Self-Esteem and Social Adjustment in Depressed Youths: A Randomized Trial Comparing Psychodynamic Psychotherapy and Family Therapy

Kolaitis, Gerasimos; Giannakopoulos, George; Tomaras, Vlassis; Christogiorgos, Stelios; Pomini, Valeria; Layiou-Lignos, Effie; Tzavara, Chara; Rhode, Maria; Miles, Gillian; Joffe, Ilan; Trowell, Judith; Tsiantis, John

doi:10.1159/000358289

Cited by 10 publications

(5 citation statements)

References 8 publications

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“…In comparison to a systems integrative family therapy, the study found significant reductions in disorder rates for both groups [10], with good outcomes being maintained six months following the end of treatment. There was also an overall reduction in comorbid conditions for young people in both arms, including improvements in family functioning, self-esteem and social adjustment [11,12].…”

Section: Introductionmentioning

confidence: 97%

What contributes to good outcomes? The perspective of young people on short-term psychoanalytic psychotherapy for depressed adolescents

2021

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Depression is the fourth leading cause of adolescent illness and disability worldwide. A growing evidence base demonstrates that Short Term Psychoanalytic Psychotherapy [STPP] is an efficacious treatment for moderate to severe adolescent depression. However, with research in its infancy, key factors contributing to efficacy are unknown. Service users’ lived experiences provide valuable insight in this area. This study aimed to elucidate what adolescents value in treatment by inductively exploring lived experiences of STPP. Five adolescents with the largest reduction in depressive symptoms scores between baseline and end of treatment, who had taken part in a large-scale randomized controlled trial, were sampled. In-depth interviews carried out soon after the end of therapy were analysed using Interpretative Phenomenological Analysis. Three superordinate themes were identified: “Therapy as a Transformational Process”, “Explorative and Exposing: The Therapeutic Space” and “Being Heard and Working Together: The Therapeutic Relationship”. Adolescents valued a process of collaborative exploration with the therapist which when it was achieved was felt to facilitate a deep-rooted transformation in self-perception. Additionally, they described how an adjustment was needed to the particular frame of a psychoanalytic therapy. However, not all participants with a good treatment outcome experienced therapy in this way, suggesting a potential gap between the quantitative assessment of outcomes, and the way young people experience and understand the change process. Clinical implications and directions for research are discussed.

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Section: Introductionmentioning

confidence: 97%

What contributes to good outcomes? The perspective of young people on short-term psychoanalytic psychotherapy for depressed adolescents

2021

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“…Both treatments demonstrated reductions in the levels of depression by the end of treatment, with approximately three-quarters of all young people no longer clinically depressed (Trowell et al, 2007). Additional analyses of this data set demonstrated that children in both groups also improved in terms of co-morbid conditions, family functioning, self-esteem and social adjustment (Garoff et al, 2012;Kolaitis et al, 2014). In the psychodynamic group, there were no relapses in the 6 months following the end of treatment.…”

Section: Depressive Disordersmentioning

confidence: 83%

The Evidence-Base for Psychodynamic Psychotherapy With Children and Adolescents: A Narrative Synthesis

et al. 2021

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Despite a rich theoretical and clinical history, psychodynamic child and adolescent psychotherapy has been slow to engage in the empirical assessment of its effectiveness. This systematic review aims to provide a narrative synthesis of the evidence base for psychodynamic therapy with children and adolescents. Building on two earlier systematic reviews, which covered the period up to 2017, the current study involved two stages: an updated literature search, covering the period between January 2017 and May 2020, and a narrative synthesis of these new studies with those identified in the earlier reviews. The updated search identified 37 papers (28 distinct studies). When combined with papers identified in the earlier systematic reviews, this resulted in a combined total of 123 papers (82 distinct studies). The narrative synthesis of findings indicates that there is evidence of effectiveness for psychodynamic therapy in treating a wide range of mental health difficulties in children and adolescents. The evidence suggests this approach may be especially effective for internalizing disorders such as depression and anxiety, as well as in the treatment of emerging personality disorders and in the treatment of children who have experience of adversity. Both the quality and quantity of empirical papers in this field has increased over time. However, much of the research demonstrates a range of methodological limitations (small sample sizes, lack of control groups etc.), and only 22 studies were Randomized Controlled Trials. Further high-quality research is needed in order to better understand the effectiveness of psychodynamic psychotherapy for children and young people.

