Psychodynamic Psychotherapy – What The Medical Literature Says

Evolution of Psychotherapy, From Freud to Today:

In the 21st century, Cognitive Behavioral Therapy (CBT) has become all the rage when it comes to therapeutic interventions for mental disorders. Not without good reason, as CBT has shown benefit as a short and effective treatment that is easily objectified for teaching to future generations. With the popularization of CBT, psychodynamic psychotherapy is no longer the new kid on the block. Indeed, many people haven’t even heard of it before. The truth is, we’ve been using psychodynamic therapy since the late 1800’s. Most current therapy modalities have roots originating in psychodynamics. Since its’ inception, psychodynamic therapy has undergone numerous modifications and improvements to bring the modality to where it is today. Gone are the years where the psychotherapist was expected to maintain neutrality and abstain from personal involvement or self-disclosure. Updates to the psychodynamic approach have fostered active and engaged variations which allow for more flexible and interactive therapeutic approaches while still maintaining the core principles of psychodynamic theory. Numerous research studies have provided objective data supporting the effectiveness of psychodynamic psychotherapy as a treatment approach. Below are some key findings.

Empirical Data and Studies in Support of Psychodynamic Therapy:

1. Leichsenring et al. (2017), published in the renown Lancet Psychiatry journal, conducted a meta-analysis and review of 64 randomized controlled trials and found that psychodynamic psychotherapy had large and stable effect sizes for various mental health conditions, including depression, anxiety disorders, and personality disorders, with results comparable to other contemporary treatments.

2. Abbass et al. (2014) conducted a meta-analysis of 33 studies of short term psychodynamic psychotherapy involving 2173 randomized participants with common mental disorders comparing short-term psychodynamic psychotherapy to a control group for general, depressive, and anxious symptom reduction. They found that the therapy group showed significant improvement in these symptom domains across many psychiatric diagnoses.

3. Shedler (2010) conducted a systematic review of over 20 meta-analysis, comparing the effectiveness of psychodynamic psychotherapy to other treatment approaches. The findings indicated that psychodynamic therapy had a moderate to large effect size and produced long-term improvements in symptoms and functioning.

4. Driessen et al. (2010) conducted a meta-analysis of over 50 studies specifically focusing on the efficacy of short-term psychodynamic psychotherapy for depression. They found that it was an effective treatment for depression, with effect sizes comparable to other forms of therapy such as CBT. They found that short term psychodynamic therapy was significantly more effective than control conditions at post-treatment on improving depression, general psychopathology and quality of life measures.

5. De Maat et al. (2009) performed a systematic review in which they examined 27 studies specifically on the efficacy of psychoanalytic psychotherapy. The review concluded that psychoanalytic therapy is effective for a wide range of mental health disorders, with strong effect sizes and success rates.

6. Fonagy et al. (2015) demonstrated the clinical benefits of long-term psychodynamic psychotherapy as an adjunct to standard medical treatment in depression and found significant improvements in remission rates of depression, emphasizing its potential for addressing complex and challenging cases.

These studies were published in prestigious medical journals and provide extensive peer-reviewed, repeatable and objective evidence that psychodynamic psychotherapy is an effective treatment approach for various mental health conditions. They repeatedly demonstrate significant and sustained improvements in symptoms, functioning, and overall well-being. Those listed above are only a few of the many research studies in support of its use. CBT is an excellent tool, but it’s not a popularity contest and psychodynamics has proven itself a tried and true treatment even prior to the advent of CBT.

Citations:

1. Leichsenring, F., Luyten, P., Hilsenroth, M. J., Abbass, A., Barber, J. P., Keefe, J. R., … & Steinert, C. (2017). Psychodynamic therapy meets evidence-based medicine: A systematic review using updated criteria. The Lancet Psychiatry, 4(3), 220-233.

2. Abbass, A., Kisely, S., Town, J. M., Leichsenring, F., Driessen, E., & De Maat, S. (2014). Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database of Systematic Reviews, (7).

3. Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98-109.

4. Driessen, E., Cuijpers, P., de Maat, S. C., Abbass, A. A., de Jonghe, F., & Dekker, J. J. (2010). The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis. Clinical Psychology Review, 30(1), 25-36.

5. 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.

6. Fonagy, P., Rost, F., Carlyle, J. A., McPherson, S., Thomas, R., & Pasco Fearon, R. M. (2015). Pragmatic randomized controlled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: The Tavistock Adult Depression Study (TADS). World Psychiatry, 14(3), 312-321.