Parental reflective function and children’s attachment-based mental state talk as predictors of outcome in psychodynamic child psychotherapy.

Abstract

Mentalization, operationalized as reflective function, is defined as the capacity to understand behavior in terms of mental states. Mentalization can be self-focused (i.e., mentalizing that focuses on one’s own thoughts and feelings) or other-focused (i.e., mentalizing that focuses on others’ thoughts and feelings). Some studies in adult psychotherapy show the importance of patients’ mentalization capacity for treatment outcome; however, this has not yet been investigated in psychodynamic child psychotherapy. This study aimed to investigate whether baseline parental reflective function (PRF) and children’s mental state talk (MST) predicted changes in emotional and behavioral problems in psychodynamic child psychotherapy. The sample included 60 Turkish school-age children (Mage = 7.90, SD = 1.35, 43.3% girls) with internalizing (18.3%), externalizing (5%), and comorbid (56.7%) problems, and 20% of the children were in the nonclinical range. The mothers were interviewed using the Parent Development Interview, which was coded for PRF (self- and child-focused). Children were administered an attachment-based story stem task, coded for MST (self- and other-focused). The Brief Problem Monitor was administered every month over the course of treatment for a total of 366 sessions. Multilevel modeling analyses indicated that mothers’ child-focused PRF and children’s self-focused MST predicted changes in problem behaviors. Parents’ mentalization about their children and children’s mentalization about their own internal states could be predictors of treatment response in psychodynamic child psychotherapy.

Psychodynamic technique and therapeutic alliance in prediction of outcome in psychodynamic child psychotherapy.

“…Failure to maintain a strong alliance with parents/ caregivers can have serious implications for treatment continuation and early dropout. Moreover, in a recent study, using the same database of psychodynamic child psychotherapy, Halfon and Besiroglu (2020a) found that parents' reflective function about their child's mental states predicted a decrease in children's problem behaviors over the course of treatment. This is especially important given that we used parent-report problem assessment measures over the course of treatment, necessitating a level of awareness and the capacity to observe changes in problem behaviors on the parents' part.…”

“…This database is part of the same research program that was designed to investigate the baseline predictors and effective treatment factors associated with outcome in psychodynamic child psychotherapy. Subsamples of this data, with partial overlaps with the data used in the manuscript, have been used in prior research.Halfon and Besiroglu (2020a) focuses on baseline parental and child mentalization as predictors of the outcome of a cross-sectional sample of 60 children and 366 sessions from different phases of their treatment. Halfon, Coskun, et al (2020) investigates the characteristics of mental state talk of 100 children from story-stems collected before treatment.…”

Maternal Psychological Distress and Children’s Internalizing/Externalizing Problems during the COVID-19 Pandemic: The Moderating Role Played by Hypermentalization

“…In literature, not only RF in general, but also hypermentalization per se, already appeared to play a role in determining children’s psychological outcomes, even if in extremely adverse contexts. Specifically, maternal RF seems to moderate the relationship between being victim of sexual abuse and child internalizing difficulties in a study involving 64 children aged 2–12 [ 28 ], and hypermentalization resulted as a unique predictor of treatment response in terms of behavioural problems, after psychodynamic child psychotherapy [ 29 ]. Both RF impairments in general and hypermentalization per se have also been shown to be associated with psychological atypical functioning (e.g., [ 30 , 31 ]).…”

Session adherence to prototypical psychotherapy process as a correlate of outcome in a naturalistic study of child mentalization-informed psychodynamic play therapy.

“…After this session, the therapist presented a clinical formulation and a treatment plan. The standard treatment plan at the clinic involves weekly therapy sessions of 50 1 Subsamples of these data, with partial overlaps with the data used in the manuscript, have been used in prior research to investigate baseline mental state talk characteristics of children (Halfon, Cos kun, et al, 2020), mentalization as predictor of outcome (Halfon & Besiroglu, 2020b), psychodynamic technique and therapeutic alliance characteristics of the sessions (Halfon, 2021), affect expression characteristics using machine learning techniques (Halfon, Doyran, et al, 2020) and psychometric properties of collected measures (Halfon & Besiroglu, 2020a;Halfon, Çavdar, et al, 2020;Halfon, Özsoy, et al, 2020). minutes with the child along with monthly parent sessions.…”