Integrating developmental factors into the theoretical and empirical advancement of family-systemic psychotherapy with children
Willis, Amber Brewer
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Children are among the most influential members of a family system, yet they are commonly excluded from family therapy. The purpose of this dissertation is to explore the potential for including children in family therapy. This dissertation contains a review of literature and three publishable manuscripts on developmental applications in theory-building and empirical evaluation of psychosocial treatments for children. Although individual child therapy approaches are considered, greater emphasis is placed on family-systemic therapies for child-focused problems. The first manuscript provides a review of the empirical status of trauma treatments for children in the birth-to-six age range. Treatments were grouped into 4 categories of empirical support (i.e., I: well-established; II: probably efficacious; III: possibly efficacious; IV: untested), based on a classification scheme informed by recommendations from the Division 12 Task Force on Psychosocial Interventions (Chambless et al., 1996; Chambless & Hollon, 1998). Child Parent Psychotherapy (CPP) and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) were the only two models in this review to meet criteria for well-established treatments with trauma-exposed young children. In the second manuscript, a theoretical evaluation is presented of an attachment-based family therapy model (i.e., Emotionally Focused Family Therapy: EFFT) recently recommended for use with young children. Suggestions are offered for integrating play therapy activities and developmental considerations within an EFFT framework throughout the course of treatment. The third manuscript comprises a report of an observational study on family play therapy techniques, child participation, and a variety of outcomes in family therapy sessions with children ages 4 to 12. Study findings revealed that increased use of play-based techniques was associated with longer child talk times as well as more positive reports of the child-therapist relationship and participants’ overall emotional experience in session. Conclusions and recommendations for future research are provided at the end of this work.