The evaluation of process and outcome in individual child psychotherapy.

The purpose of this study was to demonstrate the use of an objective method for the evaluation of therapy process and outcome in cases of individual child psychotherapy. Fourteen children ranging in age from 4 to 6 years were videotaped during the first and eighth sessions in interaction with their therapists. Approximately half the children received psychodynamic play therapy whereas the other half received client-centered play therapy. Using the Play Therapy Observational Instrument (PTOI) of Howe & Silvern (1981), videotapes were scored on 19 items. Data was reduced to 3 clusters: emotional discomfort, quality of interaction with the therapist, and beneficial fantasy play. No significant differences were obtained between therapeutic approaches. However, the PTOI was found to be sensitive to mean behavioral and verbal changes in the children from session one to session eight. Hence it appears that the PTOI scales offer clinicians a method of reviewing, tracking and assessing the process and outcome of their therapy work with children.