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With the aim of increasing knowledge about processes of change in psychodynamic individual child psychotherapy, sessions that could be called turning points were analysed.
Method In a series of sessions, five experienced therapists each identified one session that was a ‘turning-point session’ according to the following definition: ‘a session where the therapist notices that something qualitatively new may be identified concerning the behaviour of the child or the child's way of showing his/her inner world, or where something new enters the interplay between the child and the therapist.’
Each therapist was interviewed three times, immediately after the turning-point session, one year later and approximately two years later. Process records, information collected through a questionnaire and the interviews were analysed using a hermeneutic approach.
Results In order to understand the mechanisms behind these therapeutic changes, it is fruitful to study the therapeutic process preceding the turning point, the countertransference of the therapist and changes in the setting of the therapy. The therapists often identified changes when something unpredictable or unusual had happened in the usually rather predictable therapeutic space. Three of the five turning points occurred after interruptions in therapy. Parallel processes in the parents’ therapy and in the therapist's own supervision were other important aspects. A key principle underlying changes of this kind could be described in terms of ‘intersubjectivity’. It is the emotional meeting between two subjects, each influencing the other, which prepares the way for change to take place.
KEYWORDS Child psychotherapy; intersubjectivity; turning points; processes of change; psychodynamics; psychotherapeutic processes.