Varieties of Long-Term Outcome Among Patients in Psychoanalysis and Long-Term Psychotherapy: A Review of Findings in the Stockholm Outcome of Psychoanalysis and Psychotherapy Project (Stoppp)

Abstract

This paper reports the main findings of a large-scale study of subsidized psychoanalysis and long-term psychotherapy. More than 400 people in various phases, before, during and after subsidized psychoanalysis or long-term psychodynamic psychotherapy, were followed up for a period of three years with personal interviews, questionnaires and official statistics. Our analyses revealed progressive improvement the longer patients were in treatment--impressively strong among patients in psychoanalysis--on self-rating measures of symptom distress and morale. Improvement, however, was equally weak in both groups on a self-rating measure of social relations. Dosage factors (treatment duration and session frequency in combination) partly accounted for the outcome differences between those referred to psychoanalysis and those referred to long-term psychotherapy. Attitudes and ideals among therapists and analysts concerning the goals and means of psychotherapy were also associated with patient outcome, although in rather complex ways. A significant part of the outcome differences between patients in psychoanalysis and in psychotherapy could be explained by the adoption, in a large group of therapists, of orthodox psychoanalytic attitudes that seemed to be counterproductive in the practice of psychotherapy but not in psychoanalysis. It is suggested that this effect may be a negative transfer of the psychoanalytic stance into psychotherapeutic practice and that this may be especially pronounced when the attitudes are not backed up by psychoanalytic training.

História recente e perspectivas atuais da pesquisa de resultados em psicoterapia psicanalítica de longa duração

“…With regard to assessed treatments, we did not find detailed descriptions of treatments used, except in the studies by Leichsenring et al 36 , Huber et al 42 and Grande et al 16 This is certainly one of the factors limiting the reach of our conclusions in this study, but not disregarding them.…”

“…19 Table 3 presents the summary of nine outcome studies over this period (one was mentioned earlier). Therapists (209) Control ( Brockmann et al 21 Behavioral psychotherapy (31) Psychoanalysis ( Wilczek et al 39 Psychoanalytic psychotherapy (36 (17) Medication (5) Without therapy (7) Design Grande et al 16 Psychodynamic therapy (27) Psychoanalytic therapy (32) Design: prospective naturalistic 43 A globalized world brings us unquestionable benefits, such as democratization of knowledge and the possibility of exchanging ideas with researchers all over the world in "our own office. "…”

“…26,27,36,41 In two of those studies, 36,41 the authors believe that such superiority is limited by the issue of treatment duration and intensity.…”

Estudos clínicos em psicoterapia psicodinâmica: uma revisão do follow-up das intervenções

“…Os efeitos da TCC sobre os sintomas do paciente parecem se dar de forma mais rápi-da, porém em follow-up mais longo, a tendência é que esses efeitos não persistam (Taylor, 2012). Os tratamentos psicodinâmicos de longo prazo e a psicanálise tenderam a apresentar melhores resultados em seguimentos pós alta mais longos, nos quais existe uma tendência clara rumo à diminuição de sintomas que ocorre após o tratamento ser encerrado (Freedman et al, 2001;Sandell et al, 2000).…”

Abandono de psicoterapia com crianças

“…Estudos reportam uma correlação positiva entre a quantidade de tempo de trabalho e os resultados do tratamento 21 . Em geral, os terapeutas iniciantes tendem a criar expectativas ideais e não reais de seu trabalho, aspirando algo perfeito e além do esperado pelo paciente 22 .…”