New and Emerging Research

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In their paper 'Psychodynamic psychotherapy for children and adolescents: a critical review of the evidence base', Midgley & Kennedy (2011) provide a useful summary of the growth of research into child psychotherapy in recent years, and some of the excellent work that is currently being undertaken to demonstrate further not only that child and adolescent psychotherapy works, but also why and how it works, for whom, and what works best in what circumstances.

One such major research study is the IMPACT (Improving Mood with Psychoanalytic and Cognitive Therapies) Trial, funded by the Health Technology Assessment Branch, National Institute of Health Research, UK (ISRCTN 83033550), which launched in 2010.

This pragmatic superiority Randomised Control Trial (RCT) compares the effectiveness of Treatment as Usual (psychiatric management and support and medication as necessary), Short-Term Psychoanalytic Psychotherapy (STPP) with parallel parent support, and Cognitive Behavioural Therapy (CBT) in the treatment and relapse prevention of adolescent depression. The study has recruited 475 participants in three areas of the UK, including Manchester and the Wirral, and is now closed to recruitment.

IMPACT is based on an ‘intention to treat design’ and includes full health economic analysis, as well as several sub-studies, e.g. analysis of whether cortisol levels and genes influence intervention response, magnetic resonance imaging to explore brain function and intervention effects, and a qualitative exploration of young people’s experiences of overcoming depression and being involved in the trial.

It is anticipated that the findings will contribute further to the NICE guidelines for children and young people with depression. The research is being led by Professor Ian Goodyer, University of Cambridge, Professor Peter Fonagy, University College, London, and Professor Jonathan Hill, University of Manchester.

For further details of the main study protocol, see Goodyer et al. (2011) ‘Improving mood with psychoanalytic and cognitive therapies (IMPACT): a pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depression: study protocol for a randomised controlled trial’. For an interesting article about child psychotherapists’ experiences of taking part in the trail, see Henton and Midgley (2012) ‘A path in the woods: child psychotherapists’ participation in a large randomized controlled trial’.

For other recent research, please see Abbass et al. (2013) ‘Psychodynamic psychotherapy for children and adolescents: A meta-analysis of short-term psychodynamic models’. This meta-analysis of 11 studies (total n=655) analyses the effectiveness of psychodynamic psychotherapy for children and adolescents across a range of common mental health disorders, including depression, anxiety, anorexia nervosa, and borderline personality disorder. It cites robust (g=1.07, 95% CI=0.80-1.34) within group effect sizes, suggesting that treatment may be effective for this age group and across these disorders.
 

References:

Abbass, A. et al. (2013) ‘Psychodynamic psychotherapy for children and adolescents: A meta-analysis of short-term psychodynamic models’, Journal of the American Academy of Child and Adolescent Psychiatry 52(8):863-875.

Goodyer, I. et al. (2011) ‘Improving mood with psychoanalytic and cognitive therapies (IMPACT): a pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depression: study protocol for a randomised controlled trial’, Trials 12(175)  doi: 10.1186/1745-6215-12-175.

Henton, I. and Midgley, N. (2012) ‘A path in the woods: child psychotherapists’ participation in a large randomized controlled trial’, Counselling and Psychotherapy Research: Linking research with practice 12(3) doi: 10.1080.14733145.2012.678270