Psychodynamic psychotherapy with children and young people at a crossroads

The account of the research and the findings indicate that psychodynamic therapy and its application within publicly funded services is at a crossroads. As discussed in this chapter, the move to prove efficacy and relevance of psychodynamic psychotherapy with children and young people, via the randomised controlled trial may not only be considered inappropriate but also outdated. Mary Target (2012) in an address to the British Psychoanalytical Society Research Lecture has described the prejudice concerning psychodynamic research amongst those bodies responsible for research funding. These funding bodies tend to take the position that no amount of evidence can ever justify a psychodynamic approach (Troupp and Catty, 2012). This may lead us to question why we persist with trying to force our way through a door that appears to remain so resolutely closed. How can this be in the real interests of the people we are trying to help, namely children, parents and families?

A different line of approach is needed, in which the focus of our efforts more appropriately shifts to that of primary prevention. Read and Bentall (2012) for example, in their paper on the impact of negative childhood experiences, make the point that the mental health professions have been slow, as well as reluctant, to acknowledge the role of childhood adversity and its impact on future psychiatric and social disorders. Read and Bentall advocate that the most effective way to ameliorate this problem is to put our energies into primary prevention, exploring the causes of these problems within a broader psychological and social context. This view is supported in further studies on the impact of adverse childhood experiences on adult health behaviours and outcomes (Bentall et al., 2012; Bellis et al., 2014). The following chapter will make a case for the recalibration of the psychodynamic enterprise as a whole, and for a re-evaluation and valuing of what this approach has to offer to children, young people, parents and families, both with respect to therapeutic intervention as well as to this broader objective of child, adolescent and family wellbeing.

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