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Evaluation of Literature Regarding Specific Theories and Techniques

Discussion in 'Psychology [Psy.D. / Ph.D.]' started by MBellows, Apr 19, 2013.

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  1. MBellows

    MBellows

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    As requested in another thread, we should probably have a specific thread for debating the literature regarding specific techniques and theories in psychology. The thread in question was speaking to psychodynamic/psychoanalytic theory, but there is no reason for the thread to be limited solely to that subject. Please feel free to post references to articles that you feel pertinent to the validation of specific theories and techniques.
  2. MBellows

    MBellows

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    Psychodynamic/Psychoanalytic references from original thread.

  3. ela

    ela

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    Thanks MBellows.

    A few more, in order to keep them up top with the other psychd/psycha resources:

    Clarkin, J.F., Levy, K.N., Lenzenweger, M.F., and Kenberg, O.F. (2007). Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study. The American Journal of Psychiatry, 164, 922-928.

    Diguer, L., Barber, J.P., Luborsky, L. (1993). Three concomitants: Personality disorders, psychiatric severity, and outcome of dynamic psychotherapy of major depression. American Journal of Psychiatry, 150, 1246-1248.

    Doering, S., Horz, S., Rentrop, M., Fishcer-Kern, M. et al. (2010). Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial. British Journal of Psychiatry, 196, 389-395.

    G. O Gabbard, G. O., & Bennett, T. J. (2006). Psychoanalytic and psychodynamic psychotherapy for depression and dysthymia. In D. J. Stein, D. J. Kupfer, A. F, Schatzberg (Eds.) Textbook of mood disorders. (pp. 389-405). Washington, DC: American Psychiatric Publishing. (review)

    Hilsenroth, M. J. (2007). A programmatic study of short-term psychodynamic psychotherapy: Assessment, process, outcome, and training. Psychotherapy Research, 17(1), 31-45.

    Hilsenroth, M. J., Ackerman, S. J., Blagys, M. D., Baity, M. R., & Mooney, M. A. (2003). Short-term psychodynamic psychotherapy for depression: An examination of statistical, clinically significant, and technique-specific change. Journal of Nervous and Mental Disease, 191, 349-357.

    Leichsenring, F., & Leibing, E. (2007). Psychodynamic psychotherapy: A systematic review of techniques, indications and empirical evidence. Psychology and Psychotherapy: Theory, Research and Practice, 80, 217-228.

    Simpson, S., Corney, R., Fitzgerald, P., & Beecham, J. (2003). A randomized controlled trial to evaluate the effectiveness and cost-effectiveness of psychodynamic counseling for general practice patients with chronic depression. Psychological Medicine, 33, 229-239.


    My intention in posting these ref's is not to flood the page, brush my hands, and say "See, it works". Rather, the "there's no body of evidence for psychoanalytic/dynamic approaches" refrain is tiring, and hopefully pulling these together can serve as a starting point.
  4. MBellows

    MBellows

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    You're welcome! And I hope that people can at least try and keep the discussion focused primarily on the articles brought up in these and future posts. If people want to quote what they have said from the previous thread about different specific studies, I'll let them do that.

    The only thing that I really had to add beyond that is to restate the previously mentioned point that PA and recent time limited PD therapies are not the same, with an obvious admission that there have been some awesome recent contributions from the latter, some of which are cited above.
  5. Ollie123

    Ollie123

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    Please do share! More readings is great - I just want to see the discussion move beyond that (and hope to contribute to it later).

    My accusations in the previous thread was not necessarily that there haven't been any studies published (there clearly have - I don't know anyone that would disagree with that) its that the existing evidence is generally quite limited/weak/flawed. This is why it bothers me when I've tried to have the discussions and people have basically been citing the abstracts and completely unable to discuss design issues, etc.

    Another issue is that at present, the evidence is limited to a fairly narrow scope of practice (primarily mood dx and Axis II from my reading of the lit) and many (I'd argue a vast majority) of practitioners are using it for purposes far outside that practice from the other thread, I'll once again point out...what happens if you are an analyst and someone with OCD comes into your practice. Do you refer out? My experience has been that most would not, nor would they even mention to the client the lack of evidence for their treatment plan - which in my eyes is abhorrent and the main reason I get fired up about this issue. Maybe one of the articles above addresses this but last I checked there was virtually no empirical work on analytic tx in that area. Not that its the most prevalent disorder people are likely to see in practice, but I think it speaks to broader issues.

    Also agree with mbellows that we need to be clear what we are discussing. References to TL dynamic tx are not what the original discussion was about. Yes, even there I think there is plenty of room for discussion but it is worlds ahead of the traditional analytic model which I thought was the focus of our discussion.
  6. ela

    ela

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    Recent article of interest, comparing CBT to Psychodynamic (short term = 16 sessions) therapy for depressed outpatients.

    "No significant differences between treatments were found."

    Driessen E et al. The efficacy of cognitive-behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: A randomized clinical trial. Am J Psychiatry 2013 Sep 1; 170:1041. (http://dx.doi.org/10.1176/appi.ajp.2013.12070899)
    - See more at: http://www.jwatch.org/na32040/2013/...py-depressed-outpatients#sthash.qj6bFaUV.dpuf


    http://ajp.psychiatryonline.org/article.aspx?articleID=1734470
  7. psycscientist

    psycscientist

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    I think it's more important to examine studies that include extended follow-up and examine differential rates of relapse than to just look at race horse studies that only measure patients at the end of treatment. It may be that a variety of treatments work to help the patient get better over the course of short-term treatment, but I would argue that it's more important to know what treatment is going to sustain that change and prevent relapse over the long-term.
  8. LivingOffLoans

    LivingOffLoans

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    Here:

    Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65 (2), 98-109.

    Surprised no one included this one yet. The full article for it can be found here
  9. CheetahGirl

    CheetahGirl Clinical Psych PhD Candidate

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    I agree.

    MBellows, great thread. I wanted to add more to the other thread you mentioned but didn't have time to respond intelligibly. I still don't have time to reply to discussion about psychodynamic treatments not having solid evidence-based literature to back up the theories. That is a difficult question to answer without reviewing my past 6-years. There is plenty of evidence; however, unless you study dynamic theory, you may not get the point that psychodynamics is not about SHORT-TERM treatment. Intrapsychic, interpersonal, long-lasting change takes time...years. So, yes, the service delivery matters, but what matters more...is the therapist's understanding of the patient's dynamics at play and the therapist's conceptualization of those dynamics. I feel psychodynamic theory is most powerful when combined with other modes of training. I am not an analyst (yet...if ever), but I'm sure most analysts don't solely use unsubstantiated, non-empirically based treatments based on Freudian theory (circa 1920s)...if they did, it's malpractice and more harm will be done than good. That whole concept of "if it's not one thing, it's your mother," is ancient...although attachment theory IS routed in empirical-based, longitundinal studies that support it, interpersonally, relationally, dynamically, neurobiologically, socially, etc. Just start with any of Allan Schore's work...or Lyons-Ruth...or Beatrice Beebe...or Arietta Slade...I could go on and on.

    I like this thread though, and thanks for sharing these references. I'll dig deep and find some myself when I pull my head out of the internship/dissertation sand.
    Last edited: Sep 7, 2013

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