Information for GP's and other Health Professionals considering psychoanalytic treatment for their patients.

These services are provided by specialist practitioners, including psychiatrists, clinical psychologists, psychologists, social workers and other health professionals who have completed the internationally accredited training in psychoanalysis.
 
You may have patients who would benefit from this intensive treatment.

Downloadable Brochure

How Can Psychoanalysis Help Me?

The brochure is designed to help patients understand something about the nature of psychoanalytic treatment and the conditions for which is indicated. It also provides contact details for arranging a psychoanalytic consultation to explore the possibility of this treatment.

Downloadable Animation

Psychoanalysis For Me...

The animation is designed to provide an accessible way of gaining an impression of what is involved in psychoanalysis and psychoanalytic treatment.

Evidence Base for Psychoanalysis

Although establishing the efficacy of psychoanalysis and long-term psychoanalytic psychotherapy is difficult, there is a growing body of evidence from studies meeting appropriate quality standards that indicate that psychoanalysis is an effective treatment, and that initial post-treatment effects tend to improve during follow-up (Sandell, 2012).

In the Stockholm Outcome of Psychotherapy and Psychoanalysis Project (STOPPP) (Sandell, 1999) patients receiving intensive psychoanalytic treatment not only demonstrated positive change at the conclusion of treatment but continued to show improvement at three-year follow-up.

Although randomized controlled trials may be considered the gold standard for medical outcome research, they may not be the most appropriate design for psychoanalytic outcome studies (de Jonge, 2012; de Maat, 2009). Notwithstanding, the few available have revealed encouraging outcomes of psychoanalytic treatment. For example, a randomized controlled trial (Bateman & Fonagy, 2001) randomly assigned individuals with a diagnosis of borderline personality disorder to a psychoanalytically oriented day-hospital treatment or psychiatric treatment as usual. The patients with borderline pathology made considerable gains relative to the controls and such improvements were not only maintained in the 18 months following discharge, but increased over time, even though the day hospital group received less treatment than the control group.

The Sheffield Psychotherapy Project (Shapiro et al, 1995) also found evidence for the effectiveness of psychodynamic treatment of major depression. There is also impressive outcome data for psychoanalytic treatment for panic disorder (Milrod, Busch & Cooper, 1997; Leichsenring & Rabung 2008).

A study by Leuzinger-Bohleber et al (2002) which involved a large-scale follow-up (at 6.5 years after the completion of treatment) found that 80% patients showed good outcomes in relation to depression and anxiety. Savings were also demonstrated in relation to the use of hospital and outpatient medical treatment of physical symptoms. This study also highlighted the maintenance of treatment gains and the other non-symptom improvements that were conducive to wellbeing including psychological changes at the level of self-understanding, and interpersonal-relational and work-related domains.

Meta-analytic studies, which pool single studies into larger groups of patients, also support the contention that psychoanalysis demonstrates significant change at treatment completion, with continued improvements evident at follow-up. See, for example, deMaat (2009, 2013), Lamb (2004), Leichsenring & Rabung (2008, 2011), and Smit (2012).

The specific domains of personality function that improve with treatment include global psychiatric symptom reduction, target complaints, interpersonal relationships, social and work adjustment, life satisfaction, with attendant reductions in health care utilization and costs (deMaat, 2009, 2012; Leichsenring & Rabung, 2008, 2011).

Results drawn from pooling all outcome effectiveness studies of psychoanalysis lead to the conclusion that if patients are well chosen, between 60%-90% show significant positive gain and achieve clinically significant change. Psychoanalysis is therefore comparable in its effectiveness with a range of commonly used medical treatments (e.g., the 5-year survival for colon cancer varies between 6% -74%; for breast cancer, 22% - 100%). 
 
Although the characteristics distinguishing psychodynamic/psychoanalytic psychotherapy from psychoanalysis have not been consensually delineated within the psychoanalytic research community, comparison studies favour psychoanalysis. It is not yet understood whether the effect is general or specific to psychoanalysis, given that positive outcome has generally been found to be a function of treatment duration. However, studies of the effectiveness of cognitive behavioural therapy (CBT) found that CBT was more effective when CBT therapists recruited psychodynamic processes into their treatment (Ablon & Jones, 1998, 1999, 2002), suggesting the specific effectiveness of psychodynamic processes.

