To compile, review, and comment upon the application of psychotherapy to the treatment of psychiatric disorders first appearing in childhood and adolescence.
Method:
Representative research papers published over the past 4 decades on the subject of psychotherapy of children and adolescents were compiled. Selection for inclusion in this review was based upon salience to the subject of treatment of child psychiatric disorders. Special consideration was given to large-scale and metaanalytic studies, as well as to studies comparing psychotherapy with other forms of treatment.
Results:
There is mixed evidence for the efficacy of psychotherapy for child psychiatric disorders. There are few direct comparisons between treatment modalities in the child psychiatric literature. Methodological problems include a history of theoretical development of therapies without reference to current conceptions of mental illness, a paucity of direct comparisons among psychotherapies and between psychotherapy and other psychiatric treatments, inconsistent definition of psychotherapy from study to study, and inconsistency in stated outcome measures. In general, cognitive–behavioural therapies performed better in application to child psychiatric disorders than did insight-oriented therapies.
Conclusions:
Outcome research in child-oriented psychotherapy is still in its infancy. There are simply too few studies of many therapies and many conditions to draw firm conclusions about efficacy. More work is needed in matching discrete, consistently applied therapies to selected psychiatric pathologies. Questions regarding psychotherapy's potential application to prevention of mental illness and to management of distress surrounding mental illness (as distinct from treatment of the illness itself) remain to be answered.
HaworthMR. Child psychotherapy. New York: Basic Books; 1947.
2.
PaulGL. Outcome research in psychotherapy. Journal of Consulting Psychology1967;31:109–18.
3.
GarfieldSL. Evaluating the psychotherapies. Behavior Therapy1981; 12:295–307.
4.
WeiszJRWeissB.Assessing the effects of clinic-based psychotherapy with children and adolescents. J Consult Clin Psychol1989;57:741–6.
5.
KazdinAE. Psychotherapy for children and adolescents. In: BerginAEGarfieldSL, editors. Handbook of psychotherapy and behavior change. New York: J Wiley; 1994. p 543–94.
6.
WeiszJRWeissBDonenbergGR. The lab versus the clinic: Effects of child and adolescent psychotherapy. Am Psychol1992;47:1578–85.
7.
SteenbargerBN. Duration and outcome in psychotherapy: An integrative review. Prof Psychol Res Pract1994;25:111–9.
8.
LuborskyLCrits-CristophPMintsJAuerbachA.Who will benefit from psychotherapy? predicting therapeutic outcomes. New York: Basic Books; 1988.
WeiszJRWeissBHanSSGrangerDAMortonT.Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychol Bull1995;117:450–68.
11.
DurlakJALampmanCWellsACarmodyJ.The effectiveness of child psychotherapy: A meta-analytic review. Paper presented at the convention of the Midwestern Psychological Association; Chicago, IL; 1990.
12.
KazdinAE. Effectiveness of psychotherapy with children and adolescents. J Consult Clin Psychol1991;59:785–98.
13.
EysenckHJ. The effects of psychotherapy: An evaluation. Journal of Consulting Psychology1952;16:319–24.
14.
EysenckHJ. The effects of psychotherapy. In: EysenckHJ, editor. Handbook of abnormal psychology: An experimental approach. London: Pitman Medical Publishing; 1960.
15.
EysenckHJ. The effects of psychotherapy [with commentary]. New York: International Science Press; 1966.
16.
LevittEE. The results of psychotherapy with children: An evaluation. Journal of Consulting Psychology1957;21:189–96.
17.
LevittEE. Psychotherapy with children: A further evaluation. Behav Res Ther1963;60:326–9.
18.
SmithMLGlassGV. Meta-analysis of psychotherapy outcome studies. Am Psychol1977;32:752–60.
19.
CaseyRJBermanJS. The outcome of psychotherapy for children. Psychol Bull1985;98:388–400.
20.
HeinickeCMGoldmanA.Research on psychotherapy with children: A review and suggestions for further study. Am J Orthopsychiatry1960;30:483–94.
21.
JacobsonNSTruaxP.Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol1991;59:12–9.
22.
FreedheimDKRussSW. Psychotherapy with children. In: WalkerCERobertsMC, editors. Handbook of clinical child psychology. New York: J Wiley: 1992. p 765–81.
23.
WeiszJRWeissBAlickeMDKlotzML. Effectiveness of psychotherapy with children and adolescents: Meta-analytic findings for clinicians. J Consult Clin Psychol1987;55:542–9.
24.
ShirkSRRussellRL. A re-evaluation of estimates of child therapy effectiveness. J Am Acad Child Adolesc Psychiatry1992;31:703–10.
25.
BarnettRJDochertyJPFrommeltGM. A review of psychotherapy research since 1963. J Am Acad Child Adolesc Psychiatry1991;30:1–14.
26.
KazdinAE. Assessing the clinical or applied importance of behavior change through social validation. Behav Mod1977;1:427–52.
27.
WolfMM. Social validity: The case for subjective measurement or how applied behavior analysis is finding its heart. J Appl Behav Anal1978;11:203–14.
28.
KazdinAEWilsonGT. Evaluation of behavior therapy: Issues, evidence, and research strategies. Cambridge (MA): Ballinger; 1978.
29.
KendallPCNorton-FordJD. Therapy outcome research methods. In: KendallPCButcherJN, editors. Handbook of research methods in clinical psychology. New York: J Wiley; 1982. p 429–60.
30.
NietzelMTTrullTJ. Meta-analytic approaches to social comparisons: A method for measuring clinical significance. Behavior Assessment1988;10:146–59.
31.
MavissakalianM.Clinically significant improvement in agoraphobia research. Behav Res Ther1986;24:369–70.
