Individual psychodynamic therapy for psychosis: a Delphi study

Abstract

There is limited empirical evidence as to how psychodynamic therapy should be conducted when working with people who experience psychosis. We describe here a three stage Delphi study exploring the degree of consensus about this among an international group of experienced psychotherapists. Of the 52 participants who received the survey questionnaire, 41 (78.8%) responded in the first round and 30 (57.6%)responded in the second. The participants agreed on many aspects of therapy, including aspects of classical technique (e.g. requirement for consistent setting) and some supportive modifications (e.g. therapists not restricting themselves to remaining emotionally neutral), but consensus was not received for other supportive modifications (e.g. guiding the patients if they are unsure of what to talk about). Participants commented that the technique should be adapted to individual needs. We believe that the findings have implications for therapy and research.

Keywords:

• Psychosis
• schizophrenia
• psychoanalytic psychotherapy
• psychodynamic psychotherapy
• Delphi

Acknowledgements

The authors are grateful to: Bent Rosenbaum for help in recruiting study participants; Neil Caton for comments on an earlier version of the statements and the final draft; Mike Fitzsimmons and Jim Geekie for comments and suggestions on an earlier version of the statements; Stacia Borenstein for comments on the final draft; and to all the study participants who gave their time to complete questionnaires.