Adolescent Psychotherapy Research Articles

Clinical and Psychosocial Predictors of Suicide Attempts and Nonsuicidal Self-Injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT)

Clinical and Psychosocial Predictors of Suicide Attempts and Nonsuicidal Self-Injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT)

Clinical and Psychosocial Predictors of Suicide Attempts and Nonsuicidal Self-Injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT)

Clinical and Psychosocial Predictors of Suicide Attempts and Nonsuicidal Self-Injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT)

Clinical and Psychosocial Predictors of Suicide Attempts and Nonsuicidal Self-Injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT)

Clinical and Psychosocial Predictors of Suicide Attempts and Nonsuicidal Self-Injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT)

Psychodynamic psychotherapy for children and adolescents: a critical review of the evidence base

For many years psychoanalytic and psychodynamic therapies have been considered to lack a credible evidence-base and have consistently failed to appear in lists of ‘empirically supported treatments’. This study systematically reviews the research evaluating the efficacy and effectiveness of psychodynamic psychotherapy for children and young people. The researchers identified 34 separate studies that met criteria for inclusion, including nine randomised controlled trials. While many of the studies reported are limited by sample size and lack of control groups, the review indicates that there is increasing evidence to suggest the effectiveness of psychoanalytic psychotherapy for children and adolescents. The article aims to provide as complete a picture as possible of the existing evidence base, thereby enabling more refined questions to be asked regarding the nature of the current evidence and gaps requiring further exploration.

The psychotherapy process with adolescents: a first pilot study and preliminary comparisons between different therapeutic modalities using the Adolescent Psychotherapy Q-Set

An innovative methodology is presented for describing the therapeutic processes involved in five types of adolescent treatments: psychoanalysis, psychodynamic psychotherapy, cognitive-behavioural therapy, mentalisation-based treatment and interpersonal psychotherapy. Using the Adolescent Psychotherapy Q-Set (APQ), 18 experienced clinicians representing these different orientations were asked to rate their ‘actual’ and ‘typical’ practice as well as give feedback on the quality of the initial face validity of the APQ items. The results suggested that this new measure can be considered a meaningful tool for describing the adolescent psychotherapy process, and that it can help us identify some interesting patterns relating to it, as well as certain similarities and differences between different therapeutic approaches.

More Than 70% Delivered by Other Methods

What I missed in the article was any mention of the fact that in the outpatient setting, more than 70% of psychotherapy for children and adolescents is delivered by other methods, such as psychoanalytic and psychodynamic methods, rather than behavioral therapy alone. I would consider including these approaches as scientifically respectable, since psychoanalysis has been dealing with the theory and treatment of obsessive-compulsive disorders for more than 100 years. With regard to the present day it is worth mentioning that concerning psychodynamic therapies a discussion draft for a psychoanalytic guideline has been available since 2007 (Zeitschrift fur “Analytische Kinder- und Jugendlichenpsychotherapie,” issue 134, 2/2007).

Wirksamkeit von Psychotherapie im Kindes- und Jugendalter

Psychotherapeutic interventions require empirical as well as scientific assessment. Specifically, the proven efficacy of psychotherapy for children and adolescents is essential. Thus, studies examining treatment efficacy and meta-analyses are necessary to compare effect sizes of individual therapeutic interventions between treatment groups and waiting control groups. Assessment of 138 primary studies from 1993-2009 documented the efficacy of psychotherapy for children and adolescents. Furthermore, behavioural therapy outperformed non-behavioural interventions, as 90% of behavioural interventions showed larger effect sizes compared to non-behavioural psychotherapy. Analysis of moderator variables demonstrated an improved treatment efficacy for individual therapy, inclusion of the family, treatment of internalised disorders, and in clinical samples. Stability of psychotherapeutic treatment effects over time was demonstrated.

Wie spezifisch ist evidenzbasierte Kinder- und Jugendlichenpsychotherapie?

Evidence-based psychotherapy (EBP) proposes the fit between a specific treatment, therapist, patient and mental disorder. At the same time, the generalization of psychotherapy research findings is intended. In this conflict between individualized and standardized treatment the search for specific active components of psychotherapy is essential to improve intervention methods as well as training of therapists. Many manualized treatments for children and adolescents are considered evidence-based, proven by its outcome. However, their active ingredients often remain unclear. The following methods to identify necessary active components for successful treatments are described: classical comparative randomized controlled trials, dismantling studies, add-on studies, meta-analyses, and the multiphase optimization strategy. Consequences for the future agenda for child and adolescent psychotherapy research are discussed.

