The evidence for psychotherapy

The key competences that underlie the body of knowledge for psychoanalytic/psychodynamic psychotherapy are summarised in the National Occupational Standards for Psychological Therapies. Download the Digest of National Occupational Standards for Psychological Therapies  or the full Psychoanalytic/Psychodynamic Competences Framework here.
The Competency Framework for Brief Dynamic Interpersonal Therapy (DIT) for Depression can be downloaded here.

Research

Tavistock Adult Depression Study - Susan McPherson, Lucy Chan, Phil Richardson, David Taylor and David Shapiro
The Tavistock Clinic is carrying out the first randomised controlled trial of psychoanalytic psychotherapy in the treatment of refractory depression. Patients who are eligible for the study are those with significant depression who have not responded successfully to previous drug treatment - with or without additional psychological interventions.

  • www.tavistockandportman.nhs.uk/adultdepressionstudy
  • Psychotherapy Evaluation Research Unit (PERU)
  • Mentalization-based treatment for borderline personality disorder
  • UCL Psychoanalysis Unit research
  • Improving Mood with Psychoanalytic and Cognitive Therapies
  • Our response to the NICE Guidelines on Depression

Long-term psychodynamic psychotherapy meta-analysis

Two meta-analysis studies by Falk Leichsenring and Sven Rabung give evidence for the efficacy of psychodynamic (and hence psychoanalytic) psychotherapy in complex mental disorders, when compared to less intensive therapies.

Falk Leichsenring and Sven Rabung, Effectiveness of Long-term Psychodynamic Psychotherapy: A Meta-analysis. JAMA. 300(13):1551-1565.

Falk Leichsenring and Sven Rabung, Long-term psychodynamic psychotherapy in complex mental disorders: update of a meta-analysis. Br J Psychiatry. 199(1):15-22.

Child Psychotherapy

The Anna Freud Centre's approach to evidence based practice: The child psychoanalytic tradition, and the perspective on developmental psychopathology, founded and elaborated by Anna Freud and her colleagues at the Centre, continues fundamentally to shape the AFC's work. In the 25 years since Anna Freud's death, the AFC and many others have worked hard to keep that tradition and perspective growing, relevant to the contemporary child mental health world, and responsive to new knowledge and methods in the worlds of clinical practice and developmental research (e.g.: Fonagy, P., Target, M.

  • Adoption and foster care
  • Social and affective neuroscience
  • Developmental neuroscience
  • Parent-Infant Project RCT
  • Child Attachment Interview

US Research

Abstract of paper in the American Psychologist: Empirical evidence supports the efficacy of psychodynamic therapy. Effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as “empirically supported” and “evidence based.” In addition, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends. Finally, nonpsychodynamic therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice. The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidence and may reflect selective dissemination of research findings.

Download the original paper from the APsaA website here

American Psychoanalytic Association research:

  • Empirical Studies of Psychoanalytic Treatments, Process, and Concepts
  • Frequently Asked Questions

What Happens in a Psychoanalysis? A View through the Lens of The Analytic Process Scales (APS)
©, Sherwood Waldron, Robert Scharf, David Hurst , Stephen Firestein & Anna Burton
Published, International Journal of Psychoanalysis, 85: 443-466

'Efficacy of psychoanalysis and intensive psychoanalytic therapy for patients with substantial phobias, anxieties and panic states: a comment with new findings from the Menninger study'
Sherwood Waldron

Resources in the media

The Economist, Intelligent Life Magazine: Freud’s ideas have become part of the fabric of everyday life—yet his methods are going out of favour. Robert Rowland Smith argues that the professionals have got it wrong.

Also: New Scientist debated whether psychoanalysis has a place in a museum dedicated to science.

Here is the response from the psychoanalytic community.

Scientific American Mind

An article in the issue of Scientific American Mind further supports the case for psychodynamic therapies. The article is by Jonathan Shedler, whose paper in American Psychologist was also cited positively in New Scientist. Together with the letter from Mary Target and colleagues to New Scientist, this is a fantastic illustration that the tide is turning in terms of the evidence base for psychoanalytic/dynamic psychotherapy.

Shedler gives his readers 'Fast Facts: The Value of Self-Examination':
'1. Psychodynamic therapy is not the psychoanalysis of Freud's day: patients sit on a chair instead of lying on a couch, have sessions once or twice - not four or five times - a week, and may finish in months as opposed to years.
2. Though often dismissed as too open-ended to solve specific problems, psychodynamic therapy alleviates symptoms as effectively as newer, more targeted therapies.
3. People who undergo psychodynamic therapy continue to make gains after the therapy ends, perhaps because it addresses underlying psychological patterns that affect many areas of life.'