Working With Dreams in Child and Adolescent Psychotherapy - A Systematic Review of Empirical Studies

Working with dreams in child and adolescent psychotherapy can support emotional stabilization, reduce nightmares, and enhance coping, according to a systematic review of 39 studies involving 1,495 participants published from 1960 to 2025. Psychodynamic approaches addressed unconscious conflicts, fears, and relational experiences, while cognitive-behavioral methods targeted nightmares and anxiety. Other interventions, including lucid dreaming and EMDR, appeared promising for nightmares and trauma-related symptoms. However, the strength of evidence is limited by small samples, lack of controls, and insufficient blinding. Methodologically robust studies are needed to substantiate these effects and implement them in clinical practice.

Study at a glance

Abstract

ObjectiveDreams are thought to reflect children's and adolescents' inner psychological processes. Despite their central role in clinical theories, their practical application and empirical grounding vary across psychotherapeutic approaches. This review systematically evaluates empirical evidence on working with dreams in child and adolescent psychotherapy.MethodThe EBSCO (MEDLINE, PsycINFO, PsycARTICLES, PSYNDEX), PubMed, Cochrane Library, and Web of Science databases were systematically searched and manually supplemented in May 2025. Methodological quality was assessed using the EPHPP-QAT. Included studies examined dream-related psychotherapeutic interventions in individuals aged 0–21 years. Results Thirty-nine studies (1,495 participants; published from 1960-2025) met the inclusion criteria. Strength of evidence is limited by small samples, lack of controls, and insufficient blinding. Psychodynamic approaches (n = 12) addressed unconscious conflicts, fears, and relational experiences, whereas cognitive-behavioral methods (n = 18) targeted nightmares and anxiety. Other interventions (n = 9), including lucid dreaming and EMDR, appeared promising for nightmares and trauma-related symptoms. ConclusionDespite methodological limitations, existing empirical research provides preliminary evidence that working with dreams in child and adolescent psychotherapy can support emotional stabilization, reduce nightmares, and enhance coping. In future research, methodologically robust studies are required to substantiate these effects and implement them in clinical practice.