Evidence Base for Psychodynamic Psychotherapy


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Questions have been asked about the evidence base supporting Psychoanalytic and Psychodynamic Psychotherapy over recent years. This has been especially the case while the efficacy of Cognitive Behaviour Therapy (CBT) has been promoted as a short term treatment for conditions such as anxiety, depression and post traumatic stress disorder.


While CBT is widely recognised as an effective treatment it is worth noting a study in Scotland (Durham, R.C et al, 2005)   that found more than 66% of people who received CBT were unable to sustain the benefits that they received from their therapy. At a 2 year follow up 19% of those completing treatment required ‘constant further treatment’ for anxiety related difficulties while 66% required further, additional treatment. In general, the findings pointed towards a trend where the positive effects of CBT eroded the longer the time period after completing treatment.



Critical opinion of Psychoanalytic and Psychodynamic Psychotherapy has spoken about the lack of well designed Randomised Control Trials (RCT) to support an evidence base for practice. This criticism was taken seriously and led to the development of a number of RCT’s that investigated the efficacy of psychotherapies under the psychoanalytic umbrella.  The collection of these RCT’s enabled Jonathan Shelder (2010) to demonstrate a trend where people who have completed a Psychoanalytic/Psychodynamic Psychotherapy of one year or longer will continue to receive benefits long after the treatment has ended. More recently Peter Fonagy, David Taylor (2015) and others have concluded a 10 year randomised control trial that has demonstrated the above findings,  concluding that Long Term Psychodynamic Psychotherapy helped people to maintain, and develop further gains 2 years after completing therapy. Patients in the trial typically suffered from ’treatment resistant’ depression and had been unable to benefit from two previous therapies.

By clicking on the PDF logo below I provide you with a link to a British Psychoanalytic Council summary paper covering this area of thinking.


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References:

Durham, R.C. et al (2005). Long-term outcomes of cognitive behaviour therapyclinical trials in central Scotland. Health Technology Assessment NHS R&D HTA Programme.

Fonagy, P. Rost, F. Carlyle, J. et al (2015). Pragmatic randomised controlled trial of long term psychoanalytic psychotherapy for treatment resistant depression: the Tavistock Adult Depression Study. World Psychiatry. 14:312-321.

Shedler, J. (2010) The efficacy of psychodynamic psychotherapy. American Psychologist, 65: 98-109.