What does it mean to ‘drop out’ of therapy? Many definitions of ‘dropout’ have been proposed, but the most widely accepted is the client ending treatment without agreement of their therapist. However, this is in some ways an external criterion that does not take into account the client’s experience of therapy, or reasons for ending it prematurely. This study aimed to identify whether there were more meaningful categories of dropout than the existing dropout definition, and to test whether this refined (...) categorisation of dropout was associated with clinical outcomes. This mixed-methods study used a subset of data from the IMPACT trial, which investigated psychological therapies for adolescent depression. Adolescents were randomly allocated to a treatment arm (Brief Psychosocial Intervention; Cognitive-Behavioural Therapy; Short-Term Psychoanalytic Psychotherapy). The sample for this study comprised 99 adolescents, aged 11-17 years. 32 were classified as having dropped out of treatment and participated in post-therapy qualitative interviews about their experiences of therapy. For 26 dropout cases, the therapist was also interviewed. 67 cases classified as having completed treatment were included to compare their outcomes to dropout cases. Interview data for dropout cases were analysed using ideal type analysis. Three types of dropout were constructed: ‘dissatisfied’ dropout, ‘got-what-they-needed’ dropout, and ‘troubled’ dropout. ‘Dissatisfied’ dropouts reported stopping therapy because they did not find it helpful. ‘Got-what-they-needed’ dropouts reported stopping therapy because they felt they had benefitted from therapy. ‘Troubled’ dropouts reported stopping therapy because of a lack of stability in their lives. The findings indicate the importance of including the perspective of clients in definitions of drop out, as otherwise there is a risk that the heterogeneity of 'dropout' cases may mask more meaningful distinctions. Clinicians should be aware of the range of issues experienced by adolescents in treatment that lead to disengagement. Our typology of dropout may provide a framework for clinical decision-making in managing different types of disengagement from treatment. (shrink)

Despite a rich theoretical and clinical history, psychodynamic child and adolescent psychotherapy has been slow to engage in the empirical assessment of its effectiveness. This systematic review aims to provide a narrative synthesis of the evidence base for psychodynamic therapy with children and adolescents. Building on two earlier systematic reviews, which covered the period up to 2017, the current study involved two stages: an updated literature search, covering the period between January 2017 and May 2020, and a narrative synthesis of (...) these new studies with those identified in the earlier reviews. The updated search identified 37 papers. When combined with papers identified in the earlier systematic reviews, this resulted in a combined total of 123 papers. The narrative synthesis of findings indicates that there is evidence of effectiveness for psychodynamic therapy in treating a wide range of mental health difficulties in children and adolescents. The evidence suggests this approach may be especially effective for internalizing disorders such as depression and anxiety, as well as in the treatment of emerging personality disorders and in the treatment of children who have experience of adversity. Both the quality and quantity of empirical papers in this field has increased over time. However, much of the research demonstrates a range of methodological limitations, and only 22 studies were Randomized Controlled Trials. Further high-quality research is needed in order to better understand the effectiveness of psychodynamic psychotherapy for children and young people. (shrink)

_What place do Anna Freud’s ideas have in the history of psychoanalysis? What can her writings teach us today about how to work therapeutically with children? Are her psychoanalytic ideas still relevant to those entrusted with the welfare of infants and young people? _ _Reading Anna Freud_ provides an accessible introduction to the writings of one of the most significant figures in the history of psychoanalysis. Each chapter introduces a number of her key papers, with clear summaries of the main (...) ideas, historical background, a discussion of the influence and contemporary relevance of her thinking, and recommendations for further reading. Areas covered include Anna Freud’s writings on: • The theory and practice of child analysis and 'developmental therapy' • The application of psychoanalytic thinking to education, paediatrics and the law • The assessment and diagnosis of childhood disorders • Psychoanalytic research and developmental psychopathology Nick Midgley draws on his extensive experience as a child psychotherapist and a teacher to bring Anna Freud's ideas to life. He illustrates the remarkable originality of her thinking, and shows how analytic ideas can be used not only in child psychotherapy, but also to inform the care of children in families, hospitals, classrooms, residential care and the court-room. __Reading Anna Freud__ will be of interest to child therapists, child analysts and psychoanalysts, as well as others working in the field of child and adolescent mental health, such as clinical psychologists, child psychiatrists and educational psychologists. It also has much to offer to those entrusted with the care of children in a wide range of settings - including teachers, nurses and social workers - for whom Anna Freud was always keen to demonstrate the value of a psychoanalytic approach. _Nick Midgley_ trained as a child and adolescent psychotherapist at the Anna Freud Centre, where he now works as a clinician and as Programme Director for the MSc in Developmental Psychology and Clinical Practice. Nick has written articles on a wide range of topics and is joint editor of _Minding the Child: Mentalization-based Interventions with Children, Young People and their Families_ and _Child Psychotherapy and Research: New Directions, Emerging Findings_. (shrink)

Essay on Transcendental Philosophy presents the first English translation of Salomon Maimon's principal work, originally published in Berlin in 1790. In this book, Maimon seeks to further the revolution in philosophy wrought by Kant's Critique of Pure Reason by establishing a new foundation for transcendental philosophy in the idea of difference. Kant judged Maimon to be his most profound critic, and the Essay went on to have a decisive influence on the course of post-Kantian German Idealism. A more recent admirer (...) was Gilles Deleuze who drew on Maimon's Essay in constructing his own philosophy of difference. This long-overdue translation makes Maimon's brilliant analysis and criticism of Kant's philosophy accessible to an English readership for the first time. The text includes a comprehensive introduction, a glossary, translators' notes, a bibliography of writings on Maimon and an index. It also includes translations of correspondence between Maimon and Kant and a letter Maimon wrote to a Berlin journal clarifying the philosophical position of the essay, all of which bring the book's context alive for the modern reader. (shrink)