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Effectiveness of Long-term Psychodynamic Psychotherapy: A Meta-analysis
Abstract
THE PLACE OF PSYCHOANALYTIC and psychodynamic treatments within psychiatry is controversial. Although some evidence supports the efficacy of short-term psychodynamic psychotherapy (STPP) for specific disorders, convincing research on the outcome of long-term psychodynamic psychotherapy (LTPP) has been lacking. Evidence suggests that short-term psychotherapy is sufficiently effective for most individuals experiencing acute distress. Evidence, however, also indicates that short-term treatments are insufficient for a considerable proportion of patients with complex mental disorders, ie, patients with multiple or chronic mental disorders or personality disorders. Some studies suggest that long-term psychotherapy may be helpful for these groups of patients. This is true not only of psychodynamic therapy but also of psychotherapeutic approaches that are usually short-term, such as cognitive-behavioral therapy (CBT). Evidence-based treatments for these patient groups are particularly important. Personality disorders, for example, are quite common in both general and clinical populations. They show a high comorbidity with a wide range of Axis I psychiatric disorders and are significantly associated with functional impairments. Furthermore, a high proportion of patients in clinical populations expeFor editorial comment see p 1587. Author Affiliations: Department of Psychosomatics and Psychotherapy, University of Giessen, Giessen (Dr Leichsenring); and Department of Medical Psychology, Univers i ty Medica l Center HamburgEppendorf, Hamburg (Dr Rabung), Germany. Corresponding Author: Falk Leichsenring, DSc, Department of Psychosomatics and Psychotherapy, University of Giessen, Ludwigstrasse 76, 35392 Giessen Germany (falk.leichsenring@psycho.med .uni-giessen.de). Context The place of long-term psychodynamic psychotherapy (LTPP) within psychiatry is controversial. Convincing outcome research for LTPP has been lacking.
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“In addition, they also seem to have found lower ESs for personality functioning (0.78) than for symptoms (target problems, 1.54; psychiatric symptoms, 0.91).”
From The Effectiveness of Long-Term Psychoanalytic Therapy: A Systematic Review of Empirical Studies (2009) · cites this paper as [22]
In the citing paper
“As a result of the different inclusion criteria, Leichsenring and Rabung 22 considered 13 studies not included in our review.”
From The Effectiveness of Long-Term Psychoanalytic Therapy: A Systematic Review of Empirical Studies (2009) · cites this paper as [22]
In the citing paper
“However, it is noteworthy that the ESs for psychotherapy found by Leichsenring and Rabung (0.78 to 1.98) were similar to the ESs that we found (0.78 to 0.94).”
From The Effectiveness of Long-Term Psychoanalytic Therapy: A Systematic Review of Empirical Studies (2009) · cites this paper as [22]
In the citing paper
“Finally, Leichsenring and Rabung confirmed our cautious findings that results of psychotherapy were stable at follow-up.”
From The Effectiveness of Long-Term Psychoanalytic Therapy: A Systematic Review of Empirical Studies (2009) · cites this paper as [22]
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“…Klein, 2014; Leichsenring, Kruse, & Rabung, 2015) – neglecting to introduce practitioners to these ideas, or denigrating these ideas, is not consistent with a teaching approach that espouses evidence-based teaching (Drisko, 2011; Drisko & Simmons, 2012; Leichsenring & Rabung, 2008; Shedler, 2010).”
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“Second, despite the recent increase in research support for the psychodynamic approach (Leichsenring & Rabung, 2008; Leichsenring, Rabung, & Leibing, 2004; Shedler, 2010), these treatments have lacked randomized controlled trials (Leichsenring, Hiller, Weissberg, & Leibing, 2006; Leichsenring &…”
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“That this is now finding empirical support – in terms of both effectiveness (Leichsenring & Rabung, 2008) and cost-effectiveness (Berghout, Zevalkink, & HakkaartVan Roijen, 2010) – is also encouraging.”
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“that long-term interactional therapy offers an advantage for the treatment of personality disorders and complex mental conditions, compared to short-term therapies [7, 8].”
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“The replication of these outcome studies and the dissemination of some of them (Fonagy & Roth, 2004; Fonagy et al, 2005; Glass, 2008; Leichsenring et al, 2008) was instrumental in supporting the creation of PIP and other similar initiatives in national and international scientific societies.”
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“Leichsenring and Rabung (2008, 2011), in a metaanalysis of the literature showed significantly higher outcomes in terms of overall effectiveness, target problems, and personality functioning with longterm psychoanalytic psychotherapy (LTPP) than with shorter forms of psychotherapy.”
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“Researchers have made convincing arguments that, despite some claims to the contrary, the evidence base for psychodynamic psychotherapy is substantial (Leichsenring, Klein, & Salzer, 2014; Leichsenring & Rabung, 2008; Shedler, 2010).”
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“The second study cited was the well-known but methodologically controversial meta-analysis of 23 studies of LTPP (individual psychodynamic psychotherapy of at least one year) conducted by Leichsenring and Rabung (2008).”
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“Fortunately, we have plenty of data supporting the overall effectiveness (e.g., Leichsenring & Rabung, 2008; Seligman, 1995; Shedler, 2010) and cost-effectiveness (e.g., Lazar, 2010) of longer-term, open-ended, and artful therapies that should be part of any conversation about what is affordable.”
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“Important future directions for research will include [ 1 ] evaluating change at follow-up using pre–post assessments, and [ 2 ] evaluating whether different treatment modalities have different impacts on changes at this level.”
BackgroundLa Psicoterapia Dinamica basata sul Modello Dinamico-Maturativo
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“Für diese Gruppe von komorbiden Störungen wurde der Begriff der „komplexen Störungen“ vorgeschlagen (12, 15, 18).”
BackgroundSelf-citation
Metadata
- Authors
- Leichsenring, F.
- Affiliations
- American Medical Association (US)
- Corresponding author
- Leichsenring, Falk
- ORCID
- Leichsenring, Falk
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2008-10-01
- Volume
- 300
- Issue
- 13
- Pages
- 1551
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W1538112934
- Cited by
- 65
- References
- 0
- Citations by year
- 2023: 1 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 3 · 2017: 1 · 2016: 1 · 2015: 4 · 2014: 7 · 2013: 9 · 2012: 5
- FWCI
- 10.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- long-term psychodynamic psychotherapy, treatment effectiveness, personality disorders, complex mental disorders, chronic mental illness, comorbidities, functional disability, outcomes research, evidence-based treatment
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