Wetenschappelijk onderzoek toont aan dat psychoanalytische psychotherapie een effectieve behandelvorm is. Zoals bij alle vormen van psychotherapie ligt wellicht een complex samenspel van factoren aan de basis van de effecten van psychoanalytische therapie. Hierbij spelen naast niet-specifieke factoren, zoals het geven van hoop en steun, ook specifieke technieken en interventies een belangrijke rol. Daarnaast bepalen zowel patiënt- als therapeutfactoren het effect van psychoanalytische therapie, zoals bijvoorbeeld de motivatie van de patiënt en de competentie van de therapeut.
Er worden drie grote vormen van psychodynamische psychotherapie onderscheiden
- Kortdurende psychodynamische psychotherapie (< 35-40 sessies)
- Langerdurende psychodynamische psychotherapie, (> 40-50 sessies)
- De klassieke psychoanalyse (een intensieve langerdurende variant van psychoanalytische therapie)
Een systematisch overzicht van de effectiviteit van psychoanalytische psychotherapie
1. Algemene Overzichten
Luyten, P., Lowyck, B. (2017). De effectiviteit van psychoanalytische therapie. Tijdschrift Klinische Psychologie.
Leichsenring, F., Luyten, P., Hilsenroth, Mark J, et al. (2015). Psychodynamic therapy meets evidence-based medicine:
a systematic review using updated criteria. Lancet Psychiatry 2015; 2: 648–60.
a) Kort- en langerdurende therapie
Leichsenring, F., Abbas, A., Luyten, P., Hilsenroth, M., Rabung, S. (2013) The Emerging Evidence for Long-Term Psychodynamic Therapy
Leichsenring, F., Abbass, A., Luyten, P., Hilsenroth, M., & Rabung, S. (2012). The emerging evidence for long-term psychodynamic therapy. Manuscript submitted for publication.
Leichsenring, F., Kruse, J., & Rabung, S. (in press). Efficacy of psychodynamic psychotherapy in specific mental disorders: A 2010 update. In P. Luyten, L. C. Mayes, P. Fonagy, M. Target & S. J. Blatt (Eds.), Contemporary psychodynamic approaches to psychopathology. New York: The Guilford Press.
Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98-109.
Hau, S., & Leuzinger-Bohleber, M. (Eds.). (2006). Psychoanalytic Psychotherapy. A summary of empirical research. Berlin: DGPT.
Midgley, N., & Kennedy, E. (in press). Psychodynamic psychotherapy for children and adolescents: A critical review of the evidence base. Journal of Child Psychotherapy.
b) Kortdurende psychoanalytische therapie
Abbass, A. A., Hancock, J. T., Henderson, J., & Kisely, S. R. (2006). Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database of Systematic Reviews: Reviews Issue 4, 18(4), CD004687.
Lewis, A. J., Dennerstein, M., & Gibbs, P. M. (2008). Short-term psychodynamic psychotherapy: review of recent process and outcome studies. Australian and New Zealand Journal of Psychiatry, 42, 445-455.
c) Langerdurende psychoanalytische therapie
Leichsenring, F., & Rabung, S. (2008). Effectiveness of long-term psychodynamic psychotherapy: A meta-analysis. Journal of the American Medical Association, 300(13), 1551-1565.
Leichsenring, F., & Rabung, S. (2011). Long-term psychodynamic psychotherapy in complex mental disorders: update of a meta-analysis. The British Journal of Psychiatry, 199(1), 15-22.
d) Psychoanalyse
de Maat, S., De Jonghe, F., de Kraker, R., Leichsenring, F., Abbass, A., Luyten, P., et al. (2011). The effectiveness of Psychoanalysis: A comparison between Psychoanalysis (PA) and Long-Term Psychoanalytic Psychotherapy (LTPP). Manuscript submitted for publication.
