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Children in psychodynamic psychotherapy: Changes in global functioning
The Erica Foundation, Sweden.
The Erica Foundation, Sweden.
2011 (English)In: Journal of Child Psychotherapy, ISSN 0075-417X, E-ISSN 1469-9370, Vol. 37, no 3, 261-279 p.Article in journal (Refereed) Published
Abstract [en]

This study was part of the Erica Process and Outcome Study. The aim was to investigate if children's global functioning improves after psychodynamic psychotherapy. Variables that may predict changes in global functioning were examined both statistically and qualitatively, for example, the child's age and gender; diagnosis and comorbidity; treatment variables. The sample consisted of 33 children (five to 10 years of age) who participated in psychodynamic psychotherapy with parallel work with parents. Twenty-nine children had at least one DSM-IV diagnosis, and 15 children had comorbid conditions. At the start of psychotherapy, the most frequent diagnoses were attention disorder and disruptive behaviour. Child psychotherapists rated the children's global functioning using CGAS and HCAM. Large effect sizes were obtained (d = 1.80 and d = 1.98). However, no statistical correlations were found between global functioning and the selected variables. In order to illuminate the complex connection between process and outcome the study was complemented with in-depth case studies where data were taken from questionnaires, completed by the child therapists every third month. Two child therapies were selected: one in which the therapist rated a large change and one in which a small change was rated (CGAS). The analysis showed that important individual change, for example, attainment of formulated goals, was not always reflected in the change rated using the CGAS. Findings suggest that psychodynamic child psychotherapy can be beneficial. However, further research is needed to identify factors that contribute to change in children's global functioning.

Place, publisher, year, edition, pages
2011. Vol. 37, no 3, 261-279 p.
Keyword [en]
CGAS, psychotherapy process, case study, outcome, treatment goals, intersubjectivity, EPOS
National Category
Pedagogy
Research subject
Education
Identifiers
URN: urn:nbn:se:su:diva-145475DOI: 10.1080/0075417x.2011.614744OAI: oai:DiVA.org:su-145475DiVA: diva2:1129658
Available from: 2017-08-05 Created: 2017-08-05 Last updated: 2017-08-28Bibliographically approved
In thesis
1. Möten i psykodynamisk barnpsykoterapi: Förväntningar, samspel och förändring
Open this publication in new window or tab >>Möten i psykodynamisk barnpsykoterapi: Förväntningar, samspel och förändring
2017 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Expectations, Interaction and Therapeutic Change in Psychodynamic Child Psychotherapy
Abstract [en]

This thesis aims to increase the knowledge of courses and processes of change prior to and during psychodynamic child psychotherapy with parallel parent contact. The dissertation examines parents’ and psychotherapists’ stated goals and expectations prior to the child’s psychotherapy, processes of change focusing on the psychotherapeutic encounter between child and psychotherapist, and outcome gauged by standardized measures compared to experienced change regarding the child’s problems. This dissertation also wants to examine different instruments for describing the psychotherapeutic process. Data was collected from systematic case studies, at different times during the course of psychotherapy, with material from different sources, such as child psychiatric assessment before and after conducted psychotherapy, questionnaires, and video taping of therapy sessions. By examining the therapeutic encounter from the perspectives of child, parent and psychotherapist, an image of psychotherapy, which illustrates the complexity of the psychotherapeutic process, was created. The thesis is based on three articles: Study I examines parents’ and psychotherapists’ goals and expectations prior to psychotherapy. Study II is a close study of a video-taped individual therapy, in which the interaction between child and therapist is examined with the rating instrument Child Psychotherapy Q-set (CPQ), the psychotherapist’s description of the psychotherapy’s process, and the self-rating instrument Feeling Word Checklist (FWC-24). Study III examines change in global functioning ability after child psychotherapy. By examining several psychotherapies in order to construct qualitative understanding of low and high change, respectively, in rated global functioning, limitations in the rating instrument Children’s Global Assessment Scale (CGAS) are analyzed. The results point to: 1. The need for a culture of cooperation between family and the one conducting the treatment, where goals are formulated together and in accordance with the family’s frame of reference and life experiences, which can increase the possibility of creating positive expectations, and of adapting treatment to the family in question. 2. Different methods of examining psychotherapy reflect and complete the image of the psychotherapy process. 3. The psychotherapy process’s complexity and the difficulty in describing the effect of therapy with simple measurements or remaining psychiatric symptoms. Positive change in several areas, such as the child experiencing increased independence, gets access to more positive affections, has improved self-esteem and a more optimistic idea of the future, could be described as psychological phenomena and can be difficult to encompass with narrow psychiatric terminology. 4. The intersubjectivity between child and psychotherapist appears essential. The therapist’s attitude and interventions are characterized by creating a steady therapeutic framework for exploring the child’s problems. 5.  The importance of the therapist’s meta-competence, i.e., overarching competencies that psychotherapists need to use to guide any intervention, what interventions to use, and when they are suitable. 

Place, publisher, year, edition, pages
Stockholm: Institutionen för pedagogik och didaktik, Stockholms universitet, 2017. 29 p.
Series
Doktorsavhandlingar från Institutionen för pedagogik och didaktik, 53
Keyword
Child psychotherapy, expectations, therapeutic alliance, common factors, psychotherapy process, outcome, case study, treatment goals, intersubjectivity, mixed-methods
National Category
Pedagogy
Research subject
Education
Identifiers
urn:nbn:se:su:diva-145474 (URN)978-91-7649-870-5 (ISBN)978-91-7649-871-2 (ISBN)
Public defence
2017-10-11, Stora hörsalen, Naturhistoriska riksmuseet, Frescativägen 40, Stockholm, 13:00 (Swedish)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 2: Submitted.

Available from: 2017-09-18 Created: 2017-08-28 Last updated: 2017-09-11Bibliographically approved

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