The Lausanne Trilogue Play within the outcome evaluation in infant mental health: a preliminary report

Abstract

This study aims to contribute to the scientific debate about the evaluation of the intervention in infant mental health and presents the main results after one year of intervention based on integrated types of treatments (psychodynamic psychotherapy for the child/adolescent, parental support and observation and assessment of family interactions). Furthermore, the study aims to explore the use of the Lausanne Trilogue Play (LTP) as a new assessment tool for planning the of treatments. The sample consists of 23 children and adolescents, aged between 4 and 17 years old, and their families, attending the Infancy, Adolescence and Family Service, Local Health Unit 16 of Padua due to their psychopathological problems. In order to assess their psychological conditions we used the Child Behavior Checklist (CBCL) to evaluate psycho-behavioral problems and the LTP to assess family interactions. The CBCL was used at the time of the diagnostic assessment (T0) and after 12 months of treatment (T12). Concerning the application of LTP, the sample was divided randomly in two groups: one where LTP was used in two different time intervals during therapy (T0 and T12) and another one where it was used in three different time intervals during therapy (T0, T6 and T12) with a video-feedback intervention at time T6. Results report a favorable outcome in regards of the gravity of patients' symptoms, displaying, after one year of treatment, a statistical significant decrease in the clinical level of internalizing symptoms. In terms of family interactions, results show stability within the family patterns except for a statistically significant deterioration in the management of interactive mistakes. Regarding the use of LTP as evaluator of the above intervention, the study shows that the assessment of family's interactions during long-term psychotherapy helps clinicians focus the intervention on those aspects that remain dysfunctional. These results and the possible interpretations, however, emphasize the need for further studies on this topic.

Psychodynamic psychotherapy for children and adolescents: an updated narrative review of the evidence base

“…A recent observational study was published which reported on the outcomes of 23 children and adolescents, who received weekly psychodynamic psychotherapy, and their parents received fortnightly support sessions alongside their child's therapy (Gatta, Sisti, Sudati, Miscioscia, & Simonelli, 2016). After one year of treatment, a statistically significant reduction in internalizing symptoms was found.…”

Effectiveness of Brief Psychodynamic Therapy With Children and Adolescents: An Outcome Study

“…The present project (approved by the local ethical committee-CEP 204 SC) was based on the above-mentioned premises, giving important consideration to the family household during the process of a patient's referral into the Service. The therapeutic approach involving the parents in the treatment considers the family as a structured subsystem and a composite set of different functions and roles, amongst which the roles of parenting, co-parenting, etc (35,36).…”

Triadic Interactions in Families of Adolescents with Anorexia Nervosa and Families of Adolescents with Internalizing Disorders

“…Nevertheless a recent study (Gatta et al, 2016b), aiming to examine the usefulness of the LTP as an outcome measure, found that the LTP assessment of the family interactions might help clinicians to focus on the dysfunctional familial dynamics, thus improving the effectiveness of a video-feedback intervention with the families of children and adolescents with psychiatric disorders (i.e., significantly reducing internalizing symptoms).…”