Psychodynamic Research
While it is true that evidence for psychodynamic therapy (PDT) has considerably grown during the last decades (Barber et al., 2021; Fonagy, 2015; Leichsenring et al., 2023; Leichsenring et al., 2015; Shedler, 2010), there are still several areas of research for which further research is required. This applies, for example, to those mental disorders for which no or only a few RCTs are available, such as post-traumatic stress disorder, addictions or schizophrenia spectrum disorders in adults. In children and adolescents further RCTs are required as well, e.g. for depressive disorders, anxiety disorders, personality and conduct disorders, eating disorders or attention deficit and hyperactivity disorder. In some areas of research, the quality of studies of PDT is not yet sufficient. This applies, for example, to some studies of PDT in anxiety disorders (Leichsenring et al., 2023). Another critical issue is the width of the confidence intervals (CIs) of the effect sizes. While it is true that the CIs of the effect sizes of PDT are generally not wider than those of, for example, CBT (Leichsenring et al., 2023, supplement), more narrow CIs are desirable. The more studies are available, the more narrow the CIs and the more accurate the effect size estimates. Wide CIs may result in non-significant effect sizes in meta-analyses (e.g. Papola et al., 2023). For a critical discussion of the Papola et al. meta-analysis see Leichsenring et al. (in press). Furthermore, for short-term psychodynamic therapy (STPP) considerable evidence is available, whereas for long-time psychodynamic therapy (LTPP) evidence is relatively scarce (Clarkin et al., 2007; Doering et al., 2010; Fonagy et al., 2015; Huber et al., 2013; Leichsenring et al., 2013; Leichsenring & Rabung, 2008, 2011; Leuzinger-Bohleber et al., 2019). Furthermore, we need to find out if there is an additional gain of psychodynamic therapy compared to other therapies. Generally, it is not yet clear who benefits from which form of psychotherapy. This is a question of research which is highly important for clinical practice. In addition, for psychotherapy in general and for psychodynamic therapy in particular the active ingredients are still widely unclear. Some psychodynamic researchers seem to be tired of what they call “horse races” (RCTs). However, for the reasons noted above, further RCTs are required. This does not imply that RCTs are the only relevant methods of research. Naturalistic studies, process-outcome research and qualitative research are necessary as well. This website is open to all types of research. As the Task Force on Promotion and Dissemination of Psychological Procedures put it some years ago with reference to (short-term) psychodynamic therapy, further research is required “… if this clinically verified treatment is to survive in today’s market”(Chambless, 1993, p. 6). Today, this statement is truer than ever.
References
Barber, J. P., Muran, J. C., McCarthy, K. S., Keefe R.J., & Zilcha-Mano, S. (2021). Research on psychodynamic therapies In Barkham; M., L. G. Castonguay, ,, & W. Lutz (Eds.), Bergin and Garfield's Handbook of Psychotherapy and Behavior Change (7th ed.) (pp. 387-419). Wiley.
Chambless, D., Task Force on Promotion and Dissemination of Psychological Procedures, . (1993). A Report Adopted by the Division 12 Board of the American Psychological Association. APA.
Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007). Evaluating three treatments for borderline personality disorder: a multiwave study. American Journal of Psychiatry, 164(6), 922-928. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17541052
Doering, S., Horz, S., Rentrop, M., Fischer-Kern, M., Schuster, P., Benecke, C., Buchheim, A., Martius, P., & Buchheim, P. (2010). Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial. British Journal of Psychiatry (196), 389-395.
Fonagy, P. (2015). The effectiveness of psychodynamic psychotherapies: An update. World Psychiatry, 14(2), 137-150. https://doi.org/10.1002/wps.20235
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(3), 312-321. https://doi.org/10.1002/wps.20267
Huber, D., Henrich, G., Clarkin , J., & Klug, G. (2013). Psychoanalytic versus psychodynamic therapy for depression: a three-year follow-up study. Psychiatry 76 132-149.
Leichsenring, F., Abbass, A., Heim, N., Keefe, J. R., Kisely, S., Luyten, P., Rabung, S., & Steinert, C. (2023). The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders - an umbrella review based on updated criteria. World Psychiatry, 22(2), 286-304. https://doi.org/10.1002/wps.21104
Leichsenring, F., Abbass, A., Luyten, P., Hilsenroth, P., & Rabung, S. (2013). The emerging evidence for long-term psychodynamic therapy. Psychodynamic Psychiatry 41, 361-384.
Leichsenring, F., Leweke, F., Klein, S., & Steinert, C. (2015). The empirical status of psychodynamic psychotherapy - an update: Bambi's alive and kicking [Review]. Psychotherapy and Psychosomatics, 84(3), 129-148. https://doi.org/10.1159/000376584
Leichsenring, F., & Rabung, S. (2008). Effectiveness of long-term psychodynamic psychotherapy: a meta-analysis [Meta-Analysis]. JAMA, 300(13), 1551-1565. https://doi.org/10.1001/jama.300.13.1551
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. https://doi.org/10.1192/bjp.bp.110.082776
Leichsenring, F., Steinertc, C., Luyten, P., & Heim, N. (in press). Network meta-analysis: science or alchemy? - What works best in generalized anxiety disorder. Zeitschrift fur Psychosomatische Medizin und Psychotherapie.
Leuzinger-Bohleber, M., Hautzinger, M., Fiedler, G., Keller, W., Bahrke, U., Kallenbach, L., Kaufhold, J., Ernst, M., Negele, A., Schoett, M., Kuchenhoff, H., Gunther, F., Ruger, B., & Beutel, M. (2019). Outcome of Psychoanalytic and Cognitive-Behavioural Long-Term Therapy with Chronically Depressed Patients: A Controlled Trial with Preferential and Randomized Allocation. Canadian Journal of Psychiatry, 64(1), 47-58. https://doi.org/10.1177/0706743718780340
Papola, D., Miguel, C., Mazzaglia, M., Franco, P., Tedeschi, F., Romero, S. A., Patel, A. R., Ostuzzi, G., Gastaldon, C., Karyotaki, E., Harrer, M., Purgato, M., Sijbrandij, M., Patel, V., Furukawa, T. A., Cuijpers, P., & Barbui, C. (2023). Psychotherapies for Generalized Anxiety Disorder in Adults: A Systematic Review and Network Meta-Analysis of Randomized Clinical Trials. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2023.3971
Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. Am Psychol 65 98-109.