Two-Year Outcomes for Italian Children Receiving Psychodynamic Psychotherapy vs. Community Services for Internalizing Problems

A team of researchers and clinicians at the University of Pisa, Italy, compared outcomes for 29 6- to 10-year-olds who received an 11-week psychotherapy protocol and 29 comparison children who qualified for the protocol but were referred to community services because slots were unavaible for the psychotherapy protocol.

Although the groups were not randomly assigned, they did not differ significantly in baseline characteristics. From the baseline assessment (Time 1) to the first reassessment 6 months later (Time 2), 14 of the 29 comparison children received treatment elsewhere. Between Time 2 and a 2-year follow-up reassessment (Time 3), mental health services were sought for 34% of the comparison children vs. 10% of the children who had received the psychotherapy protocol.

On the Children’s Global Assessment Scale (C-GAS) and the CBCL, both groups showed improvement from Time 1 to Time 2, but only the C-GAS showed signficantly more improvement for the psychotherapy group than the community services group. From Time 2 to Time 3, the C-GAS showed no more improvement for the psychotherapy group than for the community services group.

However, the CBCL showed significantly greater improvement for the psychotherapy group than for the community services group on the Total Problems, Internalizing, Externalizing, Withdrawn, Anxious/Depressed, Attention Problems, Delinquent Behavior, and Aggressive Behavior scales. Furthermore, by Time 3, significantly more of the psychotherapy group than the community services group had moved to the normal range on several CBCL scales. The authors concluded that the CBCL “data seem to provide evidence of a ‘sleeper effect'” whereby “changes in insight and self-awareness may produce more of a delayed treatment effect than in behavioral treatments” (p. 337).

Reference: Muratori, F., Picchi, L., Bruni, G., Patarnello, M., & Romagnoli, G. (2003). A two-year follow-up of psychodynamic psychotherapy for Internalizing disorders in children. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 331-339.