Research Review

Psychodynamic Psychotherapy Brings Lasting Benefits

Psychodynamic psychotherapy is effective for a wide range of mental health symptoms, including depression, anxiety, and panic- and stress-related physical ailments, and the benefits of the therapy grow after treatment has ended, according to new research published by the American Psychological Association.

To reach these conclusions, study author Jonathan Shedler, PhD, of the University of Colorado Denver School of Medicine, reviewed eight meta-analyses comprising of 160 studies of psychodynamic therapy, plus nine meta-analyses of other psychological treatments and antidepressant medications. Shedler focused on effect size, which measures the amount of change produced by each treatment. An effect size of 0.80 is considered a large effect in psychological and medical research. One major meta-analysis of psychodynamic therapy included 1,431 patients with a range of mental health problems and found an effect size of 0.97 for overall symptom improvement (the therapy was typically once per week and lasted less than a year). The effect size increased by 50%, to 1.51, when patients were re-evaluated nine or more months after therapy ended. The effect size for the most widely used antidepressant medications is a more modest 0.31. The findings are published in American Psychologist.

The eight meta-analyses, representing the best available scientific evidence on psychodynamic therapy, all showed substantial treatment benefits, according to Shedler. Effect sizes were impressive even for personality disorders, he says. “The consistent trend toward larger effect sizes at follow-up suggests that psychodynamic psychotherapy sets in motion psychological processes that lead to ongoing change, even after therapy has ended,” Shedler says. “In contrast, the benefits of other ‘empirically supported’ therapies tend to diminish over time for the most common conditions, like depression and generalized anxiety.”

“Pharmaceutical companies and health insurance companies have a financial incentive to promote the view that mental suffering can be reduced to lists of symptoms, and that treatment means managing those symptoms and little else. For some specific psychiatric conditions, this makes sense,” he adds. “But more often, emotional suffering is woven into the fabric of the person’s life and rooted in relationship patterns, inner contradictions, and emotional blind spots. This is what psychodynamic therapy is designed to address.”

Shedler acknowledged that there are many more studies of other psychological treatments (other than psychodynamic), and that the developers of other therapies took the lead in recognizing the importance of rigorous scientific evaluation. “Accountability is crucial,” said Shedler. “But now that research is putting psychodynamic therapy to the test, we are not seeing evidence that the newer therapies are more effective.”

— Source: American Psychological Association