2. De effectiviteit van psychoanalytische therapie bij specifieke stoornissen
Depressie
Luyten, P. (2014). Finally moving beyond the horse race: CBT and psychodynamic therapy equally effective for depression. Evidence Based Mental Health. doi: 10.1136/eb-2014-101770
Abbass, A., Town, J., & Driessen, E. (2011). The Efficacy of Short-Term Psychodynamic Psychotherapy for Depressive Disorders with Comorbid Personality Disorder. Psychiatry: Interpersonal and Biological Processes, 74(1), 58-71.
Driessen, E., Cuijpers, P., de Maat, S. C. M., Abbass, A. A., de Jonghe, F., & Dekker, J. J. M. (2010). The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis. Clinical Psychology Review, 30(1), 25-36.
Luyten, P., & Blatt, S. J. (in press). Psychodynamic treatment of depression. Psychiatric Clinics of North America.
Angststoornissen
Pitman, S., Slavin-Mulford, J., & Hilsenroth, M. (2014). Psychodynamic Techniques Related to Outcome for Anxiety
Disorder Patients at Different Points in Treatment. The Journal of Mental and Nervous Disease, 202(5), 391-396.
Crits-Christoph, P., Connolly Gibbons, M. B., Narducci, J., Schamberger, M., & Gallop, R. (2005). Interpersonal problems and the outcome of interpersonally oriented psychodynamic treatment of GAD. Psychotherapy: Theory, Research, Practice, Training, 42, 211-224.
Bögels, S. M., Wijts, P., & Sallaerts, S. (2003). Analytic psychotherapy versus cognitive-behavioral therapy for social phobia. In EABCT Congress. Prague.
Brom, D., Kleber, R. J., & Defares, P. B. (1989). Brief psychotherapy for posttraumatic stress disorders. Journal of Consulting and Clinical Psychology, 57, 607-612.
Knekt, P., Lindfors, O., Härkänen, T., Välikoski, M., Virtala, E., Laaksonen, M. A., et al. (2008). Randomized trial on the effectiveness of long-and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychological Medicine, 38(05), 689-703.
Knijnik, D. Z., Kapczinski, F., Chachamovich, E., Margis, R., & Eizirik, C. L. (2004). Psychodynamic group treatment for generalized social phobia. Revista Brasileira de Psiquiatria, 26, 77-781.
Leichsenring, F., Salzer, S., Jager, U., Kächele, U., Kreische, R., Leweke, F., Rüger, U., Winkelbach, C., & Leibing, E. (2009). Short-term psychodynamic psychotherapy and cognitive-behavioral therapy in generalized anxiety disorder: A randomized controlled trial American Journal of Psychiatry, 875-881.
Nolting, B., Pöhlmann, K., Salzer, S., Schauenburg, H., Stangier, U., Strauss, B., Subic-Wrana, C., Vormfelde, S., Weniger, G., Willutzki, U., Wiltink, J., & Leibing, E. (2009). The Social Phobia Psychotherapy Research Network (SOPHO-NET) - The first multi-center randomized controlled trial of psychotherapy for social phobia: rationale, methods and patient characteristics. Psychotherapy and Psychosomatics, 35-41.
Milrod, B., Leon, A. C., Busch, F., Rudden, M., Schwalberg, M., John Clarkin, J., et al. (2007). A randomized controlled clinical trial of psychoanalytic psychotherapy for panic disorder. American Journal of Psychiatry, 164(2), 265-272.
Salzer, S., Winkelbach, C., Leweke, F., Leibing, E., & Leichsenring , F. (2011). Long-term effects of short-term psychodynamic psychotherapy and cognitive-behavioural therapy in generalized anxiety disorder: 12-month follow-up. Canadian Journal of Psychiatry, 56(8), 503-508.
Somatische en functioneel somatische aandoeningen
Abbass, A., Kisely, S., & Kroenke, K. (2009). Short-Term Psychodynamic Psychotherapy for Somatic Disorders. Psychotherapy and Psychosomatics, 78(5), 265-274.
