Child and Adolescent Psychotherapists are able to provide a range of brief interventions and short-term psychotherapy. This is included as a core competency in their training.
One specific model that the majority of Child and Adolescent Psychotherapists now offer is Short-Term Psychoanalytic Psychotherapy (STPP).
Short-Term Psychoanalytic Psychotherapy (STPP)
STPP is a manualised, time-limited model of psychoanalytic psychotherapy comprising twenty-eight weekly sessions for the adolescent patient and seven sessions for parents or carers, designed so that it can be delivered within a public mental health system, such as Child and Adolescent Mental Health Services in the UK.
It has its origins in psychoanalytic theoretical principles, clinical experience, and empirical research suggesting that psychoanalytic treatment of this duration can be effective for a range of disorders, including depression, in children and young people. The manual* for STPP explicitly focuses on the treatment of moderate to severe depression, both by detailing the psychoanalytic understanding of depression in young people and through careful consideration of clinical work with this group.
Evidence of Effectiveness
The treatment approach of STPP was used in a multi-site randomised controlled trial in the UK, 'Improving Mood with Psychoanalytic and Cognitive Therapies' (IMPACT)** and internationally. The outcomes of the IMPACT study informed the update of NICE Guidance on Depression in Children and Young People***. This guidance recommends psychodynamic psychotherapy in its guidance on management of depression in children and young people:
- For 5 – 11 year olds psychodynamic psychotherapy is recommended (1.6.4) as one of the options for first line treatment for those with severe to moderate depression.
- For 12 – 18 year olds it recommends psychodynamic psychotherapy as an option to consider (1.6.6) if individual CBT would not meet the clinical needs of those with moderate to severe depression or is unsuitable for their circumstances.
- In addition the guidance recommends psychodynamic psychotherapy (approximately 30 weekly sessions) for depression unresponsive to combined treatment (1.6.13).
*Cregeen, S., Hughes, C., Midgley, N.Rhode, M. & Rustin, M. (ed. by Catty, J.) (2017). Short-term Psychoanalytic Psychotherapy for Adolescents with Depression: A Treatment Manual. London: Karnac.
**Goodyer, I., Reynolds, S., Barrett, B., Byford, S., Dubicka, B., Hill, J., Holland, F., Kelvin, R., Midgley, N., Roberts, C., Senior, R., Target, M., Widmer, B., Wilkinson, P., Fonagy, P. (2016). Effectiveness And Cost-Effectiveness Of Cognitive Behaviour Therapy And Short-Term Psychoanalytic Psychotherapy Compared With Brief Psychosocial Intervention In Maintaining Reduced Depressive Symptoms 12 months after end of treatment in Adolescents with Unipolar Major Depression (IMPACT): A Pragmatic Superiority Randomised Controlled Trial. Lancet Psychiatry.
***NICE (2019) NICE guideline [NG134] Depression in children and young people: identification and management, available at: https://www.nice.org.uk/guidance/ng134/chapter/Recommendations