Effectiveness of systematic treatment selection for psychodynamic and cognitive–behavioural therapy: randomised controlled trial in routine mental healthcare

Watzke, Birgit; Rüddel, Heinz; Jürgensen, Ralph; Koch, Uwe; Kriston, Levente; Grothgar, Barbara; Schulz, Holger

doi:10.1192/bjp.bp.109.072835

Cited by 52 publications

(38 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results are partly in agreement with those of Watzke et al's who described favorable outcome of psychodynamic groups as evaluated with the GSI, but only when patients with ICD-10 anxiety diagnoses and specific treatment goals were not included in psychodynamic treatment, but in cognitive behavioral therapy [2]. Similarly, our results are partly in agreement with those of Kirchmann et al's who found that “overly avoidant” patients with an elevated GSI-corrected phobic anxiety and interpersonal sensitivity cluster profile obtain the overall least positive outcome in psychodynamic groups [5].…”

Section: Discussionsupporting

confidence: 92%

“…Consequently, in the present study—and in agreement with Watzke et al [2] and Kirchmann et al [5]—we expect patients with anxiety symptoms as measured with the SCL-90-R subscales to be less likely to improve. Improvement in target symptoms and GSI is evaluated according to Jacobson and Truax's constructs of reliable and clinical significant change (CSC) [14].…”

Section: Introductionsupporting

confidence: 92%

“…In a recent randomized controlled trial, Watzke et al selected patients for treatment in either psychodynamic or cognitive behavioral groups [2]. Selection for psychodynamic treatment included evaluations of psychological mindedness and the ability to work with nonsymptomatic treatment goals (e.g., “the integration of unconscious experience” and to “allow experience of emotions”), whereas treatment goals that focused on coping with specific situations and ICD-10 anxiety diagnoses qualified for cognitive behavioral therapy (ibid, page 97).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

SCL-90-R Symptom Profiles and Outcome of Short-Term Psychodynamic Group Therapy

2013

View full text Add to dashboard Cite

Background. Psychodynamic group psychotherapy may not be an optimal treatment for anxiety and agoraphobic symptoms. We explore remission of SCL-90-R Global Severity Index (GSI) and target symptoms in 39 sessions of psychodynamic group therapy. Methods. SCL-90-R “target symptom” profile and GSI remission according to Danish norms were identified in 239 patients and evaluated according to reliable and clinical significant change. Results. Four major groups of target symptom cases (depression, interpersonal sensitivity, anxiety, and phobic anxiety) covered 95.7% of the sample. As opposite to phobic anxiety and anxiety patients, patients with interpersonal sensitivity obtained overall the most optimal outcome. The phobic anxiety scale, social network support, and years of school education were independent predictors of GSI remission, and a low anxiety score and absence of phobic anxiety target symptoms were independent predictors of remission of target symptom pathology. Conclusions. The negative results as associated with the SCL-90-R phobic anxiety scale and the phobic anxiety target symptom group are largely in agreement with recent studies. In contrast, whatever the diagnoses, patients with interpersonal sensitivity target symptom may be especially suited for psychodynamic group therapy. The SCL-90-R subscales may allow for a more complex symptom-related differentiation of patients compared with both diagnoses and GSI symptom load.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Introductionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

SCL-90-R Symptom Profiles and Outcome of Short-Term Psychodynamic Group Therapy

2013

View full text Add to dashboard Cite

show abstract

“…38,41,86,87,141 In the remaining 142 studies, patients became part of the "outsiders" group for a variety of reasons. Table 2 presents the details about each included study.…”

Section: Summary Of Evidencementioning

confidence: 99%

Outcomes for patients with the same disease treated inside and outside of randomized trials: a systematic review and meta-analysis

Fernandes

Bryant

Griffith

et al. 2014

CMAJ

View full text Add to dashboard Cite

“…[11][12][13] However, the effectiveness of such therapies depends on the establishment of precise indication and contraindication criteria. 14,15 Research has demonstrated that treatment dropout in psychoanalytic psychotherapy is a highly prevalent outcome, 16 causing concern among psychotherapist of different schools. High indices of dropout may possibly be explained by the lack of precise indications for treatment.…”

Section: Introductionmentioning

confidence: 99%

Is it all grist to the mill? Wandering between indications for psychoanalytic treatment and the analytic field

Gastaud

Goi

Bassols

et al. 2013

Trends Psychiatry Psychother.

