The first experimental study of transference work–in teenagers (FEST–IT): a multicentre, observer- and patient-blind, randomised controlled component study

Abstract

Background Little is known about the influence on outcome of exploration of the patient-therapist relationship (that is, transference work) in psychoanalytic psychotherapy. We hypothesized that depressed adolescents would have better long-term effects from psychoanalytic psychotherapy with than without transference work. Methods Depressed adolescent (16 to 18 years) were recruited in health authority funded out-patient clinics in Oslo and Vestfold County, Norway. They were randomized to 28 weeks of treatment with psychoanalytic psychotherapy with or without transference work. Change was assessed using linear-mixed models. The primary outcome measure was the Psychodynamic Functioning Scale (pre- post-, and 1-year post-treatment). Level of depression was measured at the same time points and during therapy (week 12, and 20). Results 69 adolescents were treated with (N = 39) or without (N = 31) transference work. The mean number of sessions was 18.6 (SD = 8,6) in the transference work group and 18.0 (SD = 10.9) in the non-transference work group. Both groups showed large and significant improvement on Psychodynamic Functioning Scale during the whole study period. The difference between the two groups was not significant during the treatment period (95% CI −.79 to 1.2, p = .674, F = .18), or from post-treatment to one-year follow-up (95% CI −.13 to .96; p = .134; F = 2.3). For the secondary outcome measures the transference work group had significantly better outcomes from 12 weeks in treatment to one-year follow-up (Beck Depression Inventory, 95% CI − 1.7 to −.14, p = .022; Montgomery and Åsberg Depression Rating Scale, 95% CI − 1.6 to −.23, p = .009). Conclusion The findings suggest that exploration of the adolescents’ relations to the therapist amplify the effects of short-term psychoanalytic psychotherapy on their depressive symptoms for adolescents with a Major Depressive Disorder. Trial registration ClinicalTrials.gov. Id: NCT01531101. Registered 8 February 2012.

Psychotherapy Dropout: Using the Adolescent Psychotherapy Q-Set to Explore the Early In-Session Process of Short-Term Psychodynamic Psychotherapy

“…This study draws on data from the FEST-IT study (Ulberg et al, 2012(Ulberg et al, , 2021. Sixty-nine adolescents with major depressive disorder (MDD) were randomised to Short Term Psychodynamic Psychotherapy (STPP) either with (n = 39) or without (n = 30) TW for 28 once-weekly 45 minute sessions.…”

“…Whilst the IMPACT study helped to demonstrate the effectiveness of STPP for depressed adolescents, questions remained about mechanisms of change. Addressing the need to investigate whether specific psychotherapeutic techniques influence outcome, the FEST-IT study (Ulberg et al, 2012(Ulberg et al, , 2021 randomised 69 depressed adolescents to 28 sessions of STPP with or without TW. In the FEST-IT study, TW is defined as the therapist working directly with the client-therapist relationship as it is manifested in the therapy setting, as compared to a therapy in which the therapist may be aware of transference dynamics but does not explicitly address these in the clinical setting.…”

“…The authors concluded that the psychodynamic approach led to improvements in family relations, insight, affect regulation, and adaptive capacity overall. However, the particular attention to thoughts and emotions of the adolescent in relation to the therapist contributed to an additional decrease in depression symptoms and severity (Ulberg et al, 2021).…”

“Like I’m Talking to a Real Person”: Exploring the Meaning of Transference for the Use and Design of AI-Based Applications in Psychotherapy

“…Transference can also act as a form of resistance and as an obstacle to treatment by keeping the patient from feeling like they can discuss certain ideas or topics, or a strong negative transference can make it hard for the patient to attend sessions regularly or even cause them to terminate the treatment (for an overview of the different effects of transference and ways of working with it, see Fink, 1997 ; Corradi, 2006 ; and Fink, 2007 , esp. chapter 7; for empirical studies of its usefulness, see Marmarosh, 2012 ; Hersoug et al, 2014 ; Suszek et al, 2015 ; Ulberg et al, 2021 ).…”

Conflicted Anger as a Central Dynamic in Depression in Adolescents—A Double Case Study

“…The described factors in the model are based upon a depiction of symptoms and problems, precipitating stressors or events, predisposing life events or stressors. This model for development of case formulations has been adopted in the British study, Improving Mood with Psychoanalytic and Cognitive Therapies [ 15 , 34 ], and in the First Experimental Study of Transference–In Teenagers (FEST-IT) [ 35 ]. Focused short-term treatments based on personalized case formulations may result in a good outcome, even in cases with patients with severe psychopathology.…”