Eetstoornissen
Bachar, E., Latzer, Y., Kreitler, S., & Berry, E. M. (1999). Empirical comparison of two psychological therapies. Self psychology and cognitive orientation in the treatment of anorexia and bulimia. Journal of Psychotherapy Practice and Research, 8, 115-128.
Dare, C., Eisler, I., Russel, G., Treasure, J., & Dodge, L. (2001). Psychological therapies for adults with anorexia nervosa. Randomised controlled trial of out-patient treatments. British Journal of Psychiatry, 178, 216-221.
Fairburn, C. G., Kirk, J., O'Connor, M., & Cooper, P. J. (1986). A comparison of two psychological treatments for bulimia nervosa. Behaviour Research and Therapy, 24, 629-643.
Fairburn, C. G., Norman, P. A., Welch, S. L., O'Connor, M. E., Doll, H. A., & Peveler, R. C. (1995). A prospective study of outcome in bulimia nervosa and the long-term effects of three psychological treatments. Archives of General Psychiatry, 52, 304-312.
Garner, D. M., Rockert, W., Davis, R., Garner, M. V., Olmsted, M. P., & Eagle, M. (1993). Comparison of cognitive-behavioral and supportive-expressive therapy for bulimia nervosa. American Journal of Psychiatry, 150, 37-46.
Gowers, D., Norton, K., Halek, C., & Vrisp, A. H. (1994). Outcome of outpatient psychotherapy in a random allocation treatment study of anorexia nervosa. International Journal of Eating Disorders, 15, 165-177.
Tasca, G. A., Ritchie, K., Conrad, G., Balfour, L., Gayrton, J., Lybanon, V., & Bissada, H. (2006). Attachment scales predict outcome in a randomized clinical trial of group psychotherapy for binge eating disorder: An aptitude by treatment interaction. Psychotherapy Research, 16, 106-121.
Wild, B., Friederich, H.-C., Gross, G., Teufel, M., Herzog, W., Giel, K., et al. (2009). The ANTOP study: Focal psychodynamic psychotherapy, cognitive-behavioural therapy, and treatment-as-usual in outpatients with anorexia nervosa - a randomized controlled trial. Trials, 10(1), 23.
Middelenmisbruik
Crits-Christoph, P., Siqueland, L., Blaine, J., Frank, A., Luborsky, L., Onken, L. S., Muenz, L. R., Thase, M. E., Weiss, R. D., Gastfriend, D. R., Woody, G. E., Barber, J. P., Butler, S. F., Daley, D., Salloum, I., Bishop, S., Najavits, L. M., Lis, J., Mercer, D., Griffin, M. L., Moras, K., & Beck, A. T. (1999). Psychosocial treatments for cocaine dependence: National Institute on Drug Abuse Collaborative Cocaine Treatment Study. Archives of General Psychiatry, 56, 493-502.
Crits-Christoph, P., Siqueland, L., McCalmont, E., Weiss, R. D., Gastfriend, D. R., Frank, A., Moras, K., Barber, J. P., Blaine, J., & Thase, M. E. (2001). Impact of psychosocial treatments on associated problems of cocaine-dependent patients. Journal of Consulting and Clinical Psychology, 69, 825-830.
Sandahl, C., Herlitz, K., Ahlin, G., & Rönnberg, S. (1998). Time-limited group psychotherapy for moderately alcohol dependent patients: A randomized controlled clinical trial. Psychotherapy Research, 8, 361-378.
Woody, G. E., Luborsky, L., McLellan, A. T., & O'Brien, C. P. (1990). Corrections and revised analyses for psychotherapy in methadone maintenance patients. Archives of General Psychiatry, 47, 788-789.
Woody, G. E., Luborsky, L., McLellan, A. T., & O'Brien, C. P. (1995). Psychotherapy in community methadone programs: a validation study. American Journal of Psychiatry, 152, 1302-1308.
