Hi Folks,

Nick has asked me to bring some of our recently published child psychotherapy research to your attention:

Goodman, G., Midgley, N., & Schneider, C.  (in press).  Describing child psychotherapy process in prototype sessions of cognitive-behavioral and psychodynamic therapy:  Is mentalization a common process factor?  Psychotherapy Research.

Abstract
Background:  There is a paucity of valid measures that support research examining the process of child psychotherapy both within and across different treatment models.
Objective:  To investigate a) whether expert clinicians within psychodynamic therapy (PDT) process and cognitive-behavioral therapy (CBT)agree on key features of child psychotherapy process using the Child Psychotherapy Process Q-Set (CPQ); b) whether these two prototypes can be empirically distinguished; and c) whether promoting mentalization (operationalized as reflective functioning [RF]) is a shared component of the way expert clinicians conceptualize these two treatment models.
Method:  Thirty-one raters with expertise in PDT, CBT and RF provided ratings of the 100 CPQ items to describe an ideal prototype session that adheres to the principles of their treatment model.  Two Q-factor analyses with varimax rotation were conducted.
Results:  Expert clinicians reached a high level of agreement on their respective PDT and CBT prototypes.  These prototypes loaded onto two independent factors.  The RF process prototype loaded onto both factors.
Conclusions:  From the theoretical perspective of expert clinicians representing PDT and CBT, these two child-focused treatment models can be empirically distinguished; however, a focus on RF appears to be a common process factor in the way both treatment models are conceptualized.

Goodman, G.  (2015).  Interaction structures between a child and two therapists in the psychodynamic treatment of a child with borderline personality disorder.  Journal of Child Psychotherapy, 41, 141-161.

Abstract
This study examined the constellation of interaction structures - repetitive patterns of interactions between patient and therapist over the course of treatment - that emerged in the psychodynamic therapy (PDT) of a child diagnosed with borderline personality disorder (BPD) and treated by two doctoral-student therapists.  Identification of these interaction structures can inform therapists of what might be expected from patients with particular symptom or behavior patterns and how interactions change over time.  This study also examined each session’s adherence to three session prototypes:  PDT, cognitive-behavioral therapy (CBT), and reflective functioning (RF) process.  The Child Psychotherapy Q-Set (CPQ; Schneider & Jones, 2004) is a 100-item instrument that assesses the processes within a single psychotherapy session.  Items reflect a wide range of therapist attitudes and behaviors, patient attitudes and behaviors, and interactions between therapist and patient.  Experts used the CPQ to define PDT, CBT, and RF process session prototypes.  The results suggested that four distinct interaction structures could be identified and that their constellations differed between the two therapists and also differed over time within each treatment.  Therapists were more structured and accommodating early on in their treatments and more interpretive later.  Prototypical PDT process was more prominent in the sessions than RF process, which in turn was more prominent than CBT process.  Unique therapeutic processes are at work in every dyad, despite holding the patient and theoretical orientation constant.  An effective treatment in one dyad might not work in another due to therapist-specific and dyad-specific effects.

Goodman, G., Reed, P., & Athey-Lloyd, L.  (2015).  Mentalization and play therapy processes between two therapists and a child with Asperger's disorder.  International Journal of Play Therapy, 24, 13-29.

Abstract
The British Association of Play Therapists (BAPT) provides a definition of play therapy (PT) that emphasizes humanistic ideals such as using nondirective play techniques to enable the child’s inner resources to bring about growth and change.  These therapeutic change processes have never been submitted to empirical testing in part because of the paucity of valid, reliable instruments to assess child psychotherapy process.  Identifying empirically supported change processes is crucial to discovering which change processes work for which child.  For example, children with Asperger’s disorder have deficits in mentalization—the ability to interpret the behaviors of self and others as motivated by underlying mental states. Would a mentalization-informed PT approach or a traditional PT approach be more effective in treating such patients?  The Child Psychotherapy Q-Set (CPQ) is a 100-item instrument that assesses the processes within a single psychotherapy session. Items reflect a wide range of therapist attitudes and behaviors, patient attitudes and behaviors, and interactions between therapist and patient. To characterize PT process, 24 BAPT play therapists were asked to use the CPQ to rate the prototypical PT session based on their knowledge of PT operationalized by the BAPT definition.  The findings indicated that according to these 24 raters, a therapist who is sensitive to the child’s feelings and level of development characterizes British PT. Two therapists treating a child with Asperger’s disorder over two years decreased their session adherence to PT while maintaining their session adherence to mentalization processes. The CPQ enables empirical treatment comparisons with the PT definition of American play therapists.

Let me know if you have any questions.  Thanks.

Geoff

Geoff Goodman, Ph.D., ABPP, FIPA, CST, CSAT-S, CMAT-S, RPT-S
Associate Professor
Clinical Psychology Doctoral Program
Long Island University
720 Northern Blvd.
Brookville, NY 11548
(516) 299-4277
http://myweb.cwpost.liu.edu/ggoodman/home.htm