DIFFERENTIAL THERAPEUTIC AND PEDAGOGICAL DECISION-MAKING IN THE TREATMENT OF CHILDREN AND ADOLESCENTS

Increasing awareness of the different effects that different methods o f psychotherapy can have has led to the demand for empirical justifica tion of the method selected for application in an individual clinical case. However, the rules of internalization inherent in the different schools of psychotherapy concerned make it difficult to implement the practical selection with reference to the effect as the selection crit erion. The present study was intended to elucidate whether decisions o n selection are made in clinical practice and, if so, how. To this end , the selection decisions made on forms of therapy to be applied by do ctors and psychologists working with patients in a university hospital department of child psychiatry were subjected to a retrospective anal ysis. The forms of therapy most frequently selected were: (1) individu al pedagogical measures, (2) behaviour therapy, (3) client-oriented pl ay therapy and (4) psychoanalytical therapy. The result of the analysi s showed that different indications were accepted for these different types of therapy. The reasons for this differential decision-making pr actice, which is definitely at odds with the claims to omnipotence tha t generally emerge from the internal perspectives of the particular sc hools of therapy, presumably lie less in a successful transfer between research and practice than in selection processes arising out of the therapists' experience. Inferences for training practice are drawn.