Cognitive, Interpersonal and Other Individual Therapies 343Direct work with children and adolescents differs in a number of ways
from that with adults. First, the child may not have wanted to be seen
alone; usually they do not have to give consent. Second, the method of
working with younger children may need to be less talk-based initially,
and focus on drawing or play to gain insight. Third, even when therapy
can help children and adolescents come to terms with a difficult situation
and offer them the opportunity to mature and change, children and
adolescents are not masters of their own fate in the same way as adults, so
they may well continue to be exposed to damaging or harmful influences,
for example, harsh punishment and neglect within the family, or a mother
who is an alcoholic. In these circumstances it is essential to try as hard
as possible to ameliorate the conditions, and it may be unethical to give
individual therapy without doing this.
There have been very few well-conducted evaluation trials of individual
dynamic psychotherapy, so it is hard to judge its effectiveness at present.
Subject review
Fonagy P, Target M. (2008) Psychodynamic treatments.In: Rutter Met al.
(eds)Rutter’s Child and Adolescent Psychiatry, 5th edn. Wiley-Blackwell,
Chichester, pp. 1079–1091.
Lochman JE, Pardini DA. (2008) Cognitive-behavioral therapies. In:
Rutter Met al.(eds)Rutter’s Child and Adolescent Psychiatry,5thedn.
Wiley-Blackwell, Chichester, pp. 1026–1045.
Further reading
Birmaher Bet al. (2000) Clinical outcome after short-term psychotherapy
for adolescents with major depressive disorder.Archives of General Psychi-
atry 57 , 29–36.
Dubicka Bet al. (2010) Combined treatment with cognitive-behavioural
therapy in adolescent depression: Meta-analysis.British Journal of Psychi-
atry 197 , 433–440.
Kennard Bet al. (2009) Remission and recovery in the Treatment for
Adolescents With Depression Study (TADS): Acute and long-term out-
comes.Journal of the American Academy of Child and Adolescent Psychiatry.
48 , 186–195.
Mufson Let al. (2004) A randomized effectiveness trial of interpersonal
psychotherapy for depressed adolescents.Archives of General Psychiatry 61 ,
577–584.
Young J, Mufson L. (2009) Interpersonal psychotherapy for adolescents.
In: Essau C (ed.)Treatments for Adolescent Depression: Theory and Practice.
Oxford University Press, Oxford, pp. 261–282.