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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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“…and homogeneity of the studies included in the metaanalysis was considerably better than that of studies used for other recently published meta-analytic reviews of established but poorly validated psychodynamic interventions (Leichsenring & Rabung, 2008; Leichsenring, Rabung, & Leibing, 2004).”
ResultThe efficacy of psychodynamic psychotherapy
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“A meta-analysis reported in the Journal of the American Medical Association (Leichsenring & Rabung, 2008) compared longterm psychodynamic therapy (" 1 year or 50 sessions) with shorter term therapies for the treatment of complex mental disorders (defined as multiple or chronic mental disorders, or personality disorder…”
BackgroundInfluentialIs cognitive–behavioral therapy more effective than other therapies?
Tolin, D. F. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.05.003 · Cited by 645
“…approaches (Butler, Chapman, Forman, & Beck, 2006; de Mello, de Jesus Mari, Bacaltchuk, Verdeli, & Neugebauer, 2005; Dobson, 1989; Driessen et al., 2010; Hofmann & Smits, 2008; Leichsenring & Rabung, 2008), unavoidably leads to controversy regarding which form of psychotherapy is most effective.”
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Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.02.026 · Cited by 586
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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