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Cited by 71Psychotherapy Techniques and ApplicationsPsychoanalysis and Psychopathology ResearchPsychological Treatments and Disorders

Differential effects of two forms of psychoanalytic therapy: Results of the Heidelberg-Berlin study

Grande, Tilman, Dilg, Reiner, Jakobsen, Thorsten, Keller, Wolfram, Krawietz, Bärbel, Langer, Monika, Oberbracht, Claudia, Stehle, Sabine +2 more·2006·Psychotherapy Research
DOI 10.1080/10503300600608082
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Abstract

This prospective naturalistic quasi-experimental study compares 2 psychodynamic therapy approaches that make up about 65% of all forms of psychotherapy currently financed by the health insurance system in Germany. Psychodynamic therapy (PD) is a focal therapy approach involving supportive elements, whereas psychoanalytic therapy (PA) encourages regressive processes, works with transference, and aims at more extensive changes to the personality (structural changes). PAs take longer and involve more sessions per week. By international standards, both approaches are regarded as long-term forms of therapy. This study investigates 2 groups of diagnostically heterogeneous patients, one PA and the other PD, matched with regard to several important parameters. The success of this matching was tested and comparability checked and substantiated on a wide range of features and scales. Treatment effects measured at end of therapy and at 1-year follow-up were analyzed with reference to the Global Severity Index (GSI) of the Symptom Checklist-90-Revised (SCL-90-R) and the Inventory of Interpersonal Problems (IIP). Both the GSI of the SCL-90-R and the total IIP score showed highly significant main effects in the whole group at end of therapy and at follow-up. A significant interaction effect between the 2 groups indicating higher efficiency for PA was found for the IIP total score with regard to the pre–post changes, with a corresponding trend in the pretherapy–follow-up changes. Evidence shows that a supplementary investigation of the specific effects of psychodynamic therapies (structural changes) is required for an accurate appreciation of their potential. Zusammenfassung Grande In einer prospektiven, naturalistischen Studie mit quasi-experimentellem Design werden zwei psychodynamische Therapieverfahren verglichen, die in Deutschland ca. 65% der kassenfinanzierten Psychotherapien ausmachen. Die tiefenpsychologisch fundierte Psychotherapie (PD) verfolgt einen fokaltherapeutischen Ansatz und enthält supportive Elemente, während in der analytische Psychotherapie regressive Prozesse gefördert, mit der Übertragung gearbeitet und umfassendere Änderungen der Persönlichkeit (sog. strukturelle Veränderungen) angestrebt werden (PA); PAs dauern deshalb länger und werden mit höherer wöchentlicher Frequenz durchgeführt. Beide Verfahren sind jedoch nach internationalen Maßstäben Langzeittherapien. Untersucht werden diagnostisch heterogene Patienten. Beide Gruppen (PA und PD) wurden hinsichtlich wichtiger Parameter parallelisiert. Der Erfolg dieser Parallelisierung wird anhand einer Vielzahl von Merkmalen und Skalen überprüft und plausibel gemacht. Anschließend werden die differentiellen Therapieeffekte zum Zeitpunkt des Therapieendes und einer 1-Jahres-Katamnese anhand der Symptom-Check-List (SCL-90-R) und des Inventory of Interpersonal Problems (IIP) untersucht. Für den IIP-Gesamtscore ergibt sich eine signifikante Wechselwirkung zum Therapieende, die eine größere Wirksamkeit der PA belegt; ein entsprechender Trend findet sich auch zum Katamnesezeitpunkt. Es wird dargelegt, dass eine ergänzende Untersuchung der spezifischen Effekte psychodynamischer Therapien (struktureller Veränderungen) notwendig ist, um ihre Potentiale angemessen zu erfassen. Résumé Les effets differentiels de deux formes de thérapie psychanalytique: resultants de l’étude Heidelberg-Berlin Cette étude naturaliste, prospective et quasi-expérimentale compare les deux approches thérapeutiques qui représentent les 65% de toutes les formes de psychothérapie couramment financées par le système d'assurance maladie en Allemagne. La thérapie psychodynamique (PD) est une approche focale incluant des éléments de soutien, et la thérapie psychanalytique (PA) encourage des processus régressifs, travaille avec le transfert et vise des changements plus amples de la personnalité (des changements structuraux). Les PA durent plus longtemps et impliquent plus de séances par semaine. Selon les standards internationaux, les deux approches sont considérées comme des formes de thérapie longues. Cette étude investigue 2 groupes de patients aux diagnostics hétérogènes, le groupe PA et le groupe PD, appariés en vue de plusieurs paramètres importants. Le succès de cet appariement était testé et la comparabilité était examinée et établie par une large gamme d’échelles. Les effets des traitements à la fin de la thérapie et une année après étaient analysés en se référant au Global Severity Index (GSI) de la Symptom Checklist-90-Revised (SCL-90-R) et de l'Inventaire de Problèmes Interpersonnels (IIP). Aussi bien le GSI de la SCL-90-R que le score total de l'IIP montraient des effets principaux hautement significatifs pour le groupe entier à la fin de la thérapie et à la catamnèse. Un effet d'interaction significatif entre les 2 groupes montrait une efficacité plus grande pour PA au score total de l'IIP pour le changement avant/après, avec une tendance correspondante pour les changements avant/

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  • Rudolf and colleagues found that long-term psychoanalytic therapy performed better than moderate-length psychoanalytic therapy (mean = 60 sessions) in terms of structural changes of personality.

    “Rudolf and colleagues 50,64 found that long-term psychoanalytic therapy performed better than moderate-length psychoanalytic therapy (mean = 60 sessions) in terms of structural changes of personality.”

    From The Effectiveness of Long-Term Psychoanalytic Therapy: A Systematic Review of Empirical Studies (2009) · cites this paper as [50]

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Authors
Grande, T., Dilg, R., Jakobsen, T., Keller, W., Krawietz, B., Langer, M., Oberbracht, C., Stehle, S., Stennes, M., & Rudolf, G.
Affiliations
Heidelberg University (DE)
Corresponding author
Grande, Tilman
ORCID
Grande, Tilman
Venue
Psychotherapy Research
Publisher
Informa UK Limited
Published
2006-08
Volume
16
Issue
4
Pages
470-485
ISSN
  • 1050-3307 (ISSN-L)
  • 1468-4381
DOI
10.1080/10503300600608082
OpenAlex
W1987254751
Cited by
71
References
46
Citations by year
2025: 2 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 1 · 2014: 4 · 2013: 5 · 2012: 6
FWCI
7.38
Type
journal article
Language
en
Open access
closed
Locations
Psychotherapy Research (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 › Psychological Treatments and Disorders
Keywords
psychoanalytic psychotherapy, psychodynamic psychotherapy, treatment outcome comparison, structural change, transference, interpersonal problems, Global Severity Index, SCL-90-R, Inventory of Interpersonal Problems, long-term psychotherapy, follow-up outcomes, Germany, psychotherapy effectiveness

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