Are psychoanalytic treatments helpful? Are psychoanalytic treatments evidence-based?

 

Ensconced in the consulting room, psychoanalytic practitioners have until very recently been averse to the intrusion entailed of research scientists. In the modern era, this stance has changed. Increasingly we see more and more outcome studies of psychoanalytic treatment. There are now a substantial volume of meta-analyses.

 

Have a look at: Leuzinger-Bohleber, M and Kächele, H. (eds.) (2015) An Open Door Review of Clinical, Conceptual, Process and Outcome Studies in Psychoanalysis

This text is a review of the evidence for the efficacy of psychoanalytic treatments, inter alia. This text is a vast compendium of abstracts and summaries that shows the great diversity of contemporary psychoanalytic research. Amongst other things, it provides a fairly recent meta-analysis by Leichensring & Klein that reviews the empirical evidence for psychodynamic-psychoanalytic therapy for specific mental disorders.

 

You can download a copy of the latest Open Door Review of Clinical, Conceptual, Process and Outcome Studies in Psychoanalysis here .

 

A number of robust studies across the world garner the evidence to support the efficacy of psychoanalytic psychotherapies.

  • Stockholm’s Outcome of Psychoanalysis and Psychotherapy Project (see Sandell et al 2002)

  • In Germany, Leichsenring and his colleagues (2002; 2004; 2008; 2015) various meta-analyses of results, including only randomised controlled trials that fulfilled rigorous criteria. Their findings confirm that short-term psychodynamic approaches are particularly effective in treating a variety of general psychiatric symptoms, social functioning and patient identified target problems.

    • Leichsenring and Rabung (2008) review of the research shows that long-term psychoanalytic psychotherapy was significantly superior to shorter-term methods of psychotherapy with regard to overall outcome, target problems and personality functioning.

    • They provide evidence of the effectiveness of long term psychotherapy for patients with complex mental disorders over any shorter term therapeutic counterparts.

    • Findings were also reported in the Scientific American.

    • “The actual benefits of intensive psychotherapy have long been controversial. Now investigators report that such therapy can be effective against chronic mental problems such as anxiety and depression. They looked at 23 studies involving 1053 patients who received long-term psychodynamic therapy, which seeks clues into the unconscious roots of disorders and focuses on the relationship between the therapist and the patient.

  • Treating specific diagnostic entities.

    • }using Diagnostic and Statistical Manual (DSM) symptom clusters there is considerable evidence of efficacy for psychodynamically-based psychotherapies for a variety of disorders. - the most effective way to treat personality disorders. Kernberg’s transference-focussed or Fonagy’s mentalisation-based approach are well known short-term approaches with robust outcome data.

    • Even in depression, interpersonal therapy – a treatment based on psychodynamic principles – shows superior results over nondirective supportive treatment and cognitive-behaviour therapies (Cuipers et al 2008). Using the disorder based approach to consider treatment effectiveness there is an ever increasing body of evidence, outperforming other treatment approaches on many variables.

  • Choi - Psychotherapy that lasted a year or longer appeared significantly more beneficial for complex mental problems than shorter-term therapies and seemed cost effective”. (Choi 2008 pg. 19).

 

Empirical Evidence for Psychoanalytic Treatments - International Psychoanalytic Association (IPA) fact sheet

The Institute of Psychoanalysis on the Evidence base of Psychoanalytic Psychotherapy.

Jonathan Shedler's review article of 2010 - Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist 65(2): 98-109.

  • The effect size for psychoanalytic psychotherapies superior to CBT and related therapies, it is superior to antidepressant medication.

  • The benefits of psychodynamic psychotherapy endure; they also increase over time.

Also worth looking at: Levy, R. A., Ablon, S.J. and Kächele, H. (eds) (2012) Psychodynamic Psychotherapy Research: Evidence-Based Practice and Practice-Based Evidence, Springer.

© 2017 by Dr Sarron Goldman

Coolbinia and Kingsley, Perth, Australia

Tel: +61 8 6304-5824

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