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

Abstract

Introduction Psychodynamic psychotherapy with children and adolescents is an approach to working with young people that draws on psychoanalytic ideas, whilst also integrating ideas from other disciplines, including developmental psychology, attachment theory and neuroscience (Alvarez, 2012; Kegerreis & Midgley, 2014; Lanyardo & Horne, 2009). Although the term 'psychodynamic therapy' covers a range of approaches, most of them share what Kegerreis & Midgley (2014) refer to as "the central idea ... that behaviour, emotions and responses have an inherent logic and meaning-a way in which the child's problems, despite their apparent unhelpfulness, make some kind of emotional sense. Their roots lie in the internal world of the child that has been built up from his earliest experiences and relationships" (p.38) i. In 2011, we published a critical review of the evidence base for psychodynamic therapy with children and adolescents (Midgley & Kennedy, 2011). In that paper, we identified 34 studies, published before March 2011, which formally evaluated therapy outcomes for children aged 3-18. Of these studies, nine were randomised controlled trials (RCTs), three had a quasiexperimental design, eight were controlled observation studies and fourteen were observational studies without a control group. Psychodynamic therapy

Depressive and Anxious Adolescents: Do They Profit from Psychodynamic Therapy?

“…Psychodynamic therapy, which works with insight into conflicts and focuses on problems and stress in close relationships, is particularly suitable for these patients. In fact, psychodynamic therapy in adolescents has historically a long tradition (Freud, 1958) and is offered frequently (Midgley et al, 2017). Looking at research, however, it is surprising that there are only a limited number of studies that assess the efficacy of psychodynamic therapy in this age group.…”

“…Two recent reviews on the state of research still indicate a high demand for psychodynamic psychotherapy studies (Midgley & Kennedy, 2011;Midgley et al, 2017). The recent meta-analysis by Weisz et al (2017) summarizes 50 years of research in this area and includes 447 studies and 30,031 patients.…”

Development of Brazilian prototypes for child psychodynamic psychotherapy and cognitive-behavioral therapy

“…This study was designed to develop Brazilian psychodynamic psychotherapy (PDT) and cognitivebehavioral therapy (CBT) prototypes for children with internalizing disorders (ID) and externalizing disorders (ED). Over the last few years, an increasing body of evidence has been accumulating for the effectiveness of PDT and CBT for children with different symptoms, 1,2 reinforcing the relevance of these treatments. However, studies that focus on how psychotherapies promote change are scarce.…”

Mentalization in Child Psychodynamic Psychotherapy

“…Research on child and adolescent psychodynamic psychotherapy (PP) has made significant advances. Many studies have already demonstrated the effectiveness of this model of treatment and have demonstrated that the effects exceed those of maturation and spontaneous remission (Midgley et al ., ; Midgley & Kennedy, ; Palmer, Nascimento & Fonagy, ). However, the question arises as to what aspects of the treatment lead to the effectiveness of this theoretical model (Ablon, Levy & Katzenstein, ).…”

“…However, the question arises as to what aspects of the treatment lead to the effectiveness of this theoretical model (Ablon, Levy & Katzenstein, ). Understanding why and how changes happen as a result of a therapeutic intervention might help to identify the active components or mechanisms of change that underlie successful clinical interventions (Midgley et al ., ; Midgley & Kennedy, ).…”