Woody, G. E., Luborsky, L., McLellan, A. T., O'Brien, C. P., Beck, A. T., Blaine, J., Herman, I., & Hole, A. (1983). Psychotherapy for opiate addicts: Does it help? Archives of General Psychiatry, 40, 639-645.
Persoonlijkheidsstoornissen
Abbass, A., Town, J., & Driessen, E. (2011). The Efficacy of Short-Term Psychodynamic Psychotherapy for Depressive Disorders with Comorbid Personality Disorder. Psychiatry: Interpersonal and Biological Processes, 74(1), 58-71.
Leichsenring, F. (2010). Evidence for psychodynamic psychotherapy in personality disorders: A review. In J. F. Clarkin, P. Fonagy & G. O. Gabbard (Eds.), Psychodynamic psychotherapy for personality disorders. A clinical handbook (pp. 421-437). Washington, DC: American Psychiatric Publishing.
Leichsenring, F., & Leibing, E. (2003). The Effectiveness of Psychodynamic Therapy and Cognitive Behavior Therapy in the Treatment of Personality Disorders: A Meta-Analysis. American Journal of Psychiatry, 160(7), 1223-1232.
Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74-84.Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74-84.
Town, J. M., Abbass, A., & Hardy, G. (2011). Short-term psychodynamic psychotherapy for personality disorders: A critical review of randomized controlled trials. Journal of Personality Disorders, 25(6), 723-740.
Vliegen, N., Hannes, K., Meurs, P. (2017). De complexiteit van klinische psychodiagnostiek vraagt methodologische diversiteit.
3. Kinderen en adolescenten
Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2006). Fostering secure attachment in infants in maltreating families through preventative interventions. Development and Psychopathology, 18, 623-649.
Goodyer, I., Tsancheva, S., Byford, S., Dubicka, B., Hill, J., Kelvin, R., et al. (2011). Improving mood with psychoanalytic and cognitive therapies (IMPACT): A pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depression: study protocol for a randomised controlled trial. Trials, 12(1), 175.
Kennedy, E., & Midgley, N. (2007). Process and outcome research in child, adolescent and parent-infant psychotherapy: A thematic review. London: North Central London Strategic Health Authority.
Lieberman, A. F., Van Horn, P., Ghosh Ippen, C. (2005). Toward Evidence-Based Treatment: Child–Parent Psychotherapy with Preschoolers Exposed to Marital Violence. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 12, 1241-1248.
Midgley, N., & Kennedy, E. (in press). Psychodynamic psychotherapy for children and adolescents: A critical review of the evidence base. Journal of Child Psychotherapy.Midgley, N., & Kennedy, E. (in press). Psychodynamic psychotherapy for children and adolescents: A critical review of the evidence base. Journal of Child Psychotherapy.
Toth, S. L., Rogosch, F. A., Manly, J. T., & Cicchetti D. (2006). The efficacy of toddler-parent psychotherapy to reorganize attachment in the young offspring of mothers with major depressive disorder: A randomized preventive trial. Journal of Consulting and Clinical Psychology, 74,1006-1016.
Trowell, J., Joffe, I., Campbell, J., Clemente, C., Almqvist, F., Soininen, M., et al. (2007). Childhood depression: A place for psychotherapy. An outcome study comparing individual psychodynamic psychotherapy and family therapy. European Child and Adolescent Psychiatry, 16(3), 157-167.
4. Kosteneffectiviteit
Abbass, A., Driessen, E., & Town, J. (2011). Cost-effectiveness of intensive short-term dynamic psychotherapy. Manuscript submitted for publication.
Berghout, C. C., Zevalkink, J., & Hakkaart-Van Roijen, L. (2010). The Effects of Long-Term Psychoanalytic Treatment on Healthcare Utilization and Work Impairment and Their Associated Costs. Journal of Psychiatric Practice, 16(4), 209-216.
