Strategies for Measuring the Quality of Psychotherapy: A White Paper to Inform Measure Development and Implementation. C. Psychodynamic Therapy

05/15/2014

Psychodynamic therapy is intended to help the individual build awareness and understanding of his or her behaviors, thoughts, and feelings, and on how past experience relates to current functioning (Shedler 2010). Psychodynamic therapy is traditionally delivered over a relatively long period of time, sometimes years; recently, however, there has been greater interest in short-term psychodynamic therapy, which is generally a maximum of 40 sessions (Leichsenring 2005).

Although one survey of mental health professionals found that 36 percent of the respondents reported using psychodynamic therapy (Cook et al. 2012), relatively few studies have rigorously evaluated its effectiveness. Some of the studies have small samples and vary in the rigor of the design, but there is evidence to support the use of psychodynamic therapy in treating depression (Abbass and Driessen 2010; Leichsenring 2005; Leichsenring and Leibing 2007). The results from a meta-analysis suggest that psychodynamic therapy used in combination with medication produces better outcomes than medication alone (Jakobsen et al. 2012), and some studies suggest that psychodynamic therapy is equally effective as CBT in treating depression (Leichensring and Leibing 2007). Although the literature on the effects of psychodynamic therapy on other common mental disorders is limited, some evidence points to its efficacy in treating some types of anxiety (Abbass and Driessen 2009; Leichsenring 2005). As summarized in Table II-1, five of the eight clinical guidelines include psychodynamic therapy; however, they range from recommending psychodynamic therapy with "moderate clinical confidence" to concluding that the "balance of benefits and harm is too close to justify a recommendation." The field would benefit from additional research on the effectiveness of different types of psychodynamic therapy on depression, anxiety, PTSD, and other common mental disorders.

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