Episode 8: Is Psychoanalysis Effective?

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Lives of the Unconscious

Summary: Is there evidence for the effectiveness of psychoanalysis and psychoanalytic-based therapy methods? For which forms of illness is it suitable? In this episode we present significant findings from research on psychoanalytic psychotherapy and address the question of whether the effectiveness of psychoanalysis is scientifically proven.

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Links:

Essays on the methodology of psychotherapy research:

  • Leichsenring, F (2004). Randomized controlled vs. naturalistic studies. A research agenda. Bull Menninger Clin; 68, 115-129.
  • Dalal, F (2018). The Cognitive Behavioural Tsunami: The Cognitive Behavioural Tsunami: Managerialism, Politics and the Corruptions of Science. London: Routledge.
  • Shean, G (2014). Limitations of Randomized Control Designs in Psychotherapy Research. Advances in Psychiatry, Article ID 561452.

Reviews and meta-analyses on psychodynamic therapies:

  • Abbass, A. A., Rabung, S., Leichsenring, F., Refseth, J. S. & Midgley, N. (2013). Psychodynamic psychotherapy for children and adolescents: a meta-analysis of short-term psychodynamic models. J Am Acad Child Adolesc Psychiatry 52, 863-875.
  • Cristea, I. A., Gentili, C., Cotet, C. D., Palomba, D., Barbui, C. & Cuijpers, P. (2017). Efficacy of Psychotherapies for Borderline Personality Disorder: A Systematic Review and Meta-analysis. JAMA Psychiatry 74, 319-328.
  • Crits-Cristoph, P., Barber, J. P. (2000). Long-term psychotherapy. In: Snyder, , C. R., Ingram, R. E. (Eds) Handbook of psychological change. John Wiley, New York, 455 – 473
  • de Maat, S., de Jonghe, F., de Kraker, R., Leichsenring, F., Abbass, A., Luyten, P., Barber, J. P., Rien, V. & Dekker, J. (2013). The current state of the empirical evidence for psychoanalysis: a meta-analytic approach. Harv Rev Psychiatry 21, 107-137.
  • de Maat, S., Philipszoon, F., Schoevers, R., Dekker, J., de Jonghe, F. (2007). Costs and benefits of long-termin psychoanalytic therapy: changes in health care use and work impairment. Harvard Rev Psychiatry, 15 (6), 289-300.
  • Fonagy, P. (2015). The effectiveness of psychodynamic psychotherapies: An update. World Psychiatry 14, 137-150.
  • Leichsenring, F. (2005): Are psychodynamic and psychoanalytic therapies effective?: A review of empirical data. In: The International Journal of Psychoanalysis. Vol. 86, 3, 841–868.
  • Leichsenring, F., Abbass, A., Luyten, P., Hilsenroth, M. & Rabung, S. (2013). The emerging evidence for long-term psychodynamic therapy. Psychodyn Psychiatry 41, 361-384.
  • Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. Am Psychol 65, 98-109.
  • Woll, C., Schönbrodt, F. (2019). A Series of Meta-Analytic Tests of the Efficacy of Long-Term Psychoanalytic Psychotherapy. European Psychologist 2020, 25, 51—72