Berghout, C. C., Zevalkink, J., & Hakkaart-van Roijen, L. (2010). A cost-utility analysis of psychoanalysis versus psychoanalytic psychotherapy. International Journal of Technology Assessment in Health Care, 26(1), 3-10.
de Maat, S., Philipszoon, F., Schoevers, R., Dekker, J., & De Jonghe, F. (2007). Costs and Benefits of Long-Term Psychoanalytic Therapy: Changes in Health Care Use and Work Impairment. Harvard Review of Psychiatry, 15(6), 289-300.
5. Hoe werkt psychanalytische psychotherapie
Beutel, M. E., Stark, R., Pan, H., Silbersweig, D., & Dietrich, S. (2010). Changes of brain activation pre- post short-term psychodynamic inpatient psychotherapy: An fMRI study of panic disorder patients. Psychiatry Research, 184(2), 96-104.
Blagys, M., & Hilsenroth, M. (2000). Distinctive features of short-term psychodynamic-interpersonal psychotherapy: A review of the comparative psychotherapy process-literature. Clinical Psychology: Science and Practice, 7, 167-188.
de Greck, M., Scheidt, L., Bälter, A. F., Frommer, J., Ulrich, C., Stockum, E., et al. (2011). Multimodal psychodynamic psychotherapy induces normalization of reward related activity in somatoform disorder. World Journal of Biological Psychiatry, 12(4), 296-308.
Diener, M. J., Hilsenroth, M., & Weinberger, J. (2007). Therapist affect focus and patient outcomes in psychodynamic psychotherapy: A meta-analysis. American Journal of Psychiatry, 164, 936-941.
Hilsenroth, M., 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(6), 349-357.
Hoglend, P., Amlo, S., Marble, A., Bogwald, K. P., Sorbye, O., Sjaastad, M. C., et al. (2006). Analysis of the patient-therapist relationship in dynamic psychotherapy: An experimental study of transference interpretations. American Journal of Psychiatry, 163(10), 1739-1746.
Hoglend, P., Bogwald, K.-P., Amlo, S., Marble, A., Ulberg, R., Sjaastad, M. C., et al. (2008). Transference Interpretations in Dynamic Psychotherapy: Do They Really Yield Sustained Effects? American Journal of Psychiatry, 165(6), 763-771.
Johansson, P., Hoglend, P., Ulberg, R., Bogwald, K. P., Amlo, S., Marble, A., et al. (2010). The mediating role of insight for long-term improvements in psychodynamic therapy. Journal of Consulting & Clinical Psychology, 78(3), 438-448.
Kennedy, E., & Midgley, N. (2007). Process and outcome research in child, adolescent and parent-infant psychotherapy: A thematic review. London: North Central London Strategic Health Authority.
Leichsenring, F., & Leibing, E. (2007). Psychodynamic psychotherapy: A systematic review of techniques, indications and empirical evidence. Psychology and Psychotherapy: Theory, Research and Practice, 80(2), 217-228.
Levy, R. A., & Ablon, S. A. (2009). Handbook of evidence based psychodynamic psychotherapy. Bridging the gap between science and practice. New York: Humana Press/Springer.
Lewis, A. J., Dennerstein, M., & Gibbs, P. M. (2008). Short-term psychodynamic psychotherapy: review of recent process and outcome studies. Australian and New Zealand Journal of Psychiatry, 42, 445-455.
Luyten, P., Blatt, S. J., & Mayes, L. C. (in press). Process and outcome in psychoanalytic psychotherapy research: The need for a (relatively) new paradigm. In R. A. Levy, J. S. Ablon & H. Kächele (Eds.), Handbook of Evidence-Based Psychodynamic Psychotherapy. Bridging the Gap Between Science and Practice (2nd ed.). New York: Humana Press/Springer.
Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98-109.
