Effectiveness Trial of Psychoanalytic Psychotherapy for Children and Adolescents with Severe Anxiety Symptoms in a Naturalistic Treatment Setting

Background The aim of the study was to look at symptom changes in naturalistic outpatient psychoanalytic child and adolescent psychotherapy for anxiety disorders in Germany. Methods (1) The first treatment period of the psychodynamic intervention group (<25 sessions) was compared with a minimal supportive treatment (waiting list) control group, and (2) the effects of long‐term psychoanalytical treatment (>25 sessions) were analysed using a longitudinal observational design. A total of 86 children and adolescents (4–21 years) were in the treatment group and 35 in the minimal supportive treatment control group. Questionnaires were administered at the beginning and end of treatment, as well as at 6‐ and 12‐month follow‐up (FU). Results When comparing the first treatment period with the minimal supportive treatment control group, both groups improved significantly with small effect sizes and no significant group differences. Both parents and patients reported moderate symptom improvements at the end of therapy (parent: d=0.58; patient: d=0.57), which were stable at FU and increased from the patient perspective (parent: d=0.37; patient: d=0.80). Conclusions The results suggest that anxiety symptoms significantly decreased during the treatment period and remained stable at FU. Due to the study design we could not rule out alternative explanations like regression to the mean.