empirical research in child psychotherapy

Some possible reasons for the historical absence of psychoanalytic outcome research are examined, particularly the incompatibilities in the world view espoused by psychoanalysis and that of most of current science and the assumption of privileged knowledge on the part of many psychoanalysts and their training institutions. It is argued that the view that psychoanalysis offers an alternative epistemology to that of scientific research maintains psychoanalysis in its inferior position. The existing evidence for the effectiveness of adult psychoanalytic psychotherapy is reviewed and the relevance of these findings to child psychotherapy outlined. Finally the author proposes a research agenda for both child and adult psychotherapy and outlines the changes that psychotherapists will need to make if they are to implement this agenda. Certaines raisons qui expliqueraient l'absence historique de recherches sur les résultats des traitements psychanalytiques sont examinées dans cet article, notamment (i) l'incompatibilité entre la vision du monde adoptée par la psychanalyse et celle qui a cours dans la plupart des disciplines scientifiques et (ii) la conviction partagée par beaucoup de psychanalystes et par leurs instituts de formation selon laquelle ils détiennent une forme privilégiée de connaissance. D'après l'auteur, affirmer que la psychanalyse se détermine en fonction d'une épistémologie autre que celle de la recherche scientifique revient à l'enfermer dans une position d'infériorité. Les preuves existantes de l'efficacité de la psychothérapie psychanalytique chez l'adulte sont passées en revue et leur éventuelle pertinence par rapport à la psychothérapie de l'enfant est brièvement décrite. Après avoir proposé un protocole de recherche pour la psychothérapie aussi bien chez l'enfant que chez l'adulte, l'auteur conclut en indiquant les modifications que les psychothérapeutes devront adopter afin de mettre en œuvre ces propositions. L'articolo analizza alcuni dei possibili motivi storici che spiegherebbero l'assenza di ricerca empirica in campo psicoanalitico, in particolare le incompatibilita' nel modo di vedere il mondo tra la psicoanalisi e la maggior parte della scienza moderna, e l'assumere da parte di molti psicoanalisti e delle loro istituzioni di essere in possesso di una conoscenza esclusiva. Nell'articolo si discute del fatto che il modo di vedere della psicoanalisi come basata su un modello epistemologico alternativo a quello della ricerca scientifica, la releghi in una posizione inferiore. Nell'articolo viene passata in rassegna la letteratura esistente sull'efficacia della psicoterapia psicoanalitica per adulti ed evidenziata l'importanza di tali risultati per la psicoterapia infantile. Infine l'autore propone un programma di ricerca sia per la psicoterapia per adulti che per quella infantile ed evidenzia quali cambiamenti gli psicoterapeuti debbano adottare per implementare tale programma. Es werden einige mögliche Gründe für das geschichtliche Fehlen von psychoanalytischer Erfolgsforschung überprüft, besonders die Unvereinbarkeiten in der Weltanschauung , für die die Psychoanalyse eintritt und die der meisten gegenwärtigen Wissenschaft und der Behauptung eines privilegierten Wissens auf Seiten vieler Psychoanalytiker und ihrer Ausbildungsinstitutionen. Es wird argumentiert, dass die Ansicht, dass die Psychoanalyse eine alternative Epistemologie zu der wissenschaftlicher Forschung anbietet, die Psychoanalyse in einer untergeordneten Position hält. Der bestehende Beweis für die Wirksamkeit psychoanalytischer Psychotherapie für Erwachsene wird rezensiert und die Relevanz dieser Erkenntnisse für Kinderpsychotherapie herausgestellt. Zuletzt schlägt der Autor eine Forschungstagesordnung sowohl für Kinder- als auch Erwachsenenen psychotherapie vor und stellt die Veränderungen dar, die Psychotherapeuten machen werden müssen, wenn sie diese Tagesordnung implementieren.

Analysis of selected methodological issues in child psychotherapy research

(1995). Analysis of selected methodological issues in child psychotherapy research. Journal of Clinical Child Psychology: Vol. 24, No. 2, pp. 141-148.

A Review of Child Psychotherapy Research Since 1963

Reports on individual nonbehavioral child and adolescent psychotherapy since 1963 are reviewed. Inclusion criteria required some minimal contrasting group. Forty-three studies were assessed for basic methodological adequacy and main findings. The authors conclude that summary impressions from this body of literature cannot be made due to the magnitude of the flaws in basic psychotherapy research methodology. Suggestions are made regarding the future of child and adolescent psychotherapy research.

Psychoanalytic Psychotherapy with Children: Current Research Trends and Challenges

To advance the field of dynamic child psychotherapy research, a shift in emphasis from questions examining treatment outcome only, to those that address treatment process, is required. Child psychoanalytic psychotherapy provides a unique set of factors for assessing what occurs between analyst and child in the consulting room and for exploring the link between the inner life of the child and symptomatic behavior. Continued development of rigorous methods for collecting and evaluating clinical data is needed. Past and current efforts in this area are presented in the description of child psychoanalytic research projects.