‘And when you were a child?’: how therapists working with parents alongside individual child psychotherapy bring the past into their work

When a child is offered psychotherapy, it is common that regular meetings will be offered to the parents. However, there are debates in the literature about the degree to which such parent work should include a focus on the parents’ own childhood experiences. This study aimed to examine the way that those offering parent work as part of a study evaluating the treatment of adolescent depression dealt with this issue in their work with parents, both in the study and in routine clinical practice. Design: five therapists were interviewed on the subject of working with parents’ childhood experiences within parent work parallel to child psychotherapy. Data were analysed qualitatively, using Interpretative Phenomenological Analysis. Findings: participants described the need to consider the different parameters of this work to individual adult therapy; in addition, participants felt that it was necessary to negotiate permission to work on the parents’ childhood experiences. They also spoke of making use of insight into the repetition of the parents’ history, the analysis of parental projections and offering containment within the relationship; this varies from the ‘transference work’ of individual therapy and a different style of interpretation was described. Conclusions: there is a need to give more attention to the neglected field of working with parents alongside individual child psychotherapy, especially at a time when such work is under threat within many public services. There are particular technical issues related to work with parents’ own childhood histories that are different to how one might work in individual therapy with a parent.     

Parent–adolescent conflict,treatment adherence and glycemic control in Type 1 diabetes: The importance of adolescent externalising symptoms

Parent–adolescent conflict has been demonstrated to relate to treatment adherence and glycemic control in adolescents with Type 1 diabetes. The present longitudinal study investigated how these variables were interrelated over time, and examined whether externalising and internalising symptoms function as mediating variables. A total of 109 adolescents with diabetes participated at four annual time points and completed measures on conflict with parents, internalising and externalising symptoms. Information on treatment non-adherence and glycemic control was obtained from treating physicians. Cross-lagged analyses from a structural equation modelling approach indicated that father–adolescent but not mother–adolescent conflict positively influenced treatment non-adherence over time, which, in turn, was associated with higher glycosylated haemoglobin-values. Further, externalising but not internalising symptoms were found to mediate the pathway from father–adolescent conflict to treatment adherence over time. Finally, mother–adolescent conflict was found to relate indirectly to treatment non-adherence through its relationship with externalising symptoms. Hence, the present longitudinal study provides evidence that externalising symptoms represent an important mechanism through which earlier experiences of parent–adolescent conflict may influence later treatment non-adherence and poorer glycemic control. Implications and suggestions for future research are outlined.