FUNCTIONS OF A CHILD'S QUESTIONS AS THE THERAPEUTIC ALLIANCE DEVELOPS

Abstract

This study proposes that an analysis of the psychological functions of a child's questions in therapy provides an accurate indication of the state of development of the therapeutic alliance. This proposition is tested through an intensive analysis of a single case. The method used in this study is naturalistic case study research into the process of psychotherapy. The analysis is conducted in several sequential steps. First a detailed case narrative is presented of ten months of individual and family psychotherapy with a nine-year-old boy. Then the nature and the developmental origins of the boy's subjective world are examined. Subsequently the development of the individual treatment relationship is explored in depth, with particular attention to the evolving transference and alliance. Finally the boy's questions are presented and their functions are determined.;The results demonstrate that questions can indeed be an accurate barometer of the state of the therapeutic alliance, once their psychological functions are elucidated. The generalizability and the clinical importance of this finding are discussed. Several theoretical implications are drawn from this study. The relative utility of psychoanalytic and experiential models of reflective thought is explored. A developmental line of reflection is proposed and described. Mirror transferences with children and adults are compared.;In summary, it is argued that an examination of questions in therapy with children can be an important clinical tool. The study of questions can help a therapist to ascertain the precise nature of a child's attempts to ally with the therapist in verbalizing the child's central psychological concerns.