The mechanisms of change in psychological interventions for children with emotional disorders

• Main Author: Andargachew, Sara
• Published: University of Oxford 2011
• Subjects: 618.9289
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.556151

There are significant variations in the effectiveness of psychological interventions for children with emotional problems and little is known about what makes them work. Nonspecific therapy factors are thought to be important to therapeutic outcome in psychological interventions for adults. However, literature in the area of child therapy is much more limited. The first paper critically reviews 14 empirical studies focusing on nonspecific factors in relation to therapeutic outcome of psychological interventions for children with emotional disorders. The nonspecific factors in question include therapeutic alliance factors, parent involvement, therapist factors and child involvement. The methodological strengths and weaknesses of these studies are considered in depth. Conclusions in this body of literature are tentative and there is limited evidence for a significant predictive relationship between nonspecific therapy factors and treatment outcome for children with emotional disorders. The purpose of paper B was to measure the relative impact of both specific and nonspecific therapy factors in relation to treatment outcome for 75 children (aged 7- 12) receiving cognitive behavioural therapy for anxiety disorders. The specific therapy factors included changes in the children's interpretations and plans in relation to hypothetically ambiguous scenarios. The nonspecific therapy factors included the therapeutic alliance, who the therapist was and adherence to a therapeutic manual. The results indicated that change in anticipated distress in response to hypothetically ambiguous scenarios (one of the specific therapy factors) was significantly associated with treatment outcome from the child's perspective. None of the nonspecific factors and none of the other specific factors were significantly associated with outcome. Perceived coping may be an important focus in psychological interventions for children with anxiety disorders. Clinical implications and considerations for future research are discussed in both papers.