Effects of Psychotherapy in Schizophrenia: II. Comparative Outcome of Two Forms of Treatment

Abstract

This study compares the effects of exploratory, insight-oriented (EIO) and reality-adaptive, supportive (RAS) forms of psychotherapy on a sample of 95 schizophrenic patients. Analyses of 2-year outcomes revealed a complex interaction between the type of psychotherapy provided and the domain of psychopathology affected. RAS psychotherapy exerted clear preferential effects in the areas of recidivism and role performance. The EIO psychotherapy exerted preferential, albeit more modest, action in the areas of ego functioning and cognition. Overall, however, the magnitude of the differences was low. The results highlighted the need for more focused studies of subgroups, and of process and contextual influences on outcome.

Psychodynamic treatment of schizophrenia: is there a future?

“…Four studies have compared psychodynamic treatment with other treatments for schizophrenia, with the primary research workers including May (1968), VandenBos (1972, 1975), Grinspoon (Grinspoon et al 1972), and Gunderson (Stanton et al 1984;Gunderson et al 1984). Table 1 provides an overview of the four studies.…”

“…Some of the data from the aforementioned outcome studies suggest that psychodynamic treatment may have deleterious rather than beneficial effects for schizophrenic patients. Gunderson et al (1984) presented data on the relation between outcome and the number of months patients were treated with psychodynamic or reality-adaptive therapy. One would expect that the longer patients remain in an effective treatment, the better their outcomes would be.…”

“…One might posit that the reason for the negative correlations between months in psychodynamic treatment and outcome is that time in therapy was largely determined by the severity of the patient's Table 2 Gunderson et al 1984, Note: + / > < 0 1 0 ; *P<0-05; ** P < 0 0 1 ; *** P < 0005; '*** P < 0001. illness. This explanation would not explain why the correlations were negative for the psychodynamic treatment but positive for the reality adaptive treatment.…”

“…It would be economical to study how the theoretical constructs presumed to be modified by psychodynamic treatment are related to outcome among schizophrenic patients before conducting further expensive outcome studies. Gunderson et al (1984) reported that there was a trend for schizophrenics who received psychoanalytic treatment to have higher scores on measures of ego functioning than schizophrenics who received reality-adaptive therapy. Despite having higher ego functioning scores, the psychodynamically treated patients had poorer social and vocational adjustment and were rehospitalized more frequently than patients receiving reality-adaptive treatment.…”

La création de partenariats : perspectives et possibilités

“…On y souligne que la psychothérapie traditionnelle, qui vise à aider l'individu à acquérir de Yinsight, n'a pas beaucoup de succès auprès des personnes ayant un tel diagnostic (Gunderson et al, 1984). (Une revue récente des données (Glass et al, 1989) révèle qu'une relation avec un clinicien expérimenté sur une période de deux ans a amélioré certains symptômes).…”