A meta-analysis of psychodynamic psychotherapy outcomes: Evaluating the effects of research-specific procedures.

Abstract

The aim of this research was to examine the extent to which the use of research-specific procedures in psychodynamic psychotherapy impacts upon treatment effectiveness and which variables moderate this potential relationship. Effects of audio/video recording of sessions, use of treatment manuals, and checks of treatment fidelity were examined. A meta-analysis was conducted on randomized controlled trials of psychodynamic psychotherapy. Forty-six independent treatment samples totaling 1615 patients were included. The magnitude of change between pretreatment and posttreatment aggregated across all studies (45 treatment samples) for overall outcome was large (d ϭ 1.01), and further improvement was observed between posttreatment and an average 12.8-month follow-up (d ϭ 0.18). Subgroup analyses comparing studies that used research-specific procedures and those that did not revealed that for posttreatment data no differences in treatment effects were found. However, the use of treatment manuals and fidelity checks were significantly associated with improvement between the end of treatment and follow-up assessment. Within the limitations of analyses, this data offered preliminary evidence that use of research-specific procedures does not contribute in a negative manner to posttreatment outcomes in psychodynamic psychotherapy, and their use contributes to positive differences that emerge with time. These findings, although observational in nature, make a case for reconsidering how dimensions of clinical utility and experimental control may be integrated in psychodynamic psychotherapy to enable further elucidation of principles that evidently work.

Interaction structures in the psychodynamic therapy of a boy diagnosed with Asperger’s disorder: a single-case study

“…In the field of psychodynamic treatment of adults this situation began to change in recent years, with the publication of a number of important reviews and meta-analyzes (De Matt, Jonghe, Schoevers & Dekker, 2009;Gerber et al, 2011;Leichsenring, 2005;Leichsenring & Rabung, 2008;Leichsenring, Rabung, & Leibing, 2004;Shedler, 2012;Town, Diener, Abbass, Leichsenring, Driesse, & Rabung, 2012). Based on Randomized Controlled Trials (RCT) or not, these revisions showed that psychodynamic psychotherapy is at least equal to other forms of treatment regarded as evidence-based and that patients receiving this treatment not only keep the gains after its end, but often continue to improve.…”

The enduring effects of psychodynamic treatments vis-à-vis alternative treatments: A multilevel longitudinal meta-analysis

“…ENDURING EFFECTS OF PSYCHODYNAMIC TREATMENTS 6 (Abbass, Town, & Driessen, 2011;Driessen, Cuijpers, de Maat, Abbass, de Jonghe & Dekker, 2010;Town, Abbass, & Hardy, 2011) and some have claimed that the benefits of psychodynamic treatments increase over time (e.g., Leichsenring, Rabung & Leibing, 2004;Town et al, 2012).…”

“…Such intrapsychic changes may account for long-term treatment benefits [of psychodynamic treatments]. (pp 102, 105) Seeking to produce evidence of the sustained benefits of psychodynamic treatments beyond treatment completion, an increasing number of meta-analyses have indicated that the benefits of psychodynamic treatments at post-treatment are maintained at follow-up, and in some instances increase over time (Abbass, Hancock, Henderson, & Kisely, 2006;Abbass, Kisely, & Kroenke, 2009;Leichsenring, Rabung & Leibing, 2004;Town et al, 2012). For example, Abbass and colleagues (Abbass, Hancock, Henderson, & Kisely, 2006;Abbass, Kisely, & Kroenke, 2009) conducted a series of meta-analyses of controlled trials of short-term dynamic therapy (STDT) and found that STDT was superior to various types of no-treatment or minimal treatment controls on a variety of outcome measures and that the effects were sustained or grew over time.…”

Treatment Fidelity Over the Last Decade in Psychosocial Clinical Trials Outcome Studies: A Systematic Review

“…The introduction of treatment manuals allowed interventions under empirical investigation to be operationalised to best support therapy delivery in line with designed treatment structures [8,9]. Manualisation enabled an intervention to be monitored for Treatment Fidelity levels according to the research protocols [4,7].…”

“…Adherence is expressed as the delivery of a key component or technique of the treatment [9]. In contrast, competence measures assess the skills or accuracy with which the treatment is implemented [22,23].…”