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Background. Psychodynamic psychotherapy is a psychological treatment approach that has a growing empirical base. Research has indicated an association between therapist-facilitated affective experience and outcome in psychodynamic therapy. Affect-phobia therapy (APT), as outlined by McCullough et al., is a psychodynamic treatment that emphasizes a strong focus on expression and experience of affect. This model has neither been evaluated for depression nor anxiety disorders in a randomized controlled trial. While Internet-delivered psychodynamic treatments for depression and generalized anxiety disorder exist, they have not been based on APT. The aim of this randomized controlled trial was to investigate the efficacy of an Internet-based, psychodynamic, guided self-help treatment based on APT for depression and anxiety disorders.Methods. One hundred participants with diagnoses of mood and anxiety disorders participated in a randomized (1:1 ratio) controlled trial of an active group versus a control condition. The treatment group received a 10-week, psychodynamic, guided self-help treatment based on APT that was delivered through the Internet. The treatment consisted of eight text-based treatment modules and included therapist contact (9.5 min per client and week, on average) in a secure online environment. Participants in the control group also received online therapist support and clinical monitoring of symptoms, but received no treatment modules. Outcome measures were the 9-item Patient Health Questionnaire Depression Scale (PHQ-9) and the 7-item Generalized Anxiety Disorder Scale (GAD-7). Process measures were also included. All measures were administered weekly during the treatment period and at a 7-month follow-up.Results. Mixed models analyses using the full intention-to-treat sample revealed significant interaction effects of group and time on all outcome measures, when comparing treatment to the control group. A large between-group effect size of Cohen’s d = 0.77 (95% CI: 0.37–1.18) was found on the PHQ-9 and a moderately large between-group effect size d = 0.48 (95% CI: 0.08–0.87) was found on the GAD-7. The number of patients who recovered (had no diagnoses of depression and anxiety, and had less than 10 on both the PHQ-9 and the GAD-7) were at post-treatment 52% in the treatment group and 24% in the control group. This difference was significant, χ2(N = 100, d f = 1) = 8.3, p < .01. From post-treatment to follow-up, treatment gains were maintained on the PHQ-9, and significant improvements were seen on the GAD-7.Conclusion. This study provides initial support for the efficacy of Internet-delivered psychodynamic therapy based on the affect-phobia model in the treatment of depression and anxiety disorders. The results support the conclusion that psychodynamic treatment approaches may be transferred to the guided self-help format and delivered via the Internet.

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There has been a strong discourse in public policy aimed at transforming rural places from venues of primary production into truly diverse socioeconomic landscapes. Yet conceptualisations of the rural as envisioned in the policy and politics of the 'new economy' often prove to be elusive on the ground. However, post-productive activity in rural areas has become a major focus for rural studies scholars. This paper investigates the ideas of post-productivism in the existing literature, and argues for a holistic understanding of post-productivism as an idea and political ambition rather than an imperative and irreversible change of rural economic activity. The purpose of the study is to make clear the division between post-productivism and the related concepts of post-production and post-productive activities in order to better understand processes of rural change in relation to different geographical contexts. It is argued that post-productivism as a concept stands apart from de facto post-production and alternative concepts such as multifunctionality and should be regarded as part of broader regional development discourses. The paper outlines several important fields in which post-productivism is a necessary component for rural transformation and development. While it is not always easily captured in indicators or empirical studies in rural locations, postproductivism exists at the level of discourse and planning and thus has real effects on the ground. The paper concludes by offering suggestions on how to apply the concepts of post-productivism, post-production and multifunctionality in future studies.Abstrakt: De senaste årens landsbygdspolitik kännetecknas av en stark diskurs för att omvandla platser från dominerande primärproduktion till skiftande socioekonomiska aktiviteter där inte minst turism förväntas inta en stark ställning. Omvandlingsambitionen framträder särskilt starkt i styrdokument och projektverksamhet, samtidigt som tydliga och omfattande reella avtryck ofta lyser med sin frånvaro. Däremot har post-produktiva verksamheter på landsbygden blivit 298/346 ett viktigt fokus för forskare. I föreliggande artikel undersöks idéer kring postproduktion och post-produktivism så som de framkommer i tidigare forskning. Det argumenteras för behovet av en helhetssyn på post-produktivism som idé och politisk ambition, liksom att ta utgångspunkt i att uppenbara förändringar av landsbygdens ekonomiska aktiviteter ännu inte är särskilt omfattande. Syftet med studien är att klargöra begreppens innehåll och relation till multifunktionalitet för att bättre förstå landsbygdens förändring i relation till olika geografiska sammanhang. Artikeln beskriver flera viktiga områden där post-produktivism är en nödvändig komponent för landsbygdens omvandling och utveckling, men att den faktiska utvecklingen och de politiska ambitionerna inte alltid går hand i hand. Artikeln avslutas genom att ge förslag på hur man kan använda begreppen inom forskningen.