Special issue: Research in child and adolescent psychotherapy

Psychotherapy research has long neglected developmental age as a specific field of investigation regarding the effectiveness of the intervention, due in part to the inherent difficulties in evaluating psychopathology and in understanding the therapeutic process in infancy, childhood, and adolescence. We are now in a new phase in which attention has been paid to the empirical evidence of psychological treatment: impressive contemporary studies on the impact of early interventions concerning at-risk parenting and child development has allowed the application of manualized therapeutic models to vulnerable families by focusing treatment on attachment and reflective function (Steele & Steele, 2018). At the same time, manualized interventions such as Mentalization-Based Treatment (MBT) have also begun to be applied to children in the 6-12 year group (Midgley et al., 2021) - as well as to adolescents (Russouw et al., 2021) - and to bring evidence of their effectiveness. Especially in childhood, new conceptualizations of child functioning have promoted new methodologies for studying the effectiveness of therapeutic processes (PDM-2, Lingiardi & McWilliams, 2017).

This Special Issue comprise eleven contributions - starting from studies on young children up to adolescents - in the field of early interventions on parent-child dyads, parent-infant psychotherapy, or childhood/adolescence psychotherapy, expanding the knowledge on these areas through qualitative and quantitative methodologies.

What characterizes most of the papers is the overarching perspective that aims to move beyond evaluating symptomatic outcome towards exploring the therapeutic process and what contributes to the effectiveness of the intervention. Contributions on early childhood offer important reflections not only on the role of reflective function and attachment (Myers, Steele, Steele, & Murphy, 2022; Sieverson et al., 2022), but also on the therapeutic process, on best practices for therapeutic action and on the quality of measures to determine efficacy in treatment and measure success in dissemination and implementation of the intervention (Armusewicz, Steele, Steele, & Murphy, 2022). The study of the subjective involvement of catalysts for change in terms of the clinicians, through the process of co-creation and implementation of the intervention on attachment, can be another lever for change (Borelli et al., 2022).

The ability and training of the clinician in psychodynamic assessment and diagnosis, informed by the PDM-2 perspective, are the focus of two contributions that through clinical cases (Bizzi, Locati, Parolin, Goetz Yael, & Brusadelli, 2022) and a study on a large sample of over 200 children (Fortunato, Tanzilli, Lingiardi, & Speranza, 2022) emphasize the importance of a reliable clinical-diagnostic evaluation of children’s mental functioning and emerging personality to promote a more accurate assessment and inform the development of individualized therapies.

Another theme that connects the papers featured in this special issue is attention to the subjective experience of therapist, parent and child within the therapeutic intervention. Just as the subjective experience of the clinician, enriched by reflection, training, and the use of qualitativequantitative measures, can be of great help in the therapeutic process, in the same way the investigation into the subjective experience of the young patient or parent can become a central aspect of the therapeutic alliance and subjective change process. Attention to the subjective perspective in the therapeutic process can provide important information for understanding the mechanisms of change in particularly vulnerable clinical populations such as children and adolescents who have been sexually abused (Capella et al., 2022), but it can also foster change itself through child-therapist or parent-therapist relationship (Nunez et al., 2022). Giving a voice to the child’s experience and the perception of his/her own well-being, as a verification of the effectiveness of the treatment, can be of great use especially in understanding how much parent and child are able to cooperate in achieving therapeutic goals starting from the understanding of suffering (Abraham, Edginton, Cottrell, & Tubeuf, 2022). At the same time it is important to have new models of intervention for children with emotional disorders that can reduce their suffering (Qanbari et al., 2022) as well as using new methodologies in the training of child psychotherapists (Bate & Tsakas, 2022).

We would like to thank all the authors and the reviewers who contributed to this Special issue. Their work may pave the way for other research that will help clinicians and researchers understand the essential mechanisms of the therapeutic process in childhood and adolescence.