The Role of Common and Specific Factors in Child Psychodynamic Psychotherapy: A Grouped Cases Study

Abstract

ABSTRACT There is a growing evidence-base that suggests the effectiveness of the psychodynamic therapies for children, but the mechanisms by which the results are achieved still demand clarification. This study aimed to analyze the role of specific and common factors in the process of psychodynamic psychotherapy for school-age children and their association with psychotherapies outcomes. A longitudinal, repeated-measures design, based on the systematic case-study method was adopted. 204 sessions from four child psychotherapies were analyzed in terms of the therapists’ techniques, the therapeutic alliance, the use of the reflective functioning approach and the role of the symbolic play in the sessions. The outcomes were assessed based on mothers’ reports about children’s symptomatic improvement. Correlational, discriminant and regression analyses were used to examine the associations and the role of each factor in those therapeutic processes. The results indicated that the use of psychodynamic techniques and a stronger therapeutic alliance impacted more significantly the symptomatic improvement. The factor that presented more changes over time was the therapeutic alliance, increasing in two cases and decreasing in one of them, which did not show clinically significant symptomatic improvement. Common and specific factors walked together in these treatments, and both were important to produce clinically significant improvements.