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Psychodynamic psychotherapy

Shlomo Mendlovic, Amit Saad, Uri Roll, Ariel Ben Yehuda, Rivka Tuval-Mashiah, Dana Atzil-Slonim
OBJECTIVE: The present study aimed to examine the association between patient-therapist micro-level congruence/incongruence ratio and psychotherapeutic outcome. METHOD: Nine good- and nine poor-outcome psychodynamic treatments (segregated by comparing pre- and post-treatment BDI-II) were analyzed (N = 18) moment by moment using the MATRIX (total number of MATRIX codes analyzed = 11,125). MATRIX congruence was defined as similar adjacent MATRIX codes. RESULTS: the congruence/incongruence ratio tended to increase as the treatment progressed only in good-outcome treatments...
March 14, 2018: Psychotherapy Research: Journal of the Society for Psychotherapy Research
Falk Leichsenring, Christiane Steinert
BACKGROUND: In psychotherapy research unified, transdiagnostic and modular treatments have emerged. This is true for both cognitive-behavioral therapy and psychodynamic therapy. Recently, two unified psychodynamic protocols were presented, one for anxiety disorders, another for depressive disorders. Integrating the treatment principles for these two highly prevalent disorder groups into one protocol for "emotional disorders" may be useful for both clinical practice and training in psychotherapy...
November 11, 2017: Journal of Affective Disorders
Raffaella Calati, Philippe Courtet, Jorge Lopez-Castroman
PURPOSE OF REVIEW: Since psychotherapies for suicide prevention are receiving increasing attention, our purpose was to evaluate the related literature [meta-analyses and reviews on their effect on suicidal outcomes (A), perspective reviews concerning specific socio-demographic and clinical features (B), original studies with particular interest (C)] published over the last 3 years. RECENT FINDINGS: (A) Across different diagnoses, particularly, efficacious psychotherapies were cognitive behavioral therapy-based ones and interventions directly addressing suicidal thoughts and behaviors during the treatment...
March 8, 2018: Current Psychiatry Reports
Bernhard Strauß, Uwe Altmann, Susanne Manes, Anne Tholl, Susan Koranyi, Tobias Nolte, Manfred E Beutel, Jörg Wiltink, Stephan Herpertz, Wolfgang Hiller, Jürgen Hoyer, Peter Joraschky, Björn Nolting, Viktoria Ritter, Ulrich Stangier, Ulrike Willutzki, Simone Salzer, Eric Leibing, Falk Leichsenring, Helmut Kirchmann
OBJECTIVES: Within a randomized controlled trial contrasting the outcome of manualized cognitive-behavioral (CBT) and short term psychodynamic therapy (PDT) compared to a waiting list condition (the SOPHO-Net trial), we set out to test whether self-reported attachment characteristics change during the treatments and if these changes differ between treatments. RESEARCH DESIGN AND METHODS: 495 patients from the SOPHO-Net trial (54.5% female, mean age 35.2 years) who were randomized to either CBT, PDT or waiting list (WL) completed the partner-related revised Experiences in Close Relationships Questionnaire (ECR-R) before and after treatment and at 6 and 12 months follow-up...
2018: PloS One
Fredric N Busch, Elizabeth L Auchincloss
Psychoanalysts have generally avoided discussion of psychoeducational interventions in the context of psychodynamic psychotherapy, despite education being a component of many psychoanalytic techniques. This wariness stems from Freud's early concerns about interventions that could be deemed "suggestion," and a misunderstanding of various aspects of neutrality, including viewing psychoeducational comments as over-gratifying or siding with the ego. Although potential pitfalls exist, the authors review clinical evidence and research that indicate the value of psychoeducational approaches for engaging patients in psychodynamic psychotherapy, considering alternative treatments, providing a psychodynamic formulation, and enhancing the therapeutic alliance...
2018: Psychodynamic Psychiatry
Yakov Shapiro
Psychodynamic psychiatry is not limited to psychotherapy practice. It is defined by systematic attention to the "common factors" underlying both psychotherapy and psychopharmacology outcomes, which include the patient's subjective systems of meaning and the complex flow of the patient-provider relationship in addition to the patient's "objective" psychopathology. It allows for a non-reductionist milieu where the meaning of the illness and the full complexity of the treatment process can be explored in order to achieve a qualitative and lasting change in the patient's psychopathology...
