Mercieca, Daniel; (2021) Children’s Views of Psychotherapy in Residential Alternative Care in Malta. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Research on children’s views of mental health services in alternative care has been identified as an underrepresented domain within literature about children in care. This practice-based qualitative enquiry aims to elicit, represent, and understand children’s accounts and evaluations of psychotherapy. It also aims to enable children’s feedback about the methods used to engage them in research. It focuses on the psychotherapy interventions offered to children by a team of psychotherapists from different modalities, working in a residential alternative care setting in Malta. The study aims to contextualise children’s views by including the perspectives of adults involved or related to the service. It problematises the similarities and differences between children’s and adults’ views of psychotherapy and seeks to understand them in the light of child– adult dynamics within a specific context. The study also involved a children’s reference group where they were consulted about the research aims and design. Fifteen children, who were attending, or had attended therapy, consented to participate. Data with children were collected through a flexible, multiple method approach where children were offered a choice regarding how they wished to express their views. The study included the inductive thematic analysis of 29 interviews with children and 13 interviews with adults. Findings convey children’s views regarding engagement, expression, change and power dynamics, and communicate children’s needs and priorities which were absent from adults’ understandings. They challenge adultdetermined psychotherapy beliefs and practices, and inform the development of psychotherapy services within the setting. By enabling and problematising children’s agency and participation, this study contributes to knowledge about children in therapy as active agents and rights holders. It communicates the opportunities revealed by such an approach within research, offering critical insights into the development of data collection tools, and proposes a relational, interactional and multi-layered conceptualisation of children’s voices and agency.

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