Effectiveness Of Long-term Psychodynamic Psychotherapy Research Articles

Follow-up of the effectiveness of long-term psychodynamic psychotherapy and psychoanalysis 5 years after the end of psychoanalysis: Minor differences in psychiatric symptoms and work ability

BackgroundPsychoanalysis (PA) has been suggested to yield further continued symptomatic and functional improvement after the end of treatment. MethodsPost-treatment work ability, psychiatric symptoms, and need for treatment were compared between PA and long-term psychodynamic psychotherapy during a five-year follow-up. The study sample consisted of 169 outpatients, suffering from long-standing mood or anxiety disorder. ResultsA slightly greater reduction in psychiatric symptoms and improvement in work ability were found in the PA group. LimitationsThis was a naturalistic study. ConclusionsPA may not be a standard treatment in a patient population like this.

Is It All about the Higher Dose? Why Psychoanalytic Therapy Is an Effective Treatment for Major Depression.

Empirical evidence for the effectiveness of long-term psychodynamic psychotherapy (LTPP) in patients with mood disorders is growing. However, it is unclear whether the effectiveness of LTPP is due to distinctive features of psychodynamic/psychoanalytic techniques or to a higher number of sessions. We tested these rival hypotheses in a quasi-experimental study comparing psychoanalytic therapy (i.e., high-dose LTPP) with psychodynamic therapy (i.e., low-dose LTPP) and cognitive-behavioural therapy (CBT) for depression. Analyses were based on a subsample of 77 subjects, with 27 receiving psychoanalytic therapy, 26 receiving psychodynamic therapy and 24 receiving CBT. Depressive symptoms, interpersonal problems and introject affiliation were assessed prior to treatment, after treatment and at the 1-, 2- and 3-year follow-ups. Psychoanalytic techniques were assessed from three audiotaped middle sessions per treatment using the Psychotherapy Process Q-Set. Subjects receiving psychoanalytic therapy reported having fewer interpersonal problems, treated themselves in a more affiliative way directly after treatment and tended to improve in depressive symptoms and interpersonal problems during follow-up as compared with patients receiving psychodynamic therapy and/or CBT. Multilevel mediation analyses suggested that post-treatment differences in interpersonal problems and introject affiliation were mediated by the higher number of sessions, and follow-up differences in depressive symptoms were mediated by the more pronounced application of psychoanalytic techniques. We also found some evidence for indirect treatment effects via psychoanalytic techniques on changes in introject affiliation during follow-up. These results provide support for the prediction that both a high dose and the application of psychoanalytic techniques facilitate therapeutic change in patients with major depression. Psychoanalytic therapy is an effective treatment for major depression, especially in the long run. The differential effectiveness of psychoanalytic therapy cannot be fully explained by its higher dose. Distinctive features of psychoanalytic technique (e.g., focusing on patients' dreams, fantasies, sexual experiences or childhood memories) may play an important role in establishing sustained therapeutic change.

Making Sense of Meta-Analysis: A Critique of “Effectiveness of Long-Term Psychodynamic Psychotherapy”

Evidence-based practice depends in part on knowledge derived from relevant research. For any given topic, there are likely to be many, potentially relevant studies; a careful appraisal and synthesis of the results of these studies is needed to understand the state of the empirical evidence. Meta-analysis is widely used to combine results of quantitative studies; yet this method is unfamiliar to many people and, as a result, meta-analyses are often uncritically accepted. In this article, we argue that meta-analysis is only one component of a good research synthesis. We critique a recent metaanalysis on the effectiveness of long-term psychodynamic psychotherapy, showing that this metaanalysis failed to meet current standards for the conduct and reporting of systematic research reviews and meta-analyses. We demonstrate the use of AMSTAR, a straightforward tool for assessing the quality of systematic reviews and meta-analyses.