2018: Psychodynamic Psychiatry
Ellen Driessen, Allan A Abbass, Jacques P Barber, Mary Beth Connolly Gibbons, Jack J M Dekker, Marjolein Fokkema, Peter Fonagy, Steven D Hollon, Elise P Jansma, Saskia C M de Maat, Joel M Town, Jos W R Twisk, Henricus L Van, Erica Weitz, Pim Cuijpers
INTRODUCTION: Short-term psychodynamic psychotherapy (STPP) is an empirically supported treatment that is often used to treat depression. However, it is largely unclear if certain subgroups of depressed patients can benefit specifically from this treatment method. We describe the protocol for a systematic review and meta-analysis of individual participant data (IPD) aimed at identifying predictors and moderators of STPP for depression efficacy. METHOD AND ANALYSIS: We will conduct a systematic literature search in multiple bibliographic databases (PubMed, PsycINFO, Embase...
February 20, 2018: BMJ Open
Winfried Rief, Stefan G Hofmann
In virtually every field of medicine, non-inferiority trials and meta-analyses with non-inferiority conclusions are increasingly common. This non-inferiority approach has been frequently used by a group of authors favoring psychodynamic therapies (PDTs), concluding that PDTs are just as effective as cognitive-behavioral therapies (CBT). We focus on these examples to exemplify some problems associated with non-inferiority tests of psychological treatments, although the problems also apply to psychopharmacotherapy research, CBT research, and others...
February 14, 2018: Psychological Medicine
Marie Ociskova, Jan Prasko, Kristyna Vrbova, Petra Kasalova, Michaela Holubova, Ales Grambal, Klara Machu
Goal: The goal of this study was to explore the impact of self-stigma on the treatment outcomes in patients with anxiety disorders and to find possible mediators of this relationship. Method: Two hundred and nine patients with anxiety disorders, who were hospitalized in a psychotherapeutic department, attended the study. The average age was 39.2±12.4 years; two-thirds were women. Most of the patients used a long-term medication. The participants underwent either cognitive behavioral therapy (CBT) or short psychodynamic therapy...
2018: Neuropsychiatric Disease and Treatment
R Meister, A Jansen, M Berger, H Baumeister, T Bschor, T Harfst, M Hautzinger, L Kriston, C Kühner, H Schauenburg, S G Schorr, F Schneider, M Härter
BACKGROUND: Depressive disorders are associated with a high burden of suffering and significantly reduce the well-being and the self-esteem of affected patients. Psychotherapy is one of the main treatment options for depressive disorders. OBJECTIVE: The aim of this article is to present the current evidence for antidepressive psychotherapeutic treatments. MATERIAL AND METHODS: During the revision of the German S3- and National Disease Management Guideline (NDMG) on unipolar depression in 2015, a comprehensive and systematic evidence search was conducted...
January 30, 2018: Der Nervenarzt
A Ströhle, T Fydrich
According to the Federal Healthcare Survey (Bundesgesundheitssurvey), approximately 15% of the German population fulfil the diagnostic criteria for at least one anxiety disorder within (any) 1 year. Women are affected approximately twice as often as men. The study by the Robert Koch Institute included the systematic assessment of panic disorder, agoraphobia, generalized anxiety disorder, social anxiety disorder and specific phobias; therefore, the question for both those affected and the treating therapist is "anxiety disorders: which psychotherapy for whom?" is of great clinical and healthcare political importance...
March 2018: Der Nervenarzt
Isobel Anne Williams, Stephanie Howlett, Liat Levita, Markus Reuber
BACKGROUND: Functional neurological symptoms (FNS) are considered non-volitional and often very disabling, but are not explainable by neurological disease or structural abnormalities. Brief Augmented Psychodynamic Interpersonal Therapy (BAPIT) was adapted to treat the putative emotion processing deficits thought to be central to FNS aetiology and maintenance. BAPIT for FNS has previously been shown to improve levels of distress and functioning, but it is unknown whether improvements on such measures correlate with changes in emotion processing ‒ which this treatment focuses on...
January 25, 2018: Behavioural and Cognitive Psychotherapy
John R Keefe, Robert J DeRubeis
OBJECTIVE: Personality disorder (PD) is a negative prognostic indicator for treatment, and absolute improvements in functioning among these patients are often modest. This may be because personality features that give rise to dysfunction in PD are not targeted optimally during most treatments. METHOD: Attachment, mentalization, core beliefs, and personality organization/defense use were identified as personality constructs that have been pursued in treatment studies and that are proposed to underlie PD...
