| Despite considerable progress made in child psychotherapy research and practice over the past decade, growing economic pressures are negatively impacting service delivery. Hence, the development of effective interventions has become top priority for researchers. Efficacy and effectiveness studies have dominated outcome research efforts; and, while they provide valuable evidence regarding the curative effects of specific interventions in remediation of specific problems, these technical studies do not account for logistical realities encountered in actual clinic practice and do not explain how psychotherapy operates to benefit children. Thus there is a gap in essential knowledge regarding how therapy works to produce beneficial outcomes.;Recommendations to improve child psychotherapy research have centered on identifying mechanisms that account for change, incorporating clinically valid constructs, and using alternative research methods that may enhance knowledge gained through positivistic means. The current project was designed with these objectives in mind, to explore how clients of child psychotherapy interpreted the effects of their treatment. The purpose of this study is to determine if a theoretical framework existed that could operationalize how changes derived from therapy transpire to produce a sense of effectiveness in real world treatment.;Grounded theory methodology was employed in interviewing and analyzing data obtained from 21 participants retrospectively reflecting on the utility of their therapy experiences as youth. Findings reveal that changes experienced are diverse and occur dynamically in the process of therapy. Functional analyses of six identified change categories and relationships between them support a conceptualization of treatment effectiveness as a spectrum that ranges in intensity and is governed by number of meaningful changes perceived. Furthermore, eight auxiliary categories emerged and describe processes that appeared to moderate treatment effectiveness in predictable ways. Implications include guiding continued research regarding the effectiveness of child psychotherapy and increasing integrity in practice. |
