Abstract
BackgroundDespite growing evidence for manualized psychodynamic treatments, there is a lack of studies on their transfer to routine practice. This is the first study to examine the effects of an additional training in manualized Short Term Psychodynamic Psychotherapy (STPP) on the outcome in routine psychotherapy for social anxiety disorder (SAD). The study is an extension to a large RCT comparing STPP to Cognitive-Behavioral Therapy of SAD.MethodsThe manualized treatment was designed for a time limited approach with 25 individual sessions of STPP over 6 months. Private practitioners were randomized to training in manualized STPP (mSTPP) vs. treatment as usual without a specific training (tauSTPP). A total of 109 patients were enrolled (105 started treatment; 75 completed at least 20 treatment sessions). Assessments were conducted pre-treatment, after 8 and 15 weeks, after 25 treatment sessions, at the end of treatment, 6 and 12 months after termination of treatment. Remission as primary outcome was defined by the Liebowitz-Social-Anxiety-Scale (LSAS) score ≤30. Secondary outcomes were response (at least 31% reduction in LSAS), treatment duration and number of sessions, changes in social anxiety (LSAS, SPAI), depression (BDI), clinical global impression (CGI), and quality of life (EQ-5D).ResultsRemission rates of mSTPP (9%) resp. tauSTPP (16%) and also response rates of 33% resp. 28% were comparable between the two treatment approaches as well as treatment duration and number of sessions. Most of the within-group differences (baseline to 25 sessions) indicated moderate to large improvements in both treatments; within-group differences from baseline to 12 months follow-up (LSAS, SPAI, BDI, CGI) were large ranging from d = −0.605 to d = −2.937. Benefits of mSTPP were limited to single outcomes.ConclusionsFindings are discussed with regard to implementation and dissemination of empirically validated treatments in psychodynamic training and practice. SAD patients with a high comorbidity of personality disorders and a long treatment history may need longer treatments.Trial registrationGerman Clinical Trials Register (DRKS) DRKS00000570, registered 03. March 2011.
Highlights
Despite growing evidence for manualized psychodynamic treatments, there is a lack of studies on their transfer to routine practice
For the total scale of 17 items we found a higher agreement to the items (p < .001) in manualized STPP (mSTPP) (M = 14.56, SD = 1.95) compared to M = 11.24 (SD 3.79) in tauSTPP
As expected behaviours referring to specific interventions of the treatment manual (e.g. I checked my anxiety formula critically) were more often practiced by patients treated with mSTPP
Summary
Despite growing evidence for manualized psychodynamic treatments, there is a lack of studies on their transfer to routine practice. This is the first study to examine the effects of an additional training in manualized Short Term Psychodynamic Psychotherapy (STPP) on the outcome in routine psychotherapy for social anxiety disorder (SAD). Social anxiety disorder (SAD) is a highly prevalent disorder with an average 12 month prevalence rate between 2% in the German [1,2,3] and 7.4% in the US population [4]. About half of all psychotherapies in German clinical practice are psychodynamic psychotherapies [8], the quality and effectiveness of psychodynamic psychotherapy for SAD is unknown. Many psychodynamic practitioners are biased against structured short-term treatment approaches and disorder specific manualized treatments have rarely been used in psychodynamic training and practice
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
