Abstract

More studies on psychotherapy with children and adolescents are needed to highlight their perspectives. Existing research has been primarily based on reports by adults such as caregivers or psychotherapists, perhaps due to methodological and ethical challenges. This is especially significant for children and adolescents who lived through difficult life experiences, such as child sexual abuse. In this chapter, we will present our research work, using drawings that capture child’s and adolescent’s views of psychotherapeutic change in therapies due to sexual abuse experiences. First, the background of studies that assess psychotherapeutic change in therapies following sexual abuse for children and adolescents will be reviewed. Then, the basis that grounds research with drawings to approach children’s perspectives, such as the interdisciplinary foundations for children’s participation, developmental characteristics of young children, and methodological and ethical issues, will be briefly presented. The last is especially relevant when researching sensitive topics like sexual abuse. For example, drawings can be considered a non-intrusive research technique that considers possible challenges in the verbal expression of young children about complex issues. Third, we will present briefly the drawing technique we have used in our research. This is the “before and after” drawing (and its variations), which aims to study psychotherapeutic change. Furthermore, a methodological proposal to perform the analysis of the drawings will be explained. The analysis includes visual narrative analysis, complemented by the children’s verbal accounts of the drawings. Lastly, we will present an analysis of the process and evolution of psychotherapeutic change in a sample of children and adolescents who had lived sexual abuse experiences by analyzing drawings made by them at different moments of their therapies as part of a longitudinal research. The discussion will highlight the possibility of listening to children’s and adolescents’ perspectives through drawings as a developmental, methodological, and ethically sensitive technique in cases of sexual abuse. The integration of drawings’ visual and verbal narratives provides further insights into participants’ perspectives, as the visual enables them to express their meanings in other ways, producing a more comprehensive and complete view of the psychotherapeutic change process. Discussion about the potential of this creative and easy-to-use technique for research, also used in clinical practice, is drawn. This is especially relevant for the Latin American context, where there are usually scarce resources for evaluating and exploring children’s therapy process. © 2025 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG.