Psychodynamic interpersonal therapy by inexperienced therapists in a naturalistic setting: a pilot study

Abstract

Background This pilot study examined the feasibility of conducting a randomized controlled trial of brief psychodynamic interpersonal (PI) therapy, carried out by inexperienced psychiatry trainees, in a secondary care psychotherapy setting with NHS psychotherapy patients waiting for a brief therapy intervention. Method Patients were randomized to receive twelve weeks' PI therapy immediately or to remain as waiting-list controls for that period, following which they received twelve weeks' PI therapy. Results Fifty-four patients entered the study, of whom thirty-three completed therapy. The data were analysed in two ways. First, significant improvement was demonstrated in those patients who completed therapy. Second, the comparison between twenty-four patients randomized to treatment and twenty-two waiting-list controls showed a non-significant trend towards greater improvement in the immediate treatment group. Conclusions The study implementation was feasible in a service setting. This study provides preliminary evidence that treatment by inexperienced therapists may be effective and that the majority of patients can be engaged in therapy. However, high attrition rates were found between waiting list and completion of therapy, and patients with a history of abuse in childhood were particularly difficult for trainees to engage in brief therapy. A definitive study with adequate power confidently to detect differences of this magnitude would require sample sizes of approximately 121 in each comparison group.