Psychoanalysis and evaluation: a stratified model focused on the uniqueness of the case

ABSTRACT

Objectives: This article addresses the methodological controversies surrounding the issue of how to evaluate the psychotherapies. It proposes to identify the principles of an integrative and stratified model in order to report the results of analytical therapy (its efficacy) based on the very effectiveness of its processes. Thus, the uniqueness of the case is put at the center of the evaluation setting.

Methods: Drawing on science studies, the authors engage in a reflexive exercise on the problem of psychoanalysis’ evaluation based on methodological questions raised in the field over time and current issues related to practice.

Results: First, the regularly asserted opposition between the norms of analytical practice and those governing standard evaluation procedures is reinterpreted as the effect of a lack of intermediate epistemic patterns.

Second, the fundamental principles of an integrative model are considered so as to translate and articulate a set of heterogeneous requirements into distinct strata.

Discussion: Since psychoanalysis is fundamentally a case-by-case practice characterized by inequivalence and unexpectedness, its utmost aim is to use a type of effectiveness based on the singularity of the case. However, this does not prevent it from being evaluable provided that the epistemic levels of the evaluation are clearly differentiated.

KEYWORDS:

• Individual case
• epistemology
• randomized controlled trials
• evaluation scales
• qualitative

Acknowledgments

This original paper was first written in French and then translated into English by Dr Victoria Grace in collaboration with the authors.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Since 1999, the Research Committee of the International Psychoanalytical Association has regularly updated an excellent summary of the scientific research relating to the evaluation of psychoanalysis as well as epistemological and methodological issues (Leuzinger-Bohleber & Kächele et al., 2015).

2. For example, they are included among the ten validated forms of healthcare in Obamacare (Lazar & Yeoman, 2014).

Additional information

Funding

This work was supported bythe Center for Research in Psychoanalysis, Medicine, and Society (CRPMS – EA 3522), Université de Paris, Paris, France.