Short-term psychodynamic psychotherapy for depression: An evaluation of statistical, clinically significant, and technique specific change

Derner Institute of Advanced Psychological Studies, Adelphi University, 158 Cambridge Ave., Garden City, New York 11530, USA.
Journal of Nervous & Mental Disease (Impact Factor: 1.69). 07/2003; 191(6):349-57. DOI: 10.1097/01.NMD.0000071582.11781.67
Source: PubMed


This study investigates the effectiveness of short-term psychodynamic psychotherapy (STPP) for depression in a naturalistic setting utilizing a hybrid effectiveness/efficacy treatment research model. Twenty-one patients were assessed pre- and post-treatment through clinician ratings and patient self-report on scales representing specific DSM-IV depressive, global symptomatology, relational, social, and occupational functioning. Treatment credibility, fidelity, and satisfaction were examined, all of which were found to be high. All areas of functioning assessed exhibited significant and positive changes. These adaptive changes in functioning demonstrated large statistical effects. Likewise, changes in depressive symptoms evaluated at the patient level utilizing clinical significance methodology were found to be high. A significant direct process/outcome link between STPP therapist techniques and changes in depressive symptoms was observed. Alternative treatment interventions within STPP were evaluated in relation to subsequent improvements in depression and were found to be nonsignificant. The present results demonstrate that robust statistical and clinically significant improvement can occur in a naturalistic/hybrid model of outpatient STPP for depression.

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    • "Several studies investigating the process of change in psychodynamic therapy have also found a significant relationship between the use of theoretically consistent techniques (such as interventions aimed at fostering emotional experience, addressing defenses, exploring the past, or drawing connections between different relationships in client's life, including with his or her therapist) and therapeutic change (e.g., Ablon & Jones, 1998; Connolly Gibbons et al., 2012; Gaston, Thompson, Gallagher, Cournoyer, & Gagon, 1998; Hillsenroth, Ackerman, Blagys, Baity, & Mooney, 2003; Ulvenes et al., 2012). Similarly, some of the core processes emphasized in humanistic and experiential treatments (such the therapist's empathy, as well as the client's deepening and processing of emotion) have been associated with positive outcome in these approaches (see Elliott, Greenberg, & Lietaer [2004] and Greenberg & Pascual-Leone [2006] for reviews). "
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    ABSTRACT: Responding to an invitation to celebrate the 50th anniversary of the journal Psychotherapy, the goal of this article is to describe three general ways by which the impact of psychotherapy might be improved: (a) clinically, by encouraging the assimilation of empirically based principles of change and psychopathology research into day-to-day practice; (b) empirically, by fostering process and outcome research focused on a wide range of common factors and basic findings; as well as (c) clinically and empirically, by facilitating active collaboration of practitioners and researchers in various types of practice-oriented research. Reflected in these three potential avenues of growth are the assumptions that (a) we can improve our understanding and impact of psychotherapy by building on convergences and complementarities across different theoretical orientations, domains of research, and professional expertise, and that (b) most of the clinical and research suggestions derived by such convergence and plurality may not require drastic changes in the practice of many psychotherapists. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Full-text · Article · Mar 2013 · Psychotherapy Theory Research Practice Training
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    • "The NICE guideline indicated that it was not possible to demonstrate a consistent picture of any clinically important benefit for short-term psychodynamic psychotherapy (STPP) in depression. While cognitive-behavioral therapy and interpersonal therapy continue to have the most evidence for efficacy [15], however, some randomized trials and meta-analyses indicated that STPP could be effective in reducing symptoms and in improving functional ability of patients with mild or moderate depression [16–20]. "
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    ABSTRACT: Objectives and Methods. This was an observational study of the efficacy of short-term psychodynamic psychotherapy (STPP) in a sample of 35 (30 women and 5 men) patients with moderate-to-severe "male depression" (Gotland Scale for Male Depression (GSMD) ≥ 13) comorbid with unipolar mood disorder (dysthymia and major depression) or anxiety disorder. Outcome measures were GSMD and BHS (Beck Hopelessness Scale) score changes from baseline. Results. Patients had a strong response to STPP on the GSMD (estimated mean score change (± SE) = -9.08 ± 2.74; P < 0.01; partial eta squared = 0.50), but not on the BHS (estimated mean score change (± SE) = -0.92 ± 1.55; P = 0.57; partial eta squared = 0.03). BHS score changes were significantly associated with GSMD score changes (Pearson's r = 0.56; P < 0.001), even when controlling for the severity of hopelessness at the baseline (partial r = 0.62; P < 0.001). Conclusions. STPP proved to be effective in patients suffering from "male depression" although hopelessness was only marginally reduced by this treatment which points to the need to better understand how STPP can be involved in the reduction of suicide risk.
    Full-text · Article · Jan 2013 · Depression research and treatment
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    • "Anche altri team di ricercatori hanno rilevato che gli elementi psicodinamici presenti nelle CBT predicono con successo l'outcome di queste terapie, in particolare rispetto alla sintomatologia depressiva (Hollon et al., 1992; Hayes, Castonguay, Goldfried, 1996). Ulteriori studi empirici hanno evidenziato l'associazione positiva tra processo psicodinamico e outcome (Barber, Crits-Christoph, Luborsky, 1996; Diener, Hilsenroth, Weinberger, 2007; Gaston et al., 1998; Hayes, Strauss, 1998; Hilsenroth et al., 2003; Hoglend et al., 2008; Norcross, 2002; Pos et al, 2003; Vocisano et al., 2004), sottolineando come anche i terapeuti CBT utilizzino di fatto interventi di natura dinamica -come le chiarificazioni e gli interventi centrati su conflitti e difese -e questi interventi sembrano avere effetti positivi sulla capacità dei pazienti di partecipare in modo produttivo alla terapia (Waldron, Helm, 2005). "

    Full-text · Chapter · Jan 2012
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