Missed Opportunity to Rectify or Withdraw a Flawed Metaanalysis of Longer-Term Psychodynamic Psychotherapy

Coyne, James C.; Bhar, Sunil; Pignotti, Monica; Tovote, K. Annika; Beck, Aaron T.

doi:10.1159/000317537

Cited by 7 publications

(5 citation statements)

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“…2 We frankly disclosed our conflicts of interest, but this should also be expected from authors publishing in the field of psychotherapy, in particular when they are strongly promoting certain forms of psychotherapy, such as Dr Leichsenring, who is a fervent advocate for psychoanalysis and has been criticised for possibly biased meta-analyses in the literature. 3 Further, the authors seem to have overlooked the part in which we mentioned adverse effects of drugs. Enduring side-effects of medications that are used for anxiety disorders are rare, however.…”

Section: Authors' Replymentioning

confidence: 99%

“…2 Third, Bandelow et al did not adhere to the logic of equivalence testing that includes the definition of a margin compatible with equivalence and performing two one-sided tests (TOST). 3 They apparently applied the more usual two-sided superiority test. However, concluding from a non-significant two-sided superiority test that two treatments (i.e.…”

mentioning

confidence: 99%

“…pharmacotherapy and psychotherapy) are equally efficacious (in the long-term) is questionable. 3 The traditional two-sided test and TOST often yield inconsistent results. 4 Fourth, furthermore, Bandelow et al seem to have not controlled for researcher allegiance.…”

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confidence: 99%

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Bandelow¹,

Sagebiel

Belz

et al. 2018

Br J Psychiatry

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the relationship between community treatment orders and readmission rates is of a different complexity than that between chemotherapy and cancer remission, or between digitalis and cardiac function. We acknowledge, and celebrate, the contribution of RCTs to evidence-based healthcare. But there remains a need for a plurality of methods. However astute and research-literate the clinician, RCTs select participants in ways that can make generalisation to real-world settings difficult. Realist approaches that help bridge the gap between the 'what' and the 'how' of clinical outcomes can only be a good thing. And the more complex the interventionand the more context dependentthe more important this is. For us, RCTs alone are unlikely to be sufficient. Parity of esteem for psychiatry is undoubtedly worthwhile, but this does not mean we have to imitate other specialities; as so often in the past, we can lead the way instead. Primus inter pares.

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Section: Authors' Replymentioning

confidence: 99%

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confidence: 99%

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Bandelow¹,

Sagebiel

Belz

et al. 2018

Br J Psychiatry

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“…Não é porque outros estudos também podem ser ruins que a má qualidade metodológica deve ser perdoada e amplamente aceita. Coyne et al (2011) posteriormente também publicaram uma tréplica aos outros apontamentos dos autores.…”

Section: Discussão Sobre O Estudounclassified

Psicanálise Funciona? Avaliando a Prova Cabal de Christian Dunker

Ferreira¹,

Andrade²,

Pereira³

et al. 2022

Preprint

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Discussões sobre a cientificidade e eficácia da psicanálise têm se popularizado, impulsionadas em parte pelo movimento da Psicologia Baseada em Evidências. Há casos em que determinados estudos são citados para atestar a eficácia de terapias psicanalíticas ou psicodinâmicas, mas pouco é discutido sobre sua qualidade metodológica, característica crucial para a justificação das intervenções. Neste artigo realizamos uma avaliação da qualidade metodológica de 17 artigos denominados como “provas cabais a favor da eficácia da psicanálise” pelo psicanalista Christian Dunker. Conduzimos avaliações pareadas e independentes sobre um estudo quase-experimento com o instrumento ROBINS-I, três ensaios clínicos randomizados com o instrumento RoB 2 e duas revisões sistemáticas, além de seis metanálises, com o instrumentos AMSTAR 2. Também discutimos a pertinência de um relato de experiências e quatro revisões narrativas. Além disso, esclarecemos confusões comuns sobre as diferenças entre avaliar a cientificidade de uma teoria e avaliar a eficácia de uma terapia, bem como as diferenças entre terapias psicanalíticas e psicodinâmicas. Ao final, os resultados mostraram que todos os estudos listados por Dunker ou obtinham a pior classificação possível para o respectivo delineamento, ou não eram de delineamentos adequados para responder sobre eficácia psicoterápica, o que impede que sejam tratados como boas provas a favor de terapias psicodinâmicas ou psicanalíticas.

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“…Whenever evidence is produced that many treatments are effective, and as effective as CBT, that evidence is attacked, in much the same way as Eysenck attacked anyone who should suggest otherwise. See, for example, exchanges about the efficacy of CBT, humanistic, and dynamic therapy in practice (Clark, Fairburn, & Wessely, 2008; Stiles, 2008; Stiles et al, 2006, 2008), the efficacy of psychodynamic therapy (Anestis, Anestis, & Lilienfeld, 2011; Beck & Bhar, 2009; Bhar & Beck, 2009; Bhar et al, 2010; Coyne, Bhar, Pignotti, Tovote, & Beck, 2011; Leichsenring & Leibing, 2003; Leichsenring & Rabung, 2011; Leichsenring et al, 2004; McKay, 2011; Shedler, 2010, 2011; Thombs, Jewett, & Bassel, 2011), and the lack of lack of evidence of treatment differences for posttraumatic stress disorder (PTSD; Benish et al, 2008; Ehlers et al, 2010; Wampold et al, 2010). Debate is an intrinsic element of scientific progress, as it clarifies inconsistencies, reveals flaws, and motivates the production of evidence.…”

Section: Progress?mentioning

confidence: 99%

The good, the bad, and the ugly: A 50-year perspective on the outcome problem.

Wampold¹

2013

Psychotherapy

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In the middle of the 20th century, Hans Eysenck reviewed studies of psychotherapy, which consisted primarily of psychoanalytic, psychodynamic, and eclectic treatments, and concluded that psychotherapy (as opposed to behavior therapy) was not effective and was possibly harmful. In the inaugural article in Psychotherapy, Hans Strupp challenged Eysenck's conclusions and discussed how psychotherapy research should progress. Eysenck criticized Strupp's conjectures and Strupp responded. In this article, I discuss progress in psychotherapy research by examining "the good, the bad, and the ugly" aspects of the Eysenck and Strupp interchange. Essentially, Eysenck and Strupp motivated researchers to pursue, with increased sophistication, process and outcome research, but each was defending a theoretical position (behavior therapy and psychodynamic therapy, respectively). Despite the progress, the conjecture at issue continues to be debated today.

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Missed Opportunity to Rectify or Withdraw a Flawed Metaanalysis of Longer-Term Psychodynamic Psychotherapy

Cited by 7 publications

References 14 publications

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Authors' reply

Psicanálise Funciona? Avaliando a Prova Cabal de Christian Dunker

The good, the bad, and the ugly: A 50-year perspective on the outcome problem.

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