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

Abstract

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.

The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis update

“…Moreover,Leichsenring, Leweke, Klein and Steinert (2015) conclude in their recent review of the empirical status of psychodynamic therapy that psychodynamic therapy and psychodynamic therapy combined with medication can presently be designated as efficacious in major depressive disorder according to the criteria for empirically supported psychological treatments formulated byChambless and Hollon (1998).Despite the supportive findings of this review, further research in STPP for depressive disorders is necessary. First, the field needs further high-quality, rigorous, controlled (non-inferiority) trials, especially with regard to the comparison of STPP versus control groups at follow-up, the comparisons of STPP versus antidepressant medication, and with regard to the effects of STPP added to medication in comparison to medication mono-treatment.…”

The Lausanne Trilogue Play within the outcome evaluation in infant mental health: a preliminary report

“…In fact, considering the high rate of incidence of psychopathology in developmental age and according to the literature and international guidelines in infant mental health, it is becoming increasingly important to explore the theme of evaluation of treatment in order to understand what the most effective method of intervention (De Coro et al, 2010;Palmer, Nascimento & Fonagy, 2013;Leichsenring, Leweke, Klein & Steinert, 2015). In the last ten years we have seen a rapid increase of studies that deal with the effectiveness of the assessment in the context of interventions run during adulthood (Dazzi, 2006;Midgley & Kennedy, 2011;Lenzo, Gargano, Mucciardi, Lo Verso & Quattropani, 2014) while there are few similar studies focusing on developmental age (Palmer et al, 2013).…”

On Mechanisms of Change in Psychodynamic Therapy

“…There is substantial evidence for PDT (Abbass et al 2014;Leichsenring et al 2015a;Leichsenring et al 2015b). No substantial differences in efficacy between the different psychotherapeutic approaches have been found (Cuijpers et al 2014;Driessen et al 2015;Keefe et al 2014).…”

“…There is growing evidence for the efficacy of psychodynamic therapy (Abbass et al 2014;Leichsenring et al 2015a;Leichsenring et al 2015b;Steinert et al 2017). However, several biases or "myths" towards psychodynamic therapy (PDT) are kept alive, including, for example, a distorted depiction of psychodynamic theory based on caricatured versions of early psychoanalytic assumptions (e.g., repressed libido as the only dynamic force) while ignoring contemporary psychodynamic approaches (Abbass et al 2017).…”