Selected studies

  • Ablon, J. S., & Jones, E. E. (1998). How expert clinicians' prototypes of an ideal treatment correlate with outcome in psychodynamic and cognitive-behavior therapy. Psychotherapy Research, 8(1), 71–83.
  • Ablon, J. S. & Jones, E. E. (2002). Validity of controlled clinical trials of psychotherapy: findings from the NIMH Treatment of Depression Collaborative Research Program. Am J Psychiatry 159, 775-783.
  • Benecke, C., Huber, D., Staats, H., Zimmermann, J., Henkel, M., Deserno, H., Wiegand-Grefe, S. & Schauenburg, H. (2016). A Comparison of Psychoanalytic Therapy and Cognitive Behavioral Therapy for Anxiety (Panic/Agoraphobia) and Personality Disorders (APD Study): Presentation of the RCT Study Design. Z Psychosom Med Psychother 62, 252-269.
  • Beutel, M., Bahrke, U., Fiedler, G., Hautzinger, M., Kallenbach, L., Kaufhold, J., Keller, W., Negele, A., Rüger, B., Leuzinger-Bohleber, M. & Ernst, M. (2016). LAC-Depressionsstudie: Psychoanalytische und kognitiv-verhaltenstherapeutische Langzeittherapien bei chronischer Depression.
  • Delgado, S.V., Strawn, J.R., Pedapadi E.V. (2015). Contemporary Psychodynamic Psychotherapy for Children and Adolescence. Integrating Intersubjectivity and Neuroscience. Heidelberg: Springer.
  • Fonagy, P., Rost, F., Carlyle, J. A., McPherson, S., Thomas, R., Pasco Fearon, R. M., Goldberg, D. & Taylor, D. (2015). Pragmatic randomized controlled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: the Tavistock Adult Depression Study (TADS). World Psychiatry 14, 312-321.
  • Fonagy, P., Lemma, A., Target, M., O´Keeffe, S. (2020). Dynamic interpersonal therapy for moderate to severe depression: a pilot randomized controlled and feasibility trial. Psychological Medicine, 50, 6, 1010—1019.
  • Huber, D., Zimmermann, J., Henrich, G. & Klug, G. (2012). Comparison of cognitive-behaviour therapy with psychoanalytic and psychodynamic therapy for depressed patients - a three-year follow-up study. Z Psychosom Med Psychother 58, 299-316.
  • Knekt P, Laaksonen MA, Raitasalo R et al. Changes in lifestylefor psychiatric patients three years after the start of short- andlong-term psychodynamic psychotherapy and solution-focused therapy. Eur Psychiatry 2010;25:1-7.87.
  • Knekt P, Lindfors O, Laaksonen MA. Review: long term psychodynamic psychotherapy improves outcomes in people withcomplex mental disorders. Evid Based Ment Health 2009;12:56.88.
  • Knekt P, Lindfors O, Harkanen T et al. Randomized trial on theeffectiveness of long- and short-term psychodynamic psycho-therapy and solution-focused therapy on psychiatric symptomsduring a 3-year follow-up. Psychol Med 2008;38:689-703.89.
  • Knekt P, Lindfors O, Laaksonen MA et al. Quasi-experimentalstudy on the effectiveness of psychoanalysis, long-term andshort-term psychotherapy on psychiatric symptoms, work abilityand functional capacity during a 5-year follow-up. J Affect Dis-ord 2011;132:37-47.
  • Lampe A, Mitmansgruber H, Gast U, Schüssler G, Reddemann L. (2008) Treatment outcome of psychodynamic trauma therapy in an inpatient setting. Neuropsychiatr.22(3):189‐197.
  • Leichsenring, F., Salzer, S., Beutel, M. E., Herpertz, S., Hiller, W., Hoyer, J., Huesing, J., Joraschky, P., Nolting, B., Poehlmann, K., Ritter, V., Stangier, U., Strauss, B., Tefikow, S., Teismann, T., Willutzki, U., Wiltink, J. & Leibing, E. (2014). Long-term outcome of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder. Am J Psychiatry 171, 1074-1082.
  • Leuzinger-Bohleber M, Hautzinger M, Fiedler G, Keller W, Bahrke U, Kallenbach L et al (2019c) Outcome of psychoanalytic and cognitive-behavioural long-term therapy with chronically depressed patients: a controlled trial with preferential and randomized allocation. Can J Psychiatry 64(1):47–58
  • Nyhuis, P. W., Niederhofer, E., Scherbaum, N., Schifano, F., Bonnet, U., Dembski, N., Niederhofer, A., Specka, M. & Tenbergen, M. (2018). Effectiveness of Psychoanalytic-Interactional Group Therapy vs. Behavioral Group Therapy in Routine Outpatient Treatment of Alcohol-Dependent Patients. Subst Use Misuse 53, 426-431.
  • Rabung, S., Leichsenring, F. (2016). Evidenz für psychodynamische Langzeittherapie. Überblick über vorliegende Reviews. Psychotherapeut, 61, 441–446.
  • Sandell, R., Blomberg, J. & Lazar, A. (1997) When reality doesn’t fit the blueprint:Doing research on psychoanalysis and long-term psychotherapy in a public healthservice program.Psychotherapy Research7: 333 – 344
  • Sandell, R., Blomberg, J. & Lazar, A. et al. (2001) Unterschiedliche Langzeitergebnissevon Psychoanalysen und Psychotherapien.Aus der Forschung des Stockholmer Projekt.Psyche, 55, 277– 310
  • Sachsse, U., Vogel, C., Leichsenring, F. (2006). Results of psychodynamically oriented trauma–focused inpatient treatment for women with complex posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD) Bulletin of the Menninger Clinic: Vol. 70, June, pp. 125-144.
  • Salzer, S., Leibing, E., Jakobsen, T., Rudolf, G., Brockmann, J., Eckert, J., Huber, D., Klug, G., Henrich, G., Grande, T., Keller, W., Kreische, R., Biskup, J., Staats, H., Warwas, J. & Leichsenring, F. (2010). Patterns of interpersonal problems and their improvement in depressive and anxious patients treated with psychoanalytic therapy. Bull Menninger Clin 74, 283-300.
  • Smit, Y., Huibers, M. J., Ioannidis, J. P., van Dyck, R., van Tilburg, W. & Arntz, A. (2012). The effectiveness of long-term psychoanalytic psychotherapy--a meta-analysis of randomized controlled trials. Clin Psychol Rev 32, 81-92.
  • Solms, M. (2015). The feeling Brain. Karnac Books: London.
  • Steinert, C, Munder, T, Rabung, S, Hoyer, J & Leichsenring, F (2017). Psychodynamic therapy: as efficacious as other empirically supported treatments? A meta-analysis testing equivalence of outcomes. Amircan Journal of Psychiatry, 174 (10), 943—953.
  • Zimmermann, J., Loffler-Stastka, H., Huber, D., Klug, G., Alhabbo, S., Bock, A. & Benecke, C. (2015). Is It All about the Higher Dose? Why Psychoanalytic Therapy Is an Effective Treatment for Major Depression. Clin Psychol Psychother 22, 469-487.

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