Beginnings of Psychotherapy with Adopted Children and Young People: A Grounded Theory Analysis

This thesis focuses on the beginnings of psychotherapy with adopted children and young people, since to date there is no empirical data available concerning an in-depth look at beginnings of psychotherapy with this group. It aims to shed light on the process of beginning of psychotherapy for adopted children and young people, to understand the emotional ramifications of beginning therapy, identify the common themes, and explore the therapeutic technique used in these initial encounters. Beginnings is a key theme in adoption, as a significant number of adopted children and young people have had distressing early life experiences of neglect, loss and abandonment. Methods: Nine sets of process notes (notes written by psychotherapists after the session to record what happened in it) from three sequential 50-minute psychotherapy assessment sessions belonging to three patients, were analysed using psychoanalytically informed grounded theory. A literature review was also performed. Findings: The literature search revealed a significant gap, finding no current publications into beginnings or opening sessions of psychotherapy for adopted children and young people. Analysis of the sessions identified six core categories of findings which include: establishing the framework and practical setting; difficulty in relating; alterations of technique; embodied unspeakable communication; patient and therapist being nice to one another; and feelings of exclusion and deprivation. The most frequent therapeutic techniques identified involved using an active, enquiring and non-challenging manner. Conclusions: This study identifies some of the challenges of getting to know someone at the start of therapy, particularly fears of rejection and elements of confusion. It shows how attention should be paid to the beginnings of psychotherapy for adopted children and young people since depth and meaning can be gained from them. This understanding has the potential to benefit the rest of the therapeutic process.