The State of the Evidence Base for Psychodynamic Psychotherapy for Children and Adolescents

Abstract

This paper reviews the outcomes of psychodynamic psychotherapy (PP) for children and adolescents reported in papers identified by a comprehensive review of the literature on treatment evaluations of psychological and medical interventions for mental disorders in pediatric populations. The review identified 48 reports based on 33 studies. Reports were individually evaluated in terms of methodological rigor.Randomized trials, quasi-experimental and observational studies are considered separately. RCTs were independently rated on a 25-item scale of methodological strengths. Although a small number of studies with findings indicating beneficial effects of PP for pediatric mental disorder were identified, the review found no compelling evidence from RCT data supporting the use of PP as an individually delivered psychological therapy. In almost all the studies, when contrasted with family-based interventions, PP fares no better and appears to produce outcomes with some delay relative to family-based therapies. While the review shows PP to be an effective treatment, it is clearly understudied and its treatment principles may be most efficaciously delivered in non-traditional contexts such as parent-child or family therapy. Further rigorous evaluations are needed but evidence to date suggests that the context in which PP is delivered should be extended from the traditional context of individual therapy.2

Interaction Structures in the Psychodynamic Psychotherapy of a Girl Diagnosed with Adjustment Disorder

“…Just as a mother tries to understand and respond to her infant's emotions and needs, so too must the therapist try to address the patient's demands and troubles. In this sense, Palmer et al (2013) state that much of what they had noted as "nontraditional applications of psychoanalytic therapy may actually end up as the most commonly used methods for delivering these therapeutic ideas. And why not?"…”

“…It is important to note that the symptoms that led Alice to be referred for therapy included somatization, and that she was still mourning the loss of her father. When working with children, therapeutic characteristics such as affective involvement, an impartial approach, and attunement of language and affect may be needed to a greater extent than when treating adults (Goodman, 2015;Palmer, Nascimento, & Fonagy, 2013).…”

Interaction structures in the psychodynamic therapy of a boy diagnosed with Asperger’s disorder: a single-case study

“…On the other hand, research examining the efficacy and effectiveness of child psychodynamic psychotherapy lagged behind, although some recent publications have been showing a growing interest in this field (Deakin & Nunes, 2008;Goodman & Athey-Lloyd, 2011;Kennedy & Midgley, 2007;Midgley & Kennedy, 2011;Midgley, Anderson, Grainger, Vuckovic-Nesic, & Urwin, 2009;Palmer, Nascimento & Fonagy, 2013). In addition, although there is an increase of studies on child psychodynamic psychotherapy, indicating an evidence base on the effectiveness and efficacy of this psychotherapeutic modality, the need for more research in this field remains, especially considering that the therapeutic process is still poorly understood.…”

“…Based on these assumptions, psychodynamic therapists continue to apply this approach in the treatment of the disorder, reporting good results (Bromfield, 2000;Fonseca, 2009;Goodman & Athey-Lloyd, 2011;Olesker, 1999;Pozzi, 2003;Shuttleworth, 1999;Topel & Lachmann, 2008). Shuttleworth (1999) has suggested that children with Asperger's disorder share some similarities with adults with narcissistic personality disorder and can be subjected to psychoanalytic intervention.…”

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

“…In fact, considering the high rate of incidence of psychopathology in developmental age and according to the literature and international guidelines in infant mental health, it is becoming increasingly important to explore the theme of evaluation of treatment in order to understand what the most effective method of intervention (De Coro et al, 2010;Palmer, Nascimento & Fonagy, 2013;Leichsenring, Leweke, Klein & Steinert, 2015). In the last ten years we have seen a rapid increase of studies that deal with the effectiveness of the assessment in the context of interventions run during adulthood (Dazzi, 2006;Midgley & Kennedy, 2011;Lenzo, Gargano, Mucciardi, Lo Verso & Quattropani, 2014) while there are few similar studies focusing on developmental age (Palmer et al, 2013).…”