References:
 
Ablon, J. S., & Jones, E. E. (1998). How expert clinicians’ prototypes of an ideal treatment correlate with outcome in psychodynamic and cognitive-behavioral therapy. Psychotherapy Research, 8, 71-83.
 
Ablon, J. S., & Jones, E. E. (1999). Psychotherapy process in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Consulting and Clinical Psychology, 67:64–75.
 
Ablon, J. S., & Jones, E. E. (2002). Validity of controlled clinical trials of psychotherapy: Findings from the NIMH Treatment of Depression Collaborative Research Program. American Journal of Psychiatry, 159, 775-783.
 
Anderson, E. M., & Lambert, M. J. (1995). Short-term dynamically oriented psychotherapy: a review and meta-analysis. Clinical Psychology Review, 15:503–514.
 
Bateman, A., & Fonagy, P. (2001). Treatment of borderline personality disorder with psychoanalytically oriented partial hospitalization: an 18-month follow-up. American Journal of Psychiatry, 158:36–42.
 
Clarkin, J. F., Foelsch, P. A., Levy, K. N., et al. (2001). The development of a psychodynamic treatment for patients with borderline personality disorder: a preliminary study of behavioral change. Journal of Personal Disorders, 15:487–495.
 
Crits-Christoph, P., & Cooper, A., & Luborsky L. (1988). The accuracy of therapists' interpretations and the outcome of dynamic psychotherapy.  Journal Consulting and Clinical Psychology, 56:490–495.
 
de Jonghe, F., de Maat, S., Barber, J. P., Abbas, A., Luyten, P., Gomperts, W., & Dekker, J. (2012). Designs for studying the effectiveness of long-term psychoanalytic treatments: balancing level of evidence and acceptability to patients. Journal of the American Psychoanalytic Association, 60(2), 361-387.
 
de Maat, S., de Jonghe, F., Schoevers, R., & Dekker, J. (2009). The effectiveness of long-term psychoanalytic therapy: a systematic review of empirical studies. Harvard Review of Psychiatry, 17(1), 1-23.
 
de Maat, S., de Jonghe, F., de Kraker, R., Leichsenring, F., Abbass, A., Luyten, P.,  & Dekker, J. (2013). The current state of the empirical evidence for psychoanalysis: a meta-analytic approach. Harvard Review of Psychiatry, 21(3), 107-137.
 
Fonagy, P. (1996). Target M. Predictors of outcome in child psychoanalysis: a retrospective study of 763 cases at the Anna Freud Centre. Journal of the American Psychoanalytical Association., 44:27–77.
 
Fonagy, P., Kachele, H., Krause. R., et al. (2002). An open door review of outcome studies in psychoanalysis, 2nd ed. London: International Psychoanalytical Association.
 
Gabbard, G. O., & Gunderson, J. G., & Fonagy, P. (2002). The place of psychoanalytic treatments within psychiatry. Archives of General Psychiatry,59:505–510.
 
Hobson, R. F. (1985). Forms of Feeling: The Heart of Psychotherapy. New York: Basic Books.
 
Høglend, P. (1993). Personality disorders and long-term outcome after brief psychodynamic psychotherapy. Journal of Personality Disorders, 7:168–181.
 
Holmes, J. (2002). All you need is cognitive behaviour therapy? British Medical Journal., 324:288–294.
 
Joyce, A. S., & Piper, W. E. (1993). The immediate impact of transference interpretation in short-term individual psychotherapy. American Journal of Psychotherapy, 47:508–526.
 
Lamb, (2004). A Meta-Analysis of Outcome Studies in Psychoanalysis. Dissertation
 
Leichsenring, F., & Rabung, S. (2008). Effectiveness of long-term psychodynamic psychotherapy: A meta-analysis. JAMA, 300(13): 1551-1565.
 
Leichsenring, F., & Rabung, S. (2011). Long-term psychodynamic psychotherapy in complex mental disorders: update of a meta-analysis. British Journal of Psychiatry, 199(1), 15-22.
 