January 19, 2018: Psychotherapy Research: Journal of the Society for Psychotherapy Research
Valentina Cardi, Kate Tchanturia, Janet Treasure
Social difficulties in eating disorders can manifest as predisposing traits and premorbid difficulties, and/or as consequences of the illness. Objective The aim of this paper is to briefly review the evidence for social problems in people with eating disorders and to consider the literature on treatments that target these features. Method A narrative review of the literature was conducted. Results People with eating disorders often manifest traits, such as shyness, increased tendency to submissiveness and social comparison, and problems with peer relationships before illness onset...
January 17, 2018: Current Neuropharmacology
Eric M Plakun
This column reviews 2 recent high-quality psychotherapy research studies. One study by Steinert and colleagues suggests that psychodynamic therapy is equivalent to cognitive behavioral therapy (CBT) (or medication when this was the comparator) for a range of disorders. A second study by Barlow and colleagues finds Unified Protocol CBT targeting underlying emotional dysregulation to be equivalent to single disorder-specific CBT for a range of anxiety disorders. Taken together, these studies help bridge the gap between CBT and psychodynamic therapy and refocus us on the realities of clinical settings, where most patients present with multiple comorbid disorders...
January 2018: Journal of Psychiatric Practice
Dennis M Kivlighan, Clara E Hill, Katherine Ross, Kathryn Kline, Amy Furhmann, Elizabeth Sauber
To test a sequential model of psychotherapy process and outcome, we included previous client distress, therapist psychodynamic techniques, dyadic working alliance, and current client distress. For 114 sets of eight-session segments in 40 cases of psychodynamic psychotherapy, clients completed the Outcome Questionnaire-45 and Inventory of Interpersonal Problems-32 after the first and final session, judges reliably coded one middle sessions on the Psychodynamic subscale of the Multitheoretical List of Therapeutic Interventions, and clients and therapists completed the Working Alliance Inventory after every session...
January 5, 2018: Psychotherapy Research: Journal of the Society for Psychotherapy Research
Otto Doerr-Zegers
Following the tradition of researchers of the phenomenological-anthropological school such as Straus, von Gebsattel, Tellenbach, and Blankenburg, the author attempts to approach the obsessive-compulsive disorder from a phenomenological perspective. This means setting aside any previous ideas about the phenomenon in question, including genetic, neurobiological, and clinical-statistical considerations. He takes as his starting point a clinically typical case he studied and treated with psychoanalytically oriented psychotherapy for many years...
January 5, 2018: Psychopathology
Michael Katz, Mark J Hilsenroth
We examined the relationship between psychodynamic techniques early in treatment with reliable change in depressive symptomatology. Forty-six patients admitted for individual psychodynamic psychotherapy who received a diagnosis representative of a depressive spectrum disorder were assessed pretreatment and posttreatment through self-report of depressive symptoms. Videotapes from two early treatment sessions (3rd and 9th) were independently rated on the Comparative Psychotherapy Process Scale for use of psychodynamic-interpersonal and cognitive-behavioural techniques, with excellent interrater reliability (intraclass correlation coefficient > ...
December 25, 2017: Clinical Psychology & Psychotherapy
Jeffrey Katzman, Anilla Del Fabbro
Psychiatric trainees are expected to learn the fundamental concepts of psychodynamic psychotherapy, but they often struggle to understand and appreciate the relevance of this work. An introduction to attachment theory can go a long way toward assisting our trainees in understanding the relevance of psychodynamic psychiatry. To help programs develop this component of their curriculum, we summarize the history of the development of the attachment paradigm including the Strange Situation and Adult Attachment Interview (AAI), useful tools to teach these concepts, as well as ramifications of this work...
2017: Psychodynamic Psychiatry
Zeynep Sahin, Bo Vinnars, Bernard S Gorman, Alexander Wilczek, Marie Åsberg, Jacques P Barber
The aim of the present study was to assess the effect of initial level of psychiatric severity on treatment outcome in psychodynamic therapy and dialectical behavior therapy (DBT) for borderline personality disorder (BPD). It was hypothesized that DBT would lead to better outcome for patients with high psychiatric severity, whereas dynamic treatment would lead to better outcome for patients with lower psychiatric severity. Data from the 5th-year follow-up of the Stockholm City Council's and the Karolinska Institute's Psychotherapy Project were used in the present study...
December 14, 2017: Personality Disorders
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