Evidence of Effectiveness
Growing Evidence for the Effectiveness of Child and Adolescent Psychotherapy
...there is now enough research evidence to claim that psychodynamic therapy is an evidence-based treatment with effect sizes similar to or superior to those reported for other psychotherapies…it is encouraging that the benefits of psychodynamic therapy not only endure after therapy ends, but increase with time. This suggests that insights gained during psychodynamic therapy may equip patients with psychological skills that grow stronger with use. (Harvard Medical School, 2010)
Several reviews over the past few years have provided useful summaries of research on the effectiveness of child and adolescent psychotherapy.
Kennedy (2004) carried out an independent Systematic Review of research into the effectiveness of psychoanalytic psychotherapy for children and young people, while Kennedy and Midgley (2007) conducted a Thematic Review. These have recently been updated by Midgley and Kennedy (2011) - see below.
The Systematic Review found that child psychotherapy was effective in treating children and young people with:
- anxiety and behaviour disorders
- personality disorders
- learning difficulties
- eating disorders
- developmental issues
It was also found to be effective in helping sexually abused girls, those who have suffered early emotional deprivation, and children with poorly controlled diabetes to manage their emotional responses to their illness. Significantly, the review found that improvements were sustained or even enhanced in the long-term, with adults who had been treated as children or adolescents still feeling the benefits of psychodynamic psychotherapy many years later. This finding, which has been labelled the ‘sleeper effect’ , was clearly demonstrated in a randomised control trial of severely depressed young people. In the study, 30 sessions of child psychotherapy plus parent work were shown to be highly effective. This led to child psychotherapy being recommended in the NICE Guidelines on childhood depression, as part of a stepped-care approach.
Thematic review of process and outcome research in child, adolescent and parent-infant psychotherapy
Kennedy and Midgley (2007) completed a thematic review examining process and outcome research in child, adolescent and parent-infant psychotherapy. This highlighted that child psychotherapists are widely engaged in research into the process of psychotherapy which has helped monitor and improve clinical practice and aided the development of client-focused services.
The research reflects three important types of questions
how does child psychotherapy work;
for whom does it work - which children and young people benefit with what kind of problems, and for how long do they need treatment; and
how psychotherapy can contribute to early intervention with parents and infants, to improve sensitivity of parenting and attachment security.
These findings, along with a wide variety of state-of-the-art research contributions, form the basis of Child Psychotherapy and Research: New Approaches, Emerging Findings (Midgley, N. et al. 2009).
Psychodynamic psychotherapy for children and adolescents: a critical review of the evidence base
Nick Midgley & Eilis Kennedy (2011)
This study provides a review of the research evaluating the efficacy and effectiveness of psychodynamic psychotherapy for children and adolescents, identifying 34 separate studies, including 9 randomized controlled trials (RCTs). Although many of the studies have limited sample sizes, the review argues that there is increasing evidence to suggest that psychoanalytic psychotherapy for this age group may be effective.
Midgely, N. and Kennedy, E. (2011) ‘Psychodynamic psychotherapy for children and adolescents: a critical review of the evidence base’, Journal of Child Psychotherapy 37(3), 232-60 doi: 10.1080/0075417X.2011.614738
An article in the February 2010 edition of Scientific American outlines new research which shows the movement to establish an evidence base for psychodynamic therapy has taken a huge step forward. Written by Raymond Levy and Stuart Ablon, the article "Talk Therapy: Off the Couch and into the Lab", reports the strongest evidence yet that psychodynamic psychotherapy works and keeps working long after the sessions stop.
The research the article refers to is Shedler’s (2010) ‘The efficacy of psychodynamic psychotherapy’, which contains a useful summary of some of the distinctive features of psychodynamic technique and a review of meta-analyses of psychodynamic psychotherapy.
Levy, R., Ablon, J. (2010) ‘Talk therapy: off the couch and into the lab’, Scientific American, Feb 23, 2010.
Shedler, J. (2010) ‘The efficacy of psychodynamic psychotherapy’, American Psychologist 65(2): 98-109 doi: 10.1037/a0018378