Trends in Psychiatry and Psychotherapy

Objective: To analyze the degree of similarity to a “psychodynamic prototype” during the first year of two children’s once-weekly psychodynamic psychotherapy. Methods: This study used a longitudinal, descriptive, repeated-measures design based on the systematic case study method. Two male school children (here referred to as Walter and Peter) and their therapists took part in the study. All sessions were video and audio recorded. Ten sessions from each case were selected for analysis in this preliminary study. Trained examiners (randomly selected in pairs) independently and blindly evaluated each session using the Child Psychotherapy Q-Set (CPQ). Experts in psychodynamic therapy and cognitive behavioral therapy from several countries rated each of the 100 CPQ items with regard to how well it characterized a hypothetical ideal session of either treatment modality. A series of paired t tests comparing analogous adherence scores within each session were conducted. Results: There were no significant correlations between time elapsed and adherence to the prototypes. Walter’s treatment adhered to both prototypes and Peter’s treatment did not adhere to either prototype. Conclusion: Child psychotherapy theory and practice are not absolutely coincident. Real psychotherapy sessions do not necessarily resemble the ideal prototypes.