Exploring psychologists' reflections on "good moments" in child psychotherapy

Carlann M. Welch (1994)

Psychotherapy research has not adequately reflected the practice of child psychotherapy. Clinical samples have been limited and the studies have rarely examined the frequently used psychodynamic, play therapy, and eclectic approaches. As a way of gaining knowledge about child therapy as it is practiced, this study explored practitioners' reflections on "good moments" in therapy. A "good moment" was defined as an episode which indicated client movement, progress, or change. Good moments were expected to represent high points in the therapy process as well as snap shots of change. One hour, face-to-face interviews were conducted with ten psychologists who are active child psychotherapists with seven or more years of post-doctoral experience. The ten participants were from a northeastern state with post-doctoral experience ranging from 11 to 25 years and a mean of 17 years. This qualitative study explored the knowledge base of child psychotherapists. A framework was developed from the psychology literature to structure the data analysis. This framework included a preliminary list of "good moment" categories, a range of information sources used by therapists, and a matrix organizing therapists' constructs of change. Key themes were condensed into a narrative which was confirmed by participants over the phone. Classification and interpretation of the data prompted changes in the preliminary framework resulting in classification of data by dimensions, specifically--behavioral, biological, cognitive, emotional, environmental, interpersonal, and intrapsychic. The findings suggest that the therapeutic activity associated with "good moment" changes crosses multiple dimensions. An eclectic approach is strongly endorsed by these results with psychologists' presentations referencing a minimum of five of the seven dimensions identified. Factors which were thought to facilitate change represented multiple dimensions and did not necessarily match the dimension(s) of the "good moments". A striking lack of information was gathered concerning the therapist's reflective personal theory and their intrapersonal experience. Implications for research, training, and the development of child psychotherapy practice are presented.