The Problem of Outcome in Child Psychoanalysis: Contributions from the Anna Freud Centre

Recent years have seen increasingly informed media presentations of psychological principles and psychological treatments. Alternative therapeutic models (pharmacotherapy, behavioral, and cognitive behavioral treatments) have received considerable exposure as have critiques of psychoanalysis and the work of Freud. Perhaps as a consequence, there is increasing unease about the time and expense involved in psychoanalytic treatment, particularly for children, who do not generally choose to come for analysis. The common-sense view outside psychoanalytic circles is, increasingly, that psychoanalysis is no more effective than other forms of treatment, some would say less, yet it takes far longer and is substantially more expensive than, for instance, medication or cognitive-behavior therapy. The traditional view on this within psychoanalysis is that analysts know their form of treatment is effective and, in fact, unique in its effects and that there is no need to prove this. For those who think beyond this, there is often a further statement that it would, in any case, be impossible to prove the value of psychoanalysis, because the important aspects of both process and outcome are (while clear to analyst and patient) unmeasurable. However,