This dissertation presents the development and findings of a long-term follow-up study of adults who received psychoanalytic treatment in childhood and adolescence at the Anna Freud Centre in London. It reviews the existing literature on outcome research of child psychotherapeutic interventions, highlighting the advances that have taken place in the last fifteen years, alongside a host of methodological challenges that continue to confront researchers in the field. Particular emphasis is given to the relative lack of outcome studies focusing on psychodynamic interventions, despite their wide usage in clinical practice, and the dearth of follow-up studies which investigate post-treatment gains beyond termination. Given the impact of developmental changes on the long-term sequelae of childhood disturbances, the need for follow-up assessments across the life span is emphasized. In addition, the dissertation discusses the limitations of outcome measures that focus solely on the symptomatology, recommending multi-level assessment procedures that incorporate a more diverse and comprehensive approach to the assessment of functioning and treatment outcome. This approach recommends the inclusion of both disturbance and functioning, and the importance of both risk and protective factors. The development of a comprehensive adult assessment interview protocol is described and the thirty-four treated subjects that comprise the study's sample are presented. Childhood variables assessed retrospectively on the basis of subjects' case files are described along with current adult demographic data. The Adult Functioning Index, based on five individual assessment measures, is presented and the relationship between childhood variables and adult functioning is analyzed. The findings highlight the importance of pre-treatment global functioning level in childhood as the best predictor of adult outcome, followed by the number of psychiatric diagnoses at the conclusion of treatment in childhood. The study's results highlight the relationship between security of attachment and adult functioning, suggesting that a secure attachment status may play a pivotal role in overcoming a poor long-term prognosis. The potential impact of treatment in childhood on security of attachment and subsequent development is discussed. The contributions and limitations of the study are outlined and recommendations for future prospective studies are described.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:423141 |
| Date | January 2005 |
| Creators | Schachter, Abigail |
| Publisher | University College London (University of London) |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://discovery.ucl.ac.uk/1446774/ |
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