As human behaviour can be complex and children are diverse beings, only some parts of the spiral may be explored yet, some children may travel around the spiral more than once. Not indicative to all children, the spiral of therapeutic change offers a clear general understanding of the process of therapy and it’s cyclical and flexible nature is appealing as it can be adapted to suit the complexities of children’s issues. This quality could be referred to as yet another strength of the SPICC model and indicates that it is dynamic and process-driven. “The Spiral of Therapeutic Change” also displays a brief solution focused core, which could be considered valuable when working with children in terms of time-constraints and cost-effectiveness. Geldard, et al., (2018) also describe the Spiral of Change as a helpful tool for evaluating progress. “The majority of child and adolescent integrative programs (CPP, TST, TF-IPT and PCIT etc.) have been designed to address specific disorders” (Krueger & Glass, 2013, p. 336), including traumatic stress, ADHD and anxiety. Krueger & Glass (2013) report that extensive research including randomised outcome studies have been conducted to demonstrate the effectiveness of a number of therapies, but by no means do all have evidence base to date. And although psychotherapy integration is an essential part of child and adolescent treatment, a limitation of the SPICC model appears to be lack of significant empirical research in the field. Furthermore, although the model contains well-established evidence based psychotherapeutic approaches, the appropriate transition between the stages is considered vital for the therapy to be effective. Geldard, et al., (2018) state this model is appropriate for use with trauma, yet a percentage of children who present with significant trauma or other more complex issues that may require more long-term help. Moreover, the expectation that the therapy should be relatively short-term may cause some counsellors to feel under pressure and move the therapy along at a pace that is more suited to their needs than those of the child.>