Revisiting 'What works for whom?' A qualitative framework for evaluating clinical effectiveness in child psychotherapy

This paper describes a framework for evaluating the effectiveness of child psychotherapy used by child psychotherapists in an inner city Child and Adolescent Mental Health Service (CAMHS). The Hopes and Expectations for Treatment Approach (HETA) involves using the assessment for psychotherapy that normally precedes treatment to derive a baseline from which to generate a set of hopes/expectations as regards the effects of the treatment on the part of parents and the psychotherapist, to be revisited one year after the start of the psychotherapy and/or at its completion. The Strength and Difficulties Questionnaire, for parents and schools, was also administered before and after the treatment. The characteristics of the first 30 children referred for psychotherapy over a particular time period are described. Of the first 15 children in this group to complete one year of individual psychotherapy, all showed change or significant change in the areas concerning parents' and therapists' hopes at the end-of-year review, as rated by parents and psychotherapists. A case of a child with conduct disorder is used to describe how the assessment generated a psychoanalytic formulation, how the therapist's understanding was fed back to the parents, and how the parents' and therapist's hopes and expectations were derived and recorded. This case illustrates powerfully the impact of trauma in the parents' backgrounds on the internal world of the child, and how the method provides a useful bridge between parent and child work. Feedback from the psychotherapists, the parents and the referrers using the framework is reviewed, and in conclusion the paper argues for the framework's value in promoting good practice in the treatment and management of complex cases and in enhancing awareness of the nature and scope of the psychotherapy process

Emotional life of autistic spectrum children: What do we want from child psychotherapy treatment?

This paper describes an ongoing evaluation of child psychotherapy with seven children with Autistic Spectrum Disorder (ASD). The assessment and evaluation model used involves parents and enhances shared understanding of each child's experience and characteristics, respecting individual strengths and limitations. Treatment aims include understanding the children's phenomenological experience and enhancing emotional regulation, to produce positive benefits for family life and the children's wellbeing. Common characteristics are identifiable despite differences between the children. Modifications in psychotherapy technique are illustrated with three cases. Nevertheless, the emerging phantasy life of these children shows commonalities with that of non-ASD children, further justifying the appropriateness of a psychoanalytic approach. The importance of these children's relationships with their psychotherapists and parents’ involvement in supporting the psychotherapy are stressed

A qualitative framework for evaluating clinical effectiveness in child psychotherapy: The Hopes and Expectations for Treatment Approach (HETA).

Child Psychotherapy and Research brings together some of the most exciting and innovative research activity taking place within psychoanalytic child psychotherapy today.Drawing on the expertise of an international range of contributors, this book describes work at the cutting edge of research in psychoanalytic child psychotherapy and related areas. It presents many of the emerging findings while also illustrating a whole range of methodologies - both quantitative and qualitative - that have been developed to investigate this field. The book examines the historical and philosophical background of child psychotherapy research and shows how research illuminates different clinical phenomena, the processes of psychotherapy, its evaluation and outcome.Recent developments in therapeutic work with children, including the increased focus on evidence-based practice, make research a much higher priority in the field than ever before. With this increasing significance, a whole new generation of clinicians are required to become familiar and competent with research methods and research literature. Child Psychotherapy and Research will be a vital resource for anyone involved in research and training related to psychotherapy and child mental health, as well as of great interest to a range of mental health professionals

Where the wild things are. Tantrums and behaviour problems in two under five boys.

Book Synopsis. This volume is the result of over twenty years of therapeutic interventions with families within the Tavistock Clinic's Under Fives Service. It describes in detail the process of understanding young children's communications and behaviour and the dynamics of family relationships within the consulting room in a lively, accessible style. It covers common themes in work with young children such as disruptive, angry behaviour, separation and sleep difficulties, and problems in the parent/couple relationship. This book is essential reading for all early years professionals hoping to gain a greater understanding of the technique, observational skills and theory which underlie a psychodynamic approach to work with the under fives