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“…When thinking about interventions to increase self‐esteem in adolescents, our results suggest that targeting emotional communication and improvement of attachment between family members may be particularly beneficial. These two techniques are also the cornerstones of certain forms of family therapy, which suggests that these forms of family therapy may be interesting avenues for further research aimed at improving self‐esteem in young persons (Diamond, 2014; Kolaitis et al, 2014). In addition, our results should be followed‐up in clinical samples, as our sample was taken from the general population.…”

Section: Discussionmentioning

confidence: 99%

Associations between childhood adversity, psychiatric symptoms, and self‐esteem outcomes in adolescents and young adults: An experience sampling study

Mazereel,

Vansteelandt,

Menne‐Lothmann

et al. 2023

J Clin Psychol

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ObjectivesSelf‐esteem and self‐esteem stability are important factors during adolescence and young adulthood that can be negatively impacted by childhood adversity and psychiatric symptoms. We examined whether childhood adversity and psychiatric symptoms are associated with decreased global self‐esteem as well as increased self‐esteem instability as measured with experience sampling method. In addition, we examined if childhood adversity moderates the association between psychiatric symptoms and self‐esteem outcomes.MethodsOur study consisted of 788 adolescents and young adults who were part of a twin pair. The twin structure was not of interest to the current study. Mean age was 16.8 (SD = 2.38, range: 14−25), 42% was male. We used a multilevel modeling approach to examine our hypotheses to account for the presence of twins in the data set.ResultsChildhood adversity and psychiatric symptoms were negatively associated with global self‐esteem (respectively standardized β = −.18, SE = 0.04, p < .0001 and standardized β = −.45, SE = 0.04, p < .0001), with a larger effect for psychiatric symptoms. Similarly, both were associated with increased self‐esteem instability (respectively standardized β = .076, SE = 0.025, p = .002 and standardized β = .11, SE = 0.021, p < .0001). In addition, interactions between childhood adversity and psychiatric symptoms on both global self‐esteem (standardized β = .06, SE = 0.01, p < .0001) and self‐esteem instability (standardized β = −.002, SE = 0.0006, p = .001) were found, showing that the negative association of psychiatric symptoms with self‐esteem outcomes is less pronounced in young people with higher levels of childhood adversity, or formulated differently, is more pronounced in young people with little or no exposure to childhood adversity.ConclusionGlobal self‐esteem and self‐esteem instability in young people are influenced by both current psychiatric symptomatology and exposure to childhood adversity. Those with more psychiatric symptoms show worse self‐esteem and higher self‐esteem instability, which is moderated by childhood adversity. For young people with high childhood adversity levels lower self‐esteem and higher self‐esteem instability are less influenced by reductions in psychiatric symptoms.

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Self-Esteem and Social Adjustment in Depressed Youths: A Randomized Trial Comparing Psychodynamic Psychotherapy and Family Therapy

Cited by 10 publications

References 8 publications

What contributes to good outcomes? The perspective of young people on short-term psychoanalytic psychotherapy for depressed adolescents

What contributes to good outcomes? The perspective of young people on short-term psychoanalytic psychotherapy for depressed adolescents

The Evidence-Base for Psychodynamic Psychotherapy With Children and Adolescents: A Narrative Synthesis

Associations between childhood adversity, psychiatric symptoms, and self‐esteem outcomes in adolescents and young adults: An experience sampling study

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