Psychodynamic therapy meets evidenced-based medicine.
A systematic review using updated criteria
Psychodynamic therapy (PDT) is an umbrella concept for treatments that operate on an interpretive-supportive continuum and is frequently used in clinical practice. The use of any form of psychotherapy should be supported by sufficient evidence. Efficacy research has been neglected in PDT for a long time. In this review, we describe methodological requirements for proofs of efficacy and summarise the evidence for use of PDT to treat mental health disorders. After specifying the requirements for superiority, non-inferiority, and equivalence trials, we did a systematic search using the following criteria: randomised controlled trial of PDT; use of treatment manuals or manual-like guidelines; use of reliable and valid measures for diagnosis and outcome; adults treated for specific mental problems. We identified 64 randomised controlled trials that provide evidence for the efficacy of PDT in common mental health disorders. Studies sufficiently powered to test for equivalence to established treatments did not find substantial differences in efficacy. These results were corroborated by several meta-analyses that suggest PDT is as efficacious as treatments established in efficacy. More randomised controlled trials are needed for some mental health disorders such as obsessive-compulsive disorder and post-traumatic stress disorder. Furthermore, more adequately powered equivalence trials are needed.
To continue reading, download the PDF here.
Sydney Ideas - What is Recognition?
With Noel Pearson and Jonathan Lear.
An interview with Neville Symington.
Open Door Review - 3rd Edition.
One of the most significant developments in the field of research into outcomes and processes in psychoanalysis in 2015 has been the publication of a third edition of the Open Door Review.
Leuzinger-Bohleber, M & Kachele, H. (Eds.) (2015). An open door review of outcome and process studies in psychoanalysis, Third Edition London: International Psychoanalytical Association.
Please click on the Open Door Review to view the electronic version of this publication (dedicated to Robert S Wallerstein) which made available to APAS by one of the Editors Professor Marianne Leuzinger-Bohleber.
The Open Door review is an essential resource for all psychoanalysts who wish to be informed about the evidence base for Psychoanalysis and psychoanalytic therapies.
CBT In The Media
'CBT is a scam and a waste of money': Popular talking therapy is not a long-term solution, says leading psychologist
By Jenny Hope, Medical Correspondent for the Daily Mail
Published: 10 November 2014
Leading psychologist Oliver James say 'extensive evidence' shows that CBT is a quick fix with no lasting benefits.People with mental health problems are victims of a ‘scam’ therapy that is wasting vast sums of money, a leading psychologist has warned. They are being misled because the short-term fix offered by Cognitive Behavioural Therapy (CBT) does not have a lasting benefit, says Oliver James.
The most popular of the ‘talking therapies’ CBT aims to help people manage their problems by changing the way they think and behave to become more positive. It is frequently recommended for people with problems ranging from anxiety and depression to eating disorders. In the short-term, 40 per cent of those who complete a course of CBT, typically five to 20 sessions of up to an hour, are said to have recovered.
But ‘extensive evidence’ shows that two years on, depressed or anxious people who had CBT were no more likely to have recovered than those who had no treatment, said Mr James. He said: ‘As a treatment, rafts of studies have shown it to be ineffective in delivering long-term therapeutic benefits to patients with anxiety and depression.
Continue Reading Here
Posted by Tim Keogh December, 2014
Neville Symington Talk
Neville Symington introduces his talk "Psychotherapy with Psychotic Patients" in Sydney. Symington explains that communication with the patient has a healing function and explains the role of psychoanalysis in counselling.
Research Shows Psychotherapy Is Effective But Underutilized
Consumers need better understanding of and access to psychological and behavioral health care, says American Psychological Association
WASHINGTON—Psychotherapy is effective, helps reduce the overall need for health services and produces long-term health improvements, according to a review of research studies conducted by the American Psychological Association.
Yet, the use of psychotherapy to treat people with mental and behavioural health issues decreased over the last decade while the use of medications to address such problems has increased, according to government and insurance industry data.
“Every day, consumers are bombarded with ads that tout drugs as the answer to their problems. Our goal is to help consumers weigh those messages with research-based information about how psychotherapy can provide them with safe, effective and long-lasting improvements in their mental and physical health,” said Melba J. T. Vasquez, PhD, past president of the American Psychological Association who led the psychotherapy effectiveness review project.
As a result of the effectiveness review project, the Association’s Council of Representatives last week adopted a resolution on psychotherapy effectiveness. The resolution cites more than 50 peer-reviewed studies on psychotherapy and its effectiveness in treating a spectrum of health issues and with a variety of populations, including children, members of minority groups and the elderly.
Key findings of the resolution:
- Research demonstrates that psychotherapy is effective for a variety of mental and behavioral health issues and across a spectrum of population groups. The average effects of psychotherapy are larger than the effects produced by many medical treatments.
- Large multi-site and meta-analytic studies have demonstrated that psychotherapy reduces disability, morbidity and mortality; improves work functioning; and decreases psychiatric hospitalization.
- Psychotherapy teaches patients life skills that last beyond the course of treatment. The results of psychotherapy tend to last longer than psychopharmacological treatments and rarely produce harmful side effects.
- While medication is appropriate in some instances, research shows that a combination of medication and psychotherapy is often most effective in treating depression and anxiety. It should also be noted that the effects produced by psychotherapy, including those for different age groups and across a spectrum of mental and physical health disorders, are often comparable to or better than the effects produced by drug treatments for the same disorders without the potential for harmful side effects that drugs often carry.
“As Americans grapple with the ever-increasing cost of health care, it is important that consumers and those who make decisions about health care access understand the potential value in both improved outcomes and cost-saving of psychotherapies,” Vasquez said. “APA applauds and continues to support collaboration of psychologists with other health care providers as part of integrated health care teams. Psychotherapies are highly effective, but only when consumers have access to them.”
Resolution on the Recognition of Psychotherapy Effectiveness – Approved August 2012
The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 137,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people’s lives
March, 2013 (Posted by Tim Keogh)