title: Implementation and outcome of child psychotherapy compared with other psychiatric treatments in a naturalistic clinical setting.
abstract: BACKGROUND
  Mental health problems of children are commonly treated by psychotherapy and other psychosocial treatments. Studies comparing different treatments in naturalistic clinical settings are few, however.
  
  
  OBJECTIVE
  We assessed the differences: 1) in symptoms and diagnoses; 2) in treatment outcome between psychotherapy and other psychosocial treatments; and 3) evaluated the effect of family background and life circumstances on the outcome.
  
  
  METHODS
  The data were collected from the psychiatric hospital records of Oulu University Hospital, Finland. All 118 children (aged < 16 years) referred to psychotherapy from the Department of Child Psychiatry in 1996-2005 and 118 age- and sex-matched children undergoing other psychosocial treatments were included. A lack of later recorded psychiatric problems was used as an indicator of good treatment outcome.
  
  
  RESULTS
  On referral, functional ability was severely impaired in almost half of the children (Children's Global Assessment Scale score < 55). Internalizing symptoms were more common in the psychotherapy group, while no difference was found in externalizing symptoms between the groups. In both groups, later psychiatric problems were associated with a child's low functional ability and poor parental coping with their responsibilities. Children with internalizing problems had impaired prognosis if they had psychosocial treatments other than psychotherapy.
  
  
  CONCLUSIONS
  Individual psychotherapy should especially be considered for children with internalizing symptoms, but the outcome of psychiatric treatment depends not only on children's own functional abilities, but also on parental abilities.
authors.affiliation: Taimi Ryynänen, Institute of Clinical Medicine, Department of Child Psychiatry and Clinic of Child Psychiatry, University of Oulu , Box 26, 90029 OYS, Oulu , Finland .
authors.forename: Taimi
authors.initials: T
authors.lastname: Ryynänen
authors.forename: Markku
authors.initials: M
authors.lastname: Alen
authors.forename: Heli
authors.initials: H
authors.lastname: Koivumaa-Honkanen
authors.forename: Leena
authors.initials: L
authors.lastname: Joskitt
authors.forename: Hanna
authors.initials: H
authors.lastname: Ebeling
mesh_terms: D000223:Adaptation, Psychological; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D010290:Parents / Q000523:psychology; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome
keywords: Child; Outcome; Psychotherapy; Treatment