Miller, Jill Marie; (1993) The development and validation of a manual of child psychoanalysis. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Although manualisation of psychotherapies is considered a precondition for systematic psychotherapy research, there has thus far been no attempt to manualise psychoanalytic treatment. The present study concerns the development of a manual of child psychoanalysis. It involves the investigation of the explicit and implicit principles which guide the work of child psychoanalysts at the Anna Freud Centre. In the first part of the thesis a historical review of the development of child psychoanalytic technique is reported. The comparison of major contributions reveals that many ambiguities exist in the recommendations made for child psychoanalytic techniques and that actual practice can only be considered to be implicitly guided by some undetermined amalgam of these recommendations. The relationship between theory and practice is explored, and the types of research usually found within child psychoanalysis are reviewed. These reviews highlight the need for manualisation which has the potential to clarify the necessary and sufficient components of child analytic treatment techniques. An initial attempt to manualise the key therapeutic ingredients, guidelines, and strategies of child psychoanalysis is presented. This attempt at systemisation is described and the results of a validation study are given. A further study is reported which attempted to validate a novel approach to the content analysis of psychoanalytic material. The validation of a second attempt at manualisation, informed by the results and difficulties encountered in the previous studies, is reported. This study explores the face validity of definitions used in the new manual and results in a comparison with analyst's explicit working models. A further, large scale empirical study is reported which attempts to determine child psychoanalyst's implicit working definitions of psychoanalytic concepts, as well as their technical means and aims. Findings indicate that systemisation of treatment techniques may be possible on the basis of this instrument. The discussion of the thesis recommends the composition of a manual for child psychoanalysis. The implications of this research for the theory and practice of child psychoanalysis are considered, as well as future directions.

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