Electronic and Traditional Ways of Communicating and Not Communicating in Adolescent Psychotherapy

Using electronic media during adolescent psychotherapy sessions allows a patient to communicate particular information, to communicate in a certain way, not to communicate in another way, or not to communicate at all. Use of electronic media is not the only way to accomplish these kinds of communications, which also occur without electronic communication. The case presented in this paper illustrates forms of communication—including electronic communication—that are intermediate between communing with oneself, as in private thoughts or in writing in a journal, and sharing thoughts with another person, as in conversation. The case is of a girl with experiences of loss and a tendency to alexithymia (trouble expressing feelings with words). After the case presentation, I will offer some thoughts of Winnicott's to give a conceptual framework for the discussion.

Psychoanalytische Therapien mit Jugendlichen: Diagnostische Unsicherheiten, Behandlungsprobleme, Qualitätssicherung

Psychoanalytic treatment of adolescents has a long tradition and is currently one of the most frequent treatments in this age group. However, not many studies document the efficacy of psychoanalytic treatments of adolescents. This article analyses the background of this deficit by focusing on recent changes in symptomatology, the widespread diagnostic insecurity and the special challenges, which such treatment demands of the therapist. The task of researching the efficacy of adolescent psychotherapy is of considerable complexity. Recent own studies about efficacy of adolescent therapy will be presented. The evidence suggests that different approaches in therapy (psychoanalytic vs. psychodynamic) are of similar efficacy. However, long-term treatments ensure a consolidation of symptom reduction. The inclusion of different perspectives (adolescent, parents, therapist) and work with parents may be effective.

A psychoanalytic perspective on hospital midwifery and birth

This paper looks at hospital midwifery and birth from a psychoanalytic perspective. It is an edited version of a dissertation written for a Masters Degree in Psychoanalytic Observational Studies, undertaken at the Northern School of Child and Adolescent Psychotherapy in Leeds. The paper uses observational material from four births to consider the emotional work of the midwife and the birthing experience.

Equine-facilitated psychotherapy for at-risk adolescents: The influence on self-image, self-control and trust

This article describes the theoretical-conceptual frame of equine-facilitated psychotherapy (EFP) for adolescents at-risk, the unique components of this intervention, and its implementation in an evaluation study. The study was conducted at a residential treatment facility for adolescents at-risk. We examined the outcomes of EFP on self-image, self-control, trust and general life satisfaction. Fourteen resident adolescents comprised the treatment group, and were compared with a matched group of 15 residents who did not receive EFP (control). The treatment comprised a weekly individual EFP session over a period of seven months. The study found a trend of positive change in all four research parameters within the treatment group. Additional indications of the intervention's positive influence were also found and are discussed.

Compassionate Confrontation Psychotherapy: Working with Gifted but Self-Destructive Adolescents in a Therapeutic Boarding School

Until bright, creative, and alienated adolescents learn to make reasonable decisions, they will not engage in proactive, constructive, and creative change. Grounded in principles of reality therapy and choice theory, compassionate confrontation psychotherapy (CCP) stresses the concepts of conscious choice and acceptance of responsibility for ones actions. CCP provides a unique therapeutic experience to induce change. Viewed from this pragmatic and humanistic perspective, the overuse of psychiatric diagnoses and psychopharmacologic treatments inadvertently relieve gifted adolescents from accepting accountability for their choices. Evidence of the success of CCP can be found in the high percentage of alumni of the John Dewey Academy who are admitted to and complete their educations at leading colleges and graduate schools. Further evidence is provided by their academic performances at those institutions of higher learning. Keywords: Adolescent psychotherapy, confrontation in psychotherapy, gifted adolescents, adolescent behavior disorders, CCP, alienated, Boarding School, Self-Destructive, Compassionate, gifted

El texto narrativo en la clínica psicoanalítica del síntoma de aprendizaje del lenguaje: un análisis estructural

<p style="text-align: justify;"><strong>Resumen</strong><br /> Este artículo presenta datos de uno de los estudios desarrollados en la tesis doctoral "El texto narrativo como intervención terapéutica en problemas del lenguaje escrito en la adolescencia: el análisis estructural del texto narrativo producido en psicoterapia de orientación psicoanalítica". Se demuestra a partir de este análisis la posibilidad de utilizar el texto narrativo como instrumento de intervención y medida de resultados en investigación en psicoterapia en la clínica del adolescente que trata síntomas en el aprendizaje del lenguaje escrito.</p><p style="text-align: justify;"><strong>Palabras clave:</strong> análisis estructural, narrativa, psicoterapia de orientación psicoanalítica.</p>