View full text Add to dashboard Cite

Determining the indications and contraindications for psychoanalytic treatment seems crucial to achieve therapeutic success and improve treatment effectiveness. In reviewing the classic literature on the topic, aspects such as age, diagnosis, motivation for treatment, present moment in life, ability to gain insight, psychic suffering when seeking treatment, defensive behaviors, and frustration tolerance are clearly analyzed by therapists/ analysts when indicating psychoanalytic treatments. However, traditionally, most criteria underlying such indications date back to a time when the therapeutic relationship was viewed merely as a therapist treating a patient, with no regard to the therapeutic relationship itself. The goal of this article was to critically review the relevance and current adequacy of indications for psychoanalytic treatment, in view of advancements in knowledge on the analytic field. Considering cases that do not evolve as expected according to the indications, patients who are better suited to certain therapists, and therapist-patient pairs that modify their interaction over the course of treatment, the main question remains on how to identify the necessary elements in evaluating a candidate patient for psychoanalytic treatment, as well as the significant elements of therapeutic action. Keywords: Psychoanalysis, psychoanalytic psychotherapy, indication, contraindication, analytic field. ResumoDeterminar critérios de indicação e contraindicação para tratamentos psicanalíticos parece um ponto técnico crucial para a obtenção de sucesso terapêutico e a elevação de seus índices de efetividade. Na revisão da literatura clássica sobre o tema, percebe-se que a idade, o diagnóstico do paciente, a motivação para tratamento, o momento de vida, a capacidade de insight, o sofrimento psíquico apresentado no momento da busca de tratamento, o estilo defensivo e a tolerância à frustração são alguns dos pontos analisados pelos terapeutas/analistas para indicar tratamentos psicanalíticos. Contudo, classicamente, tais indicações provêm de um período em que a relação terapêutica era vista meramente como um terapeuta atendendo um paciente, sem levar em conta a relação terapêutica propriamente dita. O objetivo deste artigo foi revisar criticamente a relevância e pertinência atual das indicações para tratamento psicanalítico, tendo em vista a evolução dos conhecimentos sobre o campo analítico. Considerando casos que não evoluem da maneira esperada segundo as indicações, pacientes que se adaptam melhor a determinados terapeutas e duplas que modificam sua interação ao longo do tempo de tratamento, a principal questão continua sendo como identificar quais seriam os elementos necessários na avaliação de um paciente candidato a tratamento psicanalítico, bem como os elementos significativos da ação terapêutica. Descritores: Psicanálise, psicoterapia psicanalítica, indicação, contraindicação, campo analítico.

show abstract

Effectiveness of systematic treatment selection for psychodynamic and cognitive–behavioural therapy: randomised controlled trial in routine mental healthcare

Abstract: Since systematic treatment selection seems to be able to optimise treatment outcome, at least for PDT, pursuing systematic treatment assignment strategies in mental healthcare settings is a worthwhile endeavour.

Cited by 52 publications

References 31 publications

SCL-90-R Symptom Profiles and Outcome of Short-Term Psychodynamic Group Therapy

SCL-90-R Symptom Profiles and Outcome of Short-Term Psychodynamic Group Therapy

Outcomes for patients with the same disease treated inside and outside of randomized trials: a systematic review and meta-analysis

Is it all grist to the mill? Wandering between indications for psychoanalytic treatment and the analytic field

Contact Info

Product

Resources

About