Psychodynamic Psychotherapy and Research Evidence

Glass, Richard M.

doi:10.1001/jama.300.13.1587

Cited by 38 publications

(22 citation statements)

References 74 publications

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“…In an accompanying editorial, Glass [11] declared the meta-analysis to be a 'carefully performed' (p. 1589) defense against criticisms that LTPP lacked empirical support. The meta-analysis has now also been cited as evidence for the effectiveness of psychodynamic treatments [12] , and referenced in draft guidelines for empirically supported treatments for depression [13] .…”

Section: Introductionmentioning

confidence: 99%

Is Longer-Term Psychodynamic Psychotherapy More Effective than Shorter-Term Therapies? Review and Critique of the Evidence

Bhar

Thombs

Pignotti

et al. 2010

Psychother Psychosom

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Background: In 2008, Leichsenring and Rabung performed a meta-analysis of 8 studies of longer-term psychodynamic psychotherapy (LTPP). The work was published in the Journal of the American Medical Association (vol. 300, pp 1551–1565), and they concluded that LTPP was more effective than shorter-term therapies. Method: Given that such claims have the potential to influence treatment decisions and policies, we re-examined the meta-analysis and the 8 studies. Results: We found a miscalculation of the effect sizes used to make key comparisons. Claims for the effectiveness of LTPP depended on a set of small, underpowered studies that were highly heterogeneous in terms of patients treated, interventions, comparison-control groups, and outcomes. LTPP was compared to 12 types of comparison-controls, including control groups that did not involve any psychotherapy, short-term psychodynamic psychotherapy, and unvalidated treatments. Additionally, the studies failed to protect against threats to bias, and had poor internal validity. Conclusion: Overall, we found no evidence to support claims of superiority of LTPP over shorter-term methods of psychotherapy.

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Section: Introductionmentioning

confidence: 99%

Is Longer-Term Psychodynamic Psychotherapy More Effective than Shorter-Term Therapies? Review and Critique of the Evidence

Bhar

Thombs

Pignotti

et al. 2010

Psychother Psychosom

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“…The article was entitled: ‘Psychotherapy research evidence and reimbursement decisions: Bambi meets Godzilla.' In 2008, Richard Glass [116], deputy editor of JAMA, commented on a meta-analysis of PDT by asking: ‘Psychodynamic psychotherapy and research evidence: Bambi survives Godzilla?' [[116], p 1587].…”

Section: Discussionmentioning

confidence: 99%

“…In 2008, Richard Glass [116], deputy editor of JAMA, commented on a meta-analysis of PDT by asking: ‘Psychodynamic psychotherapy and research evidence: Bambi survives Godzilla?' [[116], p 1587]. According to the review presented here, Bambi seems to be alive and kicking.…”

Section: Discussionmentioning

confidence: 99%

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

Leichsenring

Leweke

Klein

et al. 2015

Psychother Psychosom

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Background: The Task Force on Promotion and Dissemination of Psychological Procedures proposed rigorous criteria to define empirically supported psychotherapies. According to these criteria, 2 randomized controlled trials (RCTs) showing efficacy are required for a treatment to be designated as ‘efficacious' and 1 RCT for a designation as ‘possibly efficacious'. Applying these criteria modified by Chambless and Hollon, this article presents an update on the evidence for psychodynamic therapy (PDT) in specific mental disorders. Methods: A systematic search was performed using the criteria by Chambless and Hollon for study selection, as follows: (1) RCT of PDT in adults, (2) use of reliable and valid measures for diagnosis and outcome, (3) use of treatment manuals or manual-like guidelines, (4) adult population treated for specific problems and (5) PDT superior to no treatment, placebo or alternative treatment or equivalent to an established treatment. Results: A total of 39 RCTs were included. Following Chambless and Hollon, PDT can presently be designated as efficacious in major depressive disorder (MDD), social anxiety disorder, borderline and heterogeneous personality disorders, somatoform pain disorder, and anorexia nervosa. For MDD, this also applies to the combination with pharmacotherapy. PDT can be considered as possibly efficacious in dysthymia, complicated grief, panic disorder, generalized anxiety disorder, and substance abuse/dependence. Evidence is lacking for obsessive-compulsive, posttraumatic stress, bipolar and schizophrenia spectrum disorder(s). Conclusions: Evidence has emerged that PDT is efficacious or possibly efficacious in a wide range of common mental disorders. Further research is required for those disorders for which sufficient evidence does not yet exist.

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“…As you might imagine, not all in the Land of Psychotherapy Research were happy on hearing this news (Beck & Bhar, 2009;Glass, 2008;Kriston, Holzel, & Harter, 2009;Roepke & Renneberg, 2009;Thombs, Bassel, & Jewett, 2009) and the ensuing correspondence had the consistent theme of debunking positive evidence for long term treatment. The details should perhaps be consigned to the history books, but the points raised address both the nature of the original studies (the review was based on studies with small samples with a likely bias towards the positive, treating a wide range of disorders with poorly specified control groups, and uncontrolled for contact and the structure of treatment) and the methodology of the review (conflating within-group and between-group effect sizes, selective inclusion and exclusion of studies etc).…”

Section: The Story Of Long-term Psychodynamic Psychotherapymentioning

confidence: 99%

The changing shape of clinical practice: Driven by science or by pragmatics?

Fonagy

2010

Psychoanalytic Psychotherapy

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Psychodynamic Psychotherapy and Research Evidence

Cited by 38 publications

References 74 publications

Is Longer-Term Psychodynamic Psychotherapy More Effective than Shorter-Term Therapies? Review and Critique of the Evidence

Is Longer-Term Psychodynamic Psychotherapy More Effective than Shorter-Term Therapies? Review and Critique of the Evidence

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

The changing shape of clinical practice: Driven by science or by pragmatics?

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