Leff, J., Vearnals, S., & Brewin, C.R., et al.(2000). The London Depression Intervention Trial. Randomised controlled trial of antidepressants v. couple therapy in the treatment and maintenance of people with depression living with a partner: clinical outcome and costs. British Journal of Psychiatry, 177:95–100.
 
Leuzinger-Bohleber, M., & Target, M. (eds.) (2002). The Outcomes of Psychoanalytic Treatment. London: Whurr.
 
Lonigan, C. J., Elbert, J. C., & Johnson, S. B. (1998). Empirically supported psychosocial interventions for children: an overview. Journal of Clinical Child Psychology, 27:138–345.
 
Milrod, B., Busch. F., & Cooper, A. (1997). Manual for Panic-Focused Psychodynamic Psychotherapy. Washington: American Psychiatric Press.
 
Monsen, J., Odland, T., & Faugli, A. et al. (1995). Personality disorders and psychosocial changes after intensive psychotherapy: a prospective follow-up study of an outpatient psychotherapy project, 5 years after the end of treatment. Scandinavian Journal of Psychology, 36: 256–268.
 
Monsen, J. Odland, T. Faugli, A, et al. (1995). Personality disorders: changes and stability after intensive psychotherapy focusing on affect consciousness. Psychotherapy Research. 5:33–48.
 
Olfson, M. (1999). Emerging methods in mental health outcomes research. Journal of Practice Psychiatry and Behavioral Health. 5:20–24.
 
Roth, A. & Fonagy, P. (1996). What Works for Whom? A Critical Review of Psychotherapy Research. New York: Guilford Press.
 
Sandell, R. (1999). Long-term findings of the Stockholm Outcome of Psychotherapy and Psychoanalysis Project (STOPPP). Presented at the Meeting Psychoanalytic Long-Term Treatments: A Challenge for Clinical and Empirical Research in Psychoanalysis; October 1999; Hamburg.
 
Sandell, R. (2012). Research on outcomes of psychoanalysis and psychoanalysis-derived psychotherapies. Chapter 26, in Textbook of Psychoanalysis(2nd ed.).
 
Shapiro, D. A., Rees, A. Barkham, M., et al. (1995). Effects of treatment duration and severity of depression on the maintenance of gains after cognitive-behavioral and psychodynamic-interpersonal psychotherapy. Journal Consulting and Clinical Psychology, 63:378–387.
 
Smit, Y., Huibers, M. J. H., Ioannidis, J. P. A., van Dyck, R., van Tilburg, W., & Arntz, A. (2012). The effectiveness of long-term psychoanalytic psychotherapy--a meta-analysis of randomized controlled trials. Clinical Psychology Review, 32(2), 81-92.
 
Stanton, A. H., Gunderson, J. G., Knapp, P. H., et al. (1984). Effects of psychotherapy in schizophrenia: I. Design and implementation of a controlled study. Schizophrenia Bulletin, 10:520–563.
 
Stevenson, J., & Meares, R. (1992). An outcome study of psychotherapy for patients with borderline personality disorder. American Journal of Psychiatry, 149: 358–362.
 
Stevenson, J., & Meares, R. (1995). Borderline patients at 5-year follow-up. Presented at the Congress of the Royal Australia-New Zealand College of Psychiatrists. May Cairns.
 
Thompson, L. W., Gallagher, D., & Breckenridge, J. S. (1987). Comparative effectiveness of psychotherapies for depressed elders. Journal of Consulting and Clinical Psychology, 55:385–390.
 
Westen, D. (1998). The scientific legacy of Sigmund Freud: toward a psychodynamically informed psychological science. Psychological Bulletin. 124: 333–371.
 
Westen, D., & Gabbard, G. O. (2002). Developments in cognitive neuroscience: I. Conflict, compromise, and connectionism. Journal of the American Psychoanalytical Association, 50:53–98.
 
Westen, D., & Gabbard, G. O. (2002). Developments in cognitive neuroscience: II. Implications for theories of transference. Journal of the American Psychoanalytical Association, 50:99–134.