32.
LuborskyLSingerBLuborskyL.Comparative studies of psychotherapies: Is it true that “everyone has won and all must have prizes”?Arch Gen Psychiatry1975;32:995–1007.
33.
BrownJ.A review of meta-analyses conducted on psychotherapy outcome research. Clin Psychol Rev1987;7:1–23.
34.
KazdinAEBassDAyersWARodgersA.Empirical and clinical focus of child and adolescent psychotherapy research. J Consult Clin Psychol1990;58:729–40.
35.
OffordDRBennettKJ. Conduct disorder: Long-term outcomes and intervention effectiveness. J Am Acad Child Adolesc Psychiatry1994;33:1069–78.
36.
KiriginKAWolfMMBraukmanCJFixsenDLPhillipsEL. Achievement Place: A preliminary outcome evaluation. In: StumphauzerJS, editor. Progress in behavior therapy with delinquents. Springfield, (IL): Charles C Thomas; 1979.
37.
BankLMarloweJHReidJBPattersonGRWeinrottMR. A comparative evaluation of parent-training interventions for families of chronic delinquents. J Abnorm Child Psychol1991;19:15–33.
38.
AlexanderJFParsonsBV. Functional family therapy. Monterey (CA): Brooks/Cole; 1982.
39.
FonagyPTargetM.The efficacy of psychoanalysis for children with disruptive disorders. J Am Acad Child Adolesc Psychiatry1994;33:44–5.
40.
HenggelerSWMeltonGBSmithLA. Family preservation using mutisystemic therapy: An effective alternative to incarcerating serious juvenile offenders. J Consult Clin Psychol1992;60:953–61.
41.
CampbellMCuevaJE. Psychopharmacology in child and adolescent psychiatry: A review of the past seven years: Part I. J Am Acad Child Adolesc Psychiatry1995;34:1124–32.
42.
BarkelyRA. Attention-deficit hyperactivity disorder. In: MashEJBarkelyRA, editors. Treatment of childhood disorders. New York: Guilford; 1989.
43.
CarlsonCLPelhamWEMilichR, and others. Single and combined effects of methylphenidate and behavior therapy on the classroom performance of children with attention deficit-hyperactivity disorder. J Abnorm Child Psychol1992;20:213–32.
44.
ButlerLMiiezitisSFriedmanRColeE.The effect of two school-based intervention programs on depressive symptoms in preadolescents. American Educational Research Journal1980;17:111–9.
45.
WeissGHechtmanLT. Hyperactive children grown up. New York: Guilford; 1986.
46.
ReynoldsWMCoatsKI. A comparison of cognitive-behavioral therapy and relaxation training for the treatment of depression in adolescents. J Consult Clin Psychol1986;54:653–60.
47.
RobinsonLABermanJSNeimeyerRA. Psychotherapy for the treatment of depression: A comprehensive review of controlled outcome research. Psychol Bull1990;108:30–49.
48.
MufsonLMoreauDWeissmanMMWickramaratnePMartinJSamoilovA.Modification of interpersonal psychotherapy with depressed adolescents (IPT-A): Phase I and II studies. J Am Acad Child Adolesc Psychiatry1994;33:695–705.
49.
ConteHRPlutchikRPicardSKarasuTBVaccaroE.Self-report measures as predictors of psychotherapy outcome. Compr Psychiatry1988;29:355–60.
50.
KendallPC. Treating anxiety disorders in children: Results of a randomized clinical trial. J Consult Clin Psychol1994;62:100–10.
51.
TargetMFonagyP.Efficacy of psychoanalysis for children with emotional disorders. J Am Acad Child Adolesc Psychiatry1994;33:361–71.
52.
van BalkomAJvan OppenPVermeulenAWvan DyckR.A meta-analysis on the treatment of obsessive compulsive disorder: A comparison of antidepressants, behavior, and cognitive therapy. Clin Psychol Rev1994;14:359–81.
53.
WeiszJRWeissBHanSS. Bridging the gap between laboratory and clinic in child and adolescent psychotherapy. J Consult Clin Psychol1995;63:688–701.
54.
FinkelhorDBerlinerL.Research on the treatment of sexually abused children: A review and recommendations. J Am Acad Child Adolesc Psychiatry1995;34:1408–23.
55.
DiamondGSSerranoACDickeyMSonisWA. Current status of family-based outcome and process research. J Am Acad Child Adolesc Psychiatry1996;35:6–16.
56.
CohenJAMannarinoAP. A treatment outcome study for sexually abused preschool children: Initial findings. J Am Acad Child Adolesc Psychiatry1996;35:42–50.
57.
PinsofWAWynneLC. The efficacy of marital and family therapy: An empirical overview, conclusions and recommendations. Journal of Marital and Family Therapy1995;21:585–613.
58.
LegrangeDEislerIDareCRussellGFM. Evaluation of family treatments in adolescent anorexia nervosa: A pilot study. Int J Eat Disord1992;12:347–57.
59.
RobinALSiegelPTKoepkeTMoyeAWTiceS.Family therapy versus individual therapy for adolescent females with anorexia nervosa. J Dev Behav Pediatr1994;15:111–6.
60.
ShadishWRRagsdaleKGlaserRR. The efficacy and effectiveness of marital and family therapy: A perspective from meta-analysis. Journal of Marital and Family Therapy1995;21:345–60.
61.
SzmuklerGDareC.Family therapy. Current Opinion in Psychiatry1996;9:198–203.
62.
FonagyP.Evaluating the effectiveness of interventions in child psychiatry: The state of the art. Keynote address: 16th Annual Meeting of the Canadian Academy of Child Psychiatry; Quebec City, QC. 1996.
