The Efficacy of Psychodynamic Psychotherapy in Specific Mental Disorders: A 2013 Update of Empirical Evidence

Abstract

This article reviews the empirical evidence for psychodynamic therapy for specific mental disorders in adults. The focus is on randomized controlled trials (RCTs). However, this does not imply that RCTs are uncritically accepted as the gold standard for demonstrating that a treatment works. According to the results presented here, there is evidence from RCTs that psychodynamic therapy is efficacious in common mental disorders, that is, depressive disorders, anxiety disorders, somatic symptom disorders, personality disorders, eating disorders, complicated grief, posttraumatic stress disorder (PTSD), and substance-related disorder. These results clearly contradict assertions repeatedly made by representatives of other psychotherapeutic approaches claiming psychodynamic psychotherapy is not empirically supported. However, further research is needed, both on outcome and processes of psychodynamic psychotherapy. There is a need, for example, for RCTs of psychodynamic psychotherapy of PTSD. Furthermore, research on long-term psychotherapy for specific mental disorders is required.

Keywords:

• psychodynamic psychotherapy
• empirically supported treatments
• psychotherapy outcome research
• evidence-based medicine

Notes

¹ Effect sizes assessed by Falk Leichsenring and Simone Salzer.

² Brom et al. (1989) did not report means and standard deviation for the waiting list condition at follow-up, only for posttreatment. For this reason, no effect sizes for follow-up can be calculated.

³ File drawer effect: unpublished studies that may change the results of a meta-analysis.

⁴ The Q statistic is defined as the sum of the squared deviations of each study's effect estimate, weighting the contribution of each by its inverse variance. The Q statistic follows a chi-square distribution. The I² statistic indicates the extent of true heterogeneity, dividing the difference between the result of the Q test and its degrees of freedom by the Q value itself and multiplying it by 100.

Additional information

Notes on contributors

Falk Leichsenring

Falk Leichsenring, D.Sc., is a professor for psychotherapy research at the University of Giessen. He is psychologist, psychoanalyst, and training analyst. He has published extensively on psychotherapy research, including questions of methodology and philosophy of science.

Susanne Klein

Susanne Klein, M.Sc., earned her master's in psychology at the University of Innsbruck, Austria (2010). In 2011, she joined the team of psychotherapy research at the Department of Psychosomatics and Psychotherapy at the University of Giessen, Germany. She has been working as a research assistant on the social phobia psychotherapy research network (SOPHO-NET).

Simone Salzer

Simone Salzer, D.Sc., is a post-doc researcher at the Clinic of Psychosomatic Medicine and Psychotherapy, University of Goettingen, Germany. She is a psychologist, currently in psychoanalytic training, and her research focuses on the efficacy and effectiveness of psychodynamic therapies.