PSYCHOTHERAPY - DEFINITIONS, MECHANISMS OF ACTION, AND RELATIONSHIP TO ETIOLOGIC MODELS

In this paper, we define psychotherapy as a modality of treatment in w hich the therapist and patient(s) work together to ameliorate psychopa thologic conditions and functional impairment through focus on the the rapeutic relationship; the patient's attitudes, thoughts, affect, and behavior; and social context and development. The possible mechanisms of action and active ingredients of psychotherapy in children and adol escents are discussed, with an emphasis on the above-noted domains. Th e adult psychotherapy literature strongly supports the central roles o f the therapeutic relationship and therapeutic empathy; this has been much less intensively explored in the child and adolescent psychothera py literature. Similarly, there have been few studies examining the me diation of treatment effects by impact on specific domains. Ideally, t reatment studies should gather data that can be informative about the impact of putative mediating and moderating psychosocial and biologica l variables on outcome and course. The results of such studies can aid further refinements in both theories of etiology and improvement in t reatments for children and adolescents.