Specific and common therapeutic factors in psychodynamic psychotherapy for children and adolescents: an overview

The effectiveness of psychodynamic psychotherapy for children and adolescents (PPCA) has been increasingly demonstrated by a growing number of meta-analyses. However, very little is still known about the therapeutic factors responsible for this effectiveness. On the one hand, some authors have sugge...

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Main Authors: Sabine Sammer-Schreckenthaler, Gloria Lagetto, Human-Friedrich Unterrainer, Omar C. G. Gelo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Psychology
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1525849/full
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author Sabine Sammer-Schreckenthaler
Gloria Lagetto
Human-Friedrich Unterrainer
Human-Friedrich Unterrainer
Human-Friedrich Unterrainer
Human-Friedrich Unterrainer
Omar C. G. Gelo
Omar C. G. Gelo
author_facet Sabine Sammer-Schreckenthaler
Gloria Lagetto
Human-Friedrich Unterrainer
Human-Friedrich Unterrainer
Human-Friedrich Unterrainer
Human-Friedrich Unterrainer
Omar C. G. Gelo
Omar C. G. Gelo
author_sort Sabine Sammer-Schreckenthaler
collection DOAJ
description The effectiveness of psychodynamic psychotherapy for children and adolescents (PPCA) has been increasingly demonstrated by a growing number of meta-analyses. However, very little is still known about the therapeutic factors responsible for this effectiveness. On the one hand, some authors have suggested that PPCA works because of specific therapeutic factors. On the other hand, it has been suggested that the effectiveness of PPCA may be due to factors common to different approaches. In the present paper, we provide an overview and discuss some of the existing clinical-theoretical and empirical literature on specific and common factors of PPCA. Several specific and common factors of PPCA were identified. Regarding the former, these included clinical processes (insight; working through; remembering and reconstructing; catharsis, abreaction, and regression; and transference and countertransference) and therapeutic techniques (interpretation of transference, countertransference, dreams, defense mechanisms, and resistance; verbalization; mirroring; and free play). Regarding the latter, these included relational factors (therapeutic alliance and interaction structures), patient factors (willingness to participate, readiness for change, treatment involvement, and positive expectations and hope), therapist factors (interpersonal skills, direct influence skills, credibility, involving parents, playing ability, flexibility, and allegiance), parent and interpersonal environment factors (parental willingness to participate, treatment involvement, treatment expectations, and perceived barriers to treatment participation and therapeutic change; family dynamics; parent-therapist alliance; and social support), mentalizing (of the therapist, client, and parents), and play (symbolization, affect regulation, mental state talk, and patterns of interaction). PPCA appears to work through both specific and common factors, more likely through their synergic interaction. However, empirical support for these therapeutic factors and their mutual interaction remains sparse. Future qualitative and quantitative research should address more in detail the extent to which specific factors, common factors, or both account for the effectiveness of PPCA. Identifying empirically supported specific and common factors and their possible interaction can inform and improve clinical practice and training.
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spelling doaj-art-39d82ab8cb4f425d8d774801d1fd42fe2025-01-23T06:56:24ZengFrontiers Media S.A.Frontiers in Psychology1664-10782025-01-011610.3389/fpsyg.2025.15258491525849Specific and common therapeutic factors in psychodynamic psychotherapy for children and adolescents: an overviewSabine Sammer-Schreckenthaler0Gloria Lagetto1Human-Friedrich Unterrainer2Human-Friedrich Unterrainer3Human-Friedrich Unterrainer4Human-Friedrich Unterrainer5Omar C. G. Gelo6Omar C. G. Gelo7Faculty of Psychotherapy Science, Sigmund Freud University, Vienna, AustriaDepartment of Psychology and Educational Sciences, Pegaso Telematic University, Naples, ItalyFaculty of Psychotherapy Science, Sigmund Freud University, Vienna, AustriaDepartment of Religious Studies, University of Vienna, Vienna, AustriaUniversity Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, AustriaCenter for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, AustriaFaculty of Psychotherapy Science, Sigmund Freud University, Vienna, AustriaDepartment of Human and Social Sciences, University of Salento, Lecce, ItalyThe effectiveness of psychodynamic psychotherapy for children and adolescents (PPCA) has been increasingly demonstrated by a growing number of meta-analyses. However, very little is still known about the therapeutic factors responsible for this effectiveness. On the one hand, some authors have suggested that PPCA works because of specific therapeutic factors. On the other hand, it has been suggested that the effectiveness of PPCA may be due to factors common to different approaches. In the present paper, we provide an overview and discuss some of the existing clinical-theoretical and empirical literature on specific and common factors of PPCA. Several specific and common factors of PPCA were identified. Regarding the former, these included clinical processes (insight; working through; remembering and reconstructing; catharsis, abreaction, and regression; and transference and countertransference) and therapeutic techniques (interpretation of transference, countertransference, dreams, defense mechanisms, and resistance; verbalization; mirroring; and free play). Regarding the latter, these included relational factors (therapeutic alliance and interaction structures), patient factors (willingness to participate, readiness for change, treatment involvement, and positive expectations and hope), therapist factors (interpersonal skills, direct influence skills, credibility, involving parents, playing ability, flexibility, and allegiance), parent and interpersonal environment factors (parental willingness to participate, treatment involvement, treatment expectations, and perceived barriers to treatment participation and therapeutic change; family dynamics; parent-therapist alliance; and social support), mentalizing (of the therapist, client, and parents), and play (symbolization, affect regulation, mental state talk, and patterns of interaction). PPCA appears to work through both specific and common factors, more likely through their synergic interaction. However, empirical support for these therapeutic factors and their mutual interaction remains sparse. Future qualitative and quantitative research should address more in detail the extent to which specific factors, common factors, or both account for the effectiveness of PPCA. Identifying empirically supported specific and common factors and their possible interaction can inform and improve clinical practice and training.https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1525849/fullpsychodynamic psychotherapychildrenadolescentscommon factorsspecific factors
spellingShingle Sabine Sammer-Schreckenthaler
Gloria Lagetto
Human-Friedrich Unterrainer
Human-Friedrich Unterrainer
Human-Friedrich Unterrainer
Human-Friedrich Unterrainer
Omar C. G. Gelo
Omar C. G. Gelo
Specific and common therapeutic factors in psychodynamic psychotherapy for children and adolescents: an overview
Frontiers in Psychology
psychodynamic psychotherapy
children
adolescents
common factors
specific factors
title Specific and common therapeutic factors in psychodynamic psychotherapy for children and adolescents: an overview
title_full Specific and common therapeutic factors in psychodynamic psychotherapy for children and adolescents: an overview
title_fullStr Specific and common therapeutic factors in psychodynamic psychotherapy for children and adolescents: an overview
title_full_unstemmed Specific and common therapeutic factors in psychodynamic psychotherapy for children and adolescents: an overview
title_short Specific and common therapeutic factors in psychodynamic psychotherapy for children and adolescents: an overview
title_sort specific and common therapeutic factors in psychodynamic psychotherapy for children and adolescents an overview
topic psychodynamic psychotherapy
children
adolescents
common factors
specific factors
url https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1525849/full
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