Town, J. M., Diener, M. J., Abbass, A., Leichsenring, F., Driessen, E., & Rabung, S. (2012). A meta-analysis of psychodynamic psychotherapy outcomes: Evaluating the effects of research-specific procedures. Psychotherapy, 49, 276-290.
One of the main reasons that some clinicians do not participate in research is that they argue that doing so will have a negative impact on the therapeutic relationship, the therapy process, and patient outcomes. Although I have heard this from clinicians of many theoretical orientations, this opinion is perhaps most strongly held by some colleagues with a psychodynamic orientation. I identify with psychodynamic theory and practice, so this opinion about research held by some of my colleagues has been very disconcerting to me. Up to now, the best I could say in defense of practice-based research of psychodynamic therapy was to talk about my own experiences, which have been highly positive and rewarding. A recent meta analysis by Town and colleagues from Dalhousie University changes all that. (First, a note about meta analysis. Meta analysis is a statistical way of combining the effects of many studies, each of which has a number of participants, into a common metric called an effect size. By combining studies, the end result is more meaningful and more reliable than the results of any single study on its own.). The meta analysis by Town and colleagues had 45 independent samples and over 1600 patients. Results indicated that psychodynamic treatments for a variety of disorders (e.g., depression, anxiety, personality disorders) showed a significant large positive treatment effect – this is not new. What is new is that compared to conditions in which no research-specific protocols were introduced, conditions that did use research protocols were no different in terms of patient outcomes up to one year post treatment. There was even a significant small positive effect of these research protocols on outcomes from post treatment to one year post treatment. Research-specific protocols included video recordings of therapy sessions, therapists following treatment manuals, fidelity checks to make sure therapists were accurately doing psychodynamic therapy, and psychometric measurements of processes and outcomes
Research protocols do not have a negative impact on psychodynamic therapy outcomes. Perhaps research protocols should be introduced into all therapies to improve longer term outcomes in addition to studying therapy procedures and processes that work.
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