20/20 Hindsight: A 25-year programme at the Anna Freud Centre of efficacy and effectiveness research on child psychoanalytic psychotherapy.

OBJECTIVE: This paper describes the evolution of methods of enquiry-through 25 years of work, with Professor Peter Fonagy and many other colleagues-of research and theorizing about child and adolescent therapy outcomes. METHOD: The work has focused on measuring psychoanalytic outcomes, but with an increasing interest in discovering therapeutic elements across treatment modalities. RESULTS: Headline findings are described, with lessons from the ups and downs of developing (a) retrospective, follow-up, and prospective outcome studies, and (b) measures of child and family functioning. Issues of manualizing and measuring treatment process are discussed, together with the fruitfulness of mixed-method (quantitative and qualitative) process and outcome research with young people and families. CONCLUSIONS: Using the dilemmas, experiences, and findings ||of our group as examples, growing points and well as growing pains for the field are suggested.