Principles of Therapeutic Management of Adolescents with Severe Psychopathology

Long term inpatient treatment is no longer generally available for adolescents, and young patients whose behavior would have resulted in hospitalization in the past are now by default treated in outpatient settings. In order for outpatient treatment to be successful, some key ingredients are necessary. These include genuine interest and commitment on part of the therapist and the ability to communicate these to the adolescent. In addition, some of what was available in the inpatient milieu needs to be recreated in the context of the therapy, the family, the school and the community. The author draws upon the principles of systems of care, multi-systemic therapy, and his own long experience treating adolescent patients in a variety of settings to illustrate the process of effective psychotherapy of adolescents with severe psychopathology. Keywords: Adolescents, psychotherapy, psychopathology, outpatient treatment, behavior disorders, inpatient, hospitalization, outpatient settings, milieu, multi-systemic therapy

Early patterns of symptom change signal remission with interpersonal psychotherapy for depressed adolescents

This study examined whether reductions in depression symptoms at different time points over the course of therapy predict remission for depressed adolescents treated with interpersonal psychotherapy (IPT-A) or treatment as usual (TAU) delivered in school-based health clinics. Participants were 63 adolescents (ages 12-18) drawn from a randomized controlled clinical trial examining the effectiveness of IPT-A Mufson et al. [2004; Archives of General Psychiatry 61:577-584]. Adolescents were randomized to receive IPT-A or TAU delivered by school-based mental health clinicians. Assessments were completed at baseline and weeks 4, 8, 12, and 16 (or at early termination) and included the Hamilton Rating Scale for Depression (HRSD; Hamilton [1967; British Journal of Social and Clinical Psychology 6:278-2962]). Receiver operating characteristic analysis was used to identify the time point and degree of reduction in HRSD that best predicted remission (HRSD <7) at the end of the trial (week 16). Week 4 was the best time point for classifying adolescents as likely to remit or not likely to remit for both IPT-A and TAU. A 16.2% reduction in HRSD from baseline represented the best combined sensitivity and specificity in predicting week 16 remission status for adolescents treated with IPT-A. A 24.4% reduction in depressive symptoms represented the best combined sensitivity and specificity in predicting remission status for TAU. These findings provide preliminary evidence of one early marker of remission with IPT-A. Replication with larger samples would suggest that depressed adolescents who have not demonstrated at least a 16.2% reduction in their depressive symptoms after 4 weeks of IPT-A may benefit from a change in the treatment plan.

A developmentally focussed time-limited psychodynamic psychotherapy for adolescents and young adults : origins and application

Résumé Cet article traite des processus qui sont en jeu dans l’articulation et l’évaluation d’un modèle de psychothérapie psychodynamique limitée dans le temps auprès des jeunes (TPP-A). À partir d’une thérapie centrée sur un aspect important de difficulté ou de perturbation développementale, et dans une période déterminée, TPP-A vise à aider le jeune à retrouver sa capacité d’affronter des défis développementaux, et/ou voir cette capacité renforcée. L’article élabore des aspects clés du modèle et présente un cas de figure.

Nonsuicidal Self-Injury as a Predictor of Suicidal Behavior in Depressed Adolescents

Nonsuicidal Self-Injury as a Predictor of Suicidal Behavior in Depressed Adolescents

School-Based Group Psychotherapy for At-Risk Adolescents

(2011). School-Based Group Psychotherapy for At-Risk Adolescents. International Journal of Group Psychotherapy: Vol. 61, The Village Well Revisited: Honoring Anne Alonso, pp. 311-317.

FC16-06 - Understanding pathways to therapeutic change through changes in self-representation in the treatment of adolescents and young adults

IntroductionProcesses that lead to normal development of the representations of self and others are also central to understanding processes of therapeutic change. These processes primarily manifest themselves through the dialectical interpersonal exchanges of gratification and frustration, of disruptions and repair that are central to the development of the self.ObjectivesTo evaluate the contribution of different attributes of interpersonal relationships to the development of the self and patients’ well-being during the course of psychotherapy of adolescents and young adults.AimsTo map the different paths to positive therapeutic gains in psychotherapy.Methods36 adolescents and young adults were evaluated during the course of 12-month intensive psychodynamic psychotherapy. Main outcome measures were changes in the Differentiation-Relatedness scores of mother, father, significant other, self and therapist and GAF scores.ResultsWe found that changes in the level of differentiation-relatedness in patients’ self-representation were primarily associated with changes in the level of differentiation-relatedness of their description of their therapist. A best-fit model indicated that beyond change in the patient's description of the therapist and of a self-designated significant other outside the family added significantly to the explained variance predicting change in self-representation. Exploratory structural equation modeling also suggested that patients’ growing recognition of the therapeutic relationship (measured by a more matured representation of the therapist) is associated with the patients’ overall level of clinical functioning.ConclusionsThese results add further support to the importance of the therapeutic relationship in building more differentiated and integrated representations of self and of significant others.