A recent editorial discusses how research and practice interact to create better fitting models for child psychology and therapy.
Child psychology as a branch of study looks at the development of children and adolescents and tries to determine which processes are at play when a child develops normally or abnormally. In essence, the study of child psychology must look at the long-term results of certain interventions, creating therapeutic models that are applicable for practitioners.
A focus on implementation and developmental cascades
In a recent editorial published in the Journal of Child Psychology and Psychiatry, Courtenay Norbury, a professor of developmental language and communication disorders at the University College of London, points out that there are two important trends in child psychological therapy in recent years.
The first is the focus on implementation, meaning that recent research must take into account the practicality of the approach being studied. This includes cost-efficiency, ease of delivery, the frequency of delivery, and more. The second factor is a focus on developmental cascades. These cascades refer to the proposition that implementing an intervention in one developmental process can affect other developing processes. The requirement for this factor to be studied is the inclusion of long-term follow-ups, measuring the effects that persist over time.
Cascades of improvement
The author goes on to mention several recent studies that are exemplary in this respect. For example, a study that involved a cognitive behavioural intervention for insomnia in adolescents has found that improvements in sleep quality and quantity improved the overall mental health of the teens. It is also important to note that this study used more rigorous statistical techniques, making the significant results more likely to be accurate. The main downfall of this study is the small sample size, which may increase the likelihood of a positive result. Nevertheless, as the first such study, it demonstrates that there is a good chance such low-cost, easily-implemented techniques may create a cascade effect.
One size does not fit all
Further, the author mentions a study that conducted group therapy with several younger participants to address symptoms of distress and post-traumatic stress. This study is especially relevant today, with the increase in crises witnessed around the globe. The study included a long follow-up of seven to 14 months. The study reports small, yet significant improvements on several scales; however, they have encountered great variability among different participants. This is to be expected, as the author mentions since child psychology treatment is not a “one size fits all” approach.
It further represents a need for a shift from the question “does this work?” to “how do we achieve the desired outcome?”. Such small effects are also not negligible, as they may be highly beneficial to certain individuals in therapy. In the long-term, these small changes can indeed create significant cascade transformations that will drastically improve the overall mental health of the child.
The last study mentioned by Norbury involved the training of parents to educate their children and improve the children’s reading ability. The main result of this study is that the improvement of children with lower reading ability was equal to the improvement of children with better reading ability. Nonetheless, this treatment can only be applied when the parents’ reading level reaches a certain threshold. Thus, again demonstrating the importance of evaluating every child individually.
Individualized strategies are crucial
Norbury stresses the importance of considering every child’s problem individually. While it may be highly convenient and cost-efficient to have universal treatments for all children, it may not be the case in every situation.
Studies should compare different treatments with the mentality of “how can we make this work?” versus simply “what will work?” They should also increase their focus on creating longer trials, studying potential developmental cascades, while increasing the strength of the statistical methods used.
Designing more studies with these criteria in mind can help diminish the need for specialists in child psychology, however, certain cases will always require a more personalized approach, and these should not be discredited.
Written by Maor Bernshtein
Reference: Norbury, Courtenay Frazier. “One Size Does Not Fit All: Addressing the Challenges of Intervention for Complex Developmental Issues.” Journal of Child Psychology and Psychiatry, vol. 59, no. 5, 2018, pp. 487–488., doi:10.1111/jcpp.12925.