Abstract
BackgroundLittle is known about the influence on outcome of exploration of the patient-therapist relationship (that is, transference work) in psychoanalytic psychotherapy. We hypothesized that depressed adolescents would have better long-term effects from psychoanalytic psychotherapy with than without transference work.MethodsDepressed adolescent (16 to 18 years) were recruited in health authority funded out-patient clinics in Oslo and Vestfold County, Norway. They were randomized to 28 weeks of treatment with psychoanalytic psychotherapy with or without transference work. Change was assessed using linear-mixed models. The primary outcome measure was the Psychodynamic Functioning Scale (pre- post-, and 1-year post-treatment). Level of depression was measured at the same time points and during therapy (week 12, and 20).Results69 adolescents were treated with (N = 39) or without (N = 31) transference work. The mean number of sessions was 18.6 (SD = 8,6) in the transference work group and 18.0 (SD = 10.9) in the non-transference work group.Both groups showed large and significant improvement on Psychodynamic Functioning Scale during the whole study period. The difference between the two groups was not significant during the treatment period (95% CI −.79 to 1.2, p = .674, F = .18), or from post-treatment to one-year follow-up (95% CI −.13 to .96; p = .134; F = 2.3). For the secondary outcome measures the transference work group had significantly better outcomes from 12 weeks in treatment to one-year follow-up (Beck Depression Inventory, 95% CI − 1.7 to −.14, p = .022; Montgomery and Åsberg Depression Rating Scale, 95% CI − 1.6 to −.23, p = .009).ConclusionThe findings suggest that exploration of the adolescents’ relations to the therapist amplify the effects of short-term psychoanalytic psychotherapy on their depressive symptoms for adolescents with a Major Depressive Disorder.Trial registrationClinicalTrials.gov. Id: NCT01531101. Registered 8 February 2012.
Highlights
Little is known about the influence on outcome of exploration of the patient-therapist relationship in psychoanalytic psychotherapy
The aim of the study was to decide whether depressed adolescents improve significantly more from short-term psychoanalytic psychotherapy with than without transference work [16], up to 1-year followup, both in terms of overall functioning (PFS), as well as depression symptoms (BDI and MADRS)
Between February 2012 and September 2017, 70 patients were randomly assigned to psychoanalytic therapy with (N = 39) or without (N = 31) transference work. 1 patient withdrew from the study
Summary
Little is known about the influence on outcome of exploration of the patient-therapist relationship (that is, transference work) in psychoanalytic psychotherapy. We hypothesized that depressed adolescents would have better long-term effects from psychoanalytic psychotherapy with than without transference work. Mental health problems, such as anxiety and depression, are estimated to affect 30% of youth worldwide. There is a need for a more comprehensive evidence base for treatment of young people with mental health problems, including depression [1]. Empirical evidence supports treatment with psychoanalytic psychotherapy in adolescents [2,3,4]. Short-term psychoanalytic psychotherapy has been shown to promote improvement in depressed young individuals [4, 5]. The study “Improving mood with psychoanalytic and cognitive therapies” (IMPACT) is the most extensive trial in the field of youth depression psychotherapy [4]. The authors reported no evidence for the superiority of any of the three treatment modes in maintenance of reduced depression symptoms approximately 12 months after treatment [4]
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