6. Overzicht van in handleidingen omschreven (“manualized”) psychoanalytische behandelingen
Bateman, A. W., & Fonagy, P. (2006). Mentalization Based Treatment for Borderline Personality Disorder: A Practical Guide. Oxford: Oxford University Press.
Clarkin, J. F., Yeomans, F. E., & Kernberg, O. F. (2006). Psychotherapy for Borderline Personality. Focusing on Object Relations (2nd ed.). Washington: American Psychiatric Publishing.
Davanloo, H. (Ed.). (1980). Short-Term Dynamic Psychotherapy. New York: Jason Aronson.
Leichsenring F, Beutel M, Leibing E. Psychodynamic psychotherapy for social phobia: A treatment manual based on SE therapy. Bulletin of the Menninger Clinic; 2007;71:(1):56-83
Leichsenring F, Winkelbach C, Leibing E. Psychoanalytisch orientierte Fokaltherapie der Generalisierten Angststörung - ein Manual [Psychoanalytic oriented focal therapy of generalized anxiety disorder]. Psychotherapeut; 2005;50:258–264
Lemma, A., Target, M., & Fonagy, P. (2011). Brief dynamic interpersonal therapy. A clinician's guide. Oxford: Oxford University Press.
Luborsky, L. (1984). Principles of Psychoanalytic Psychotherapy: A Manual for Supportive-Expressive (SE) Treatment. New York: Basic Books.
Mann, J. (1973). Time-limited psychotherapy. Cambridge, MA: Harvard University Press.
Marziali, E. and Munroe-Blum, H. (1994) Interpersonal Group Psychotherapy for Borderline Personality Disorder. New York: Basic Books
McCullough L, Kuhn N, Andrews S, Kaplan A, Wolf J, Hurley C. Treating Affect Phobia: A Manual for Short Term Dynamic Psychotherapy. New York, NY: Guilford Press; 2003.
Midgley et al. (2009). Short term psychoanalytic psychotherapy for adolescents with moderate or severe depression. A treatment manual. Unpublished manuscript.
Milrod BL, Busch FN, Cooper AM, Shapiro T. Manual of panic-focused psychodynamic psychotherapy. Washington: American Psychiatric Press; 1997.
Piper WE, Joyce AS, McCallum M, Azim HF, Ogrodniczuk JS. Interpretive and Supportive Psychotherapies: Matching Therapy and Patient Personality. Washington, DC: American Psychological Association; 2002.
Gregory RJ, Remen AL. A manual-based psychodynamic therapy for treatment-resistant borderline personality disorder. Psychotherapy: Theory, Research, Practice, Training; 2008;45:15-27
Rockland, LH. Supportive Psychotherapy for Borderline Patients: a Psychodynamic Approac. New York: Guilford; 1992
Sifneos, P. E. (1992). Short-term anxiety-provoking psychotherapy. New York: Basic Books.
Strupp, H. H., & Binder, J. L. (1984). Psychotherapy in a new key: A guide to time-limited dynamic psychotherapy. New York: Basic Books.
Tasca, G., Mikail, S., & Hewitt, P. (2002). Group psychodynamic interpersonal psychotherapy: A manual for time limited treatment of Binge Eating Disorder. Unpublished manuscript.
Trowell, J., Joffe, I., Campbell, J., Clemente, C., Almqvist, F., Soininen, M., et al. (2007). Childhood depression: A place for psychotherapy. An outcome study comparing individual psychodynamic psychotherapy and family therapy. European Child and Adolescent Psychiatry, 16(3), 157-167.
7. Overzicht van competenties voor psychoanalytische therapie
Lemma, A., Roth, A. D., & Pilling, S. (2009). The competencies required to deliver effective psychoanalytic/psychodynamic therapy. London: University College London, UK.
Zie: http://www.ucl.ac.uk/clinical-psychology/CORE/psychodynamic_framework.htm
