The Therapeutic Process of a Child Diagnosed With Disruptive Mood Dysregulation Disorder

It has been recognized that there is a need to make psychotherapy more effective for children with disruptive symptoms. Many studies on child psychodynamic psychotherapy have indicated its effectiveness, but do not explain how this treatment works. It is not only necessary to understand how it works, but also for which therapist-patient dyads. The Child Psychotherapy Q-Set was designed to describe the therapeutic process with children, and makes it possible to identify interaction structures (i.e., repetitive patterns of interaction) and how they change in the course of a treatment. Based on these assumptions, the aim of this study was to analyze the psychotherapeutic process of a school-aged boy who presented with disruptive behavior disorder, identifying the interaction structures in his treatment. A total of 123 sessions of his treatments were analyzed and 4 interaction structures were identified: 2 became more characteristic over the course of treatment, and 2 became less characteristic. They also varied in magnitude. The therapeutic process showed characteristics consistent with the models described as ideal for psychodynamic psychotherapy, the reflective functioning process, and cognitive-behavioral therapy, in this order of significance. The study highlighted the importance of supportive interventions alongside expressive ones in the treatment of children with disruptive behavior disorders. The results also suggested the integrationist nature of most psychotherapies, and the importance of acknowledging and understanding the effective elements, rather than treatment types that can be present within any therapeutic modality.