Different perspectives in measuring processes in psychodynamic child psychotherapy

ABSTRACT

The aim of this study was to explore how different measurements can contribute to understanding processes of change in psychodynamic child psychotherapy. The Child Psychotherapy Q-Set (CPQ) was compared with the child psychotherapist’s description of the psychotherapy process, systematically collected every three months during therapy, and with the Feeling Word Checklist-24 (FWC-24) completed after each session. The aim was also to examine how these three different measurements together could describe change over time and how they were mirrored in the relationship between child and psychotherapist. The following questions were formulated: (1) What interaction structures can be identified with the CPQ? (2) How does the therapist describe the process in psychotherapy and how do therapists’ feelings appear using the FWC-24? (3) How do the different measurements enrich one another and contribute to the understanding of the psychotherapeutic process? (4) How can the therapy be described compared to a hypothetical psychodynamic child psychotherapy prototype session? A videotaped child psychotherapy was analysed in its entirety. The CPQ provided a picture of the psychotherapist’s and the child’s actions and interactions, which complemented the subjective image of the psychotherapist when filling out questionnaires and the FWC-24. Analyses of the interaction between the child and the psychotherapist indicated the importance of creating a supportive and secure environment to achieve a feeling of psychological closeness, before working with the child’s problems. The analysis of the therapy highlights the importance of the psychotherapist’s meta-competence, i.e., overarching competencies that psychotherapists need to use to guide any intervention, what interventions to use, and when they are suitable.

KEYWORDS:

• Child psychodynamic therapy
• Child Psychotherapy Q-Set
• interaction structures
• Feeling Word Checklist
• single case study
• process research

Acknowledgments

This study was supported by grants from Clas Groshinsky’s memorial foundation. The authors are most grateful to Mimmi Edgren for her work as a co-rater of the CPQ.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. A within-subjects multivariate analysis of variance (MANOVA) is conducted when an investigator wants to analyse whether there are significant differences among multiple variables (e.g., among the three prototype adherence scores) in the same sample (i.e., all the therapy sessions conducted). A pairwise statistical comparison is conducted when an investigator wants to analyse the result of a MANOVA more closely; specifically, whether there is a significant difference between two specific variables (e.g., PDT adherence and CBT adherence).

Additional information

Notes on contributors

Fredrik Odhammar

Fredrik Odhammar, Ph.D., is a licensed psychologist, licensed psychotherapist and specialist in clinical psychology. He is a teacher, supervisor and Director of Studies at the Erica Foundation in Stockholm, Sweden, an institute providing psychotherapy for children and adolescents, professional training at university level and research. In his own research he has special interest in clinical process and outcome in child psychotherapy. His previous publications have addressed goals set by children, parents and psychotherapists in psychodynamic child psychotherapy, and how therapy outcomes can be related to changes in global functioning.

Geoff Goodman

Geoff Goodman, Ph.D., is Associate Professor of Psychology in the Long Island University Clinical Psychology Doctoral Program, New York. He is also a licensed clinical and school psychologist with 26 years of experience in private practice in New York, treating children and adolescents as well as adults. He is certified by the American Board of Professional Psychology (ABPP) and is certified as both an adult and a child and adolescent psychoanalyst and Fellow of the International Psychoanalytical Association (FIPA). Goodman is also Chair of the Child, Adolescent, and Family Therapy Research (CAFTR) Special Interest Group of the Society for Psychotherapy Research.

Gunnar Carlberg

Gunnar Carlberg, Ph.D., former Professor at the Department of Education, Stockholm University and former Director of the Erica Foundation in Stockholm. He is a licensed psychologist and psychotherapist with various publications within psychodynamic developmental psychology and child and adolescent psychotherapy research.