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Must All Have Prizes? The Munich Psychotherapy Study

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Psychodynamic Psychotherapy Research

Part of the book series: Current Clinical Psychiatry ((CCPSY))

Abstract

Increasing empirical evidence [1, 2] indicates that the complex mental disorders that patients present within private practice cannot be influenced sufficiently by the short-term psychotherapies examined so far [3–5]. This finding applies in particular to major depressive disorder with recurrent episodes, of which only 27–38% remained without recurrence after short-term therapies [6]. Consequently, in the last years, research has turned more and more to long-term therapies (for example [7–9]). In a first meta-analysis on psychodynamic long-term therapies, Leichsenring and Rabung [2] found evidence of generally high effectiveness for complex mental disorders. However, studies of the effectiveness of long-term psychotherapies for major depressive disorders as a diagnostically homogeneous group do not exist, so the question regarding the effectiveness of treatments for this disorder remains unanswered so far [10]. The treatment of major depressive disorder with its frequent recurrences [11] could be considered a paradigm for the effectiveness of long-term psychotherapies, as these treatments claim to reduce not only the present symptoms but also the vulnerability for new onsets, relapse, and recurrence. So far, it remains unknown which treatment type attains this preventive effect.

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Notes

  1. 1.

    The authors want to thank Prof. L. Schindler and Dr. T. Brandl for cooperation.

References

  1. DeMaat S, de Jonghe F, Schoevers R, Dekker J. The effectiveness of long-term psychoanalytic therapy: a systematic review of empirical studies. Harv Rev Psychiatry. 2009;17:1–23.

    Article  Google Scholar 

  2. Leichsenring F, Rabung S. Effectiveness of long-term psychodynamic psychotherapy: a meta-analysis. JAMA. 2008;300:1551–65.

    Article  PubMed  CAS  Google Scholar 

  3. Abbass AA, Hancock JT, Kisely S. Short-term psychodynamic psychotherapies for common disorders (Review). The Cochrane Collaboration 2007; 1–47.

    Google Scholar 

  4. Leichsenring F, Rabung S, Leibing E. The efficacy of short-term psychodynamic psychotherapy in specific psychiatric disorders. Arch Gen Psychiatry. 2004;61:1208–16.

    Article  PubMed  Google Scholar 

  5. De Maat S, Dekker J, Schoevers R, de Jonghe F. Relative efficacy of psychotherapy in the treatment of depression: a meta-analysis. Psychother Res. 2006;16:562–72.

    Google Scholar 

  6. Westen D, Morrison K. A multidimensional meta-analysis of treatments for empirically supported therapies. J Consult Clin Psychol. 2001;69:875–99.

    Article  PubMed  CAS  Google Scholar 

  7. Leichsenring F, Winkelbach C, Leibing E. Psychoanalytically oriented focal therapy of generalized anxiety disorder. Psychotherapeutics. 2005;50:258–64.

    Article  Google Scholar 

  8. Grande T, Dilg R, Jakobsen T, Keller W, Krawietz B, Langer M, Oberbracht C, Stehle S, Stennes M, Rudolf G. Differential effects of two forms of psychoanalytic therapy: results of the Heidelberg–Berlin study. Psychother Res. 2006;16:470–85.

    Article  Google Scholar 

  9. Knekt P, Lindfors O, Laaksonen MA, Raitasalo R, Haaramo P, Järvikoski A, The Helsinki Study Group. Randomized trial on the effectiveness of long-term and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychol Med. 2008;38:689–703.

    Article  PubMed  CAS  Google Scholar 

  10. Connolly Gibbons MB, Crits-Christoph P, Hearon B. The empirical status of psychodynamic therapies. Annu Rev Clin Psychol. 2008;4:93–108.

    Article  Google Scholar 

  11. Judd LL. The clinical course of unipolar major depressive disorder. Arch Gen Psychiatry. 1997;54:989–91.

    Article  PubMed  CAS  Google Scholar 

  12. Fonagy P. Foreword. In: Richardson P, Kaechele H, Renlund C, editors. Research on psychoanalytic psychotherapy with adults. London: Karnac; 2004. p. XIX–XXVII.

    Google Scholar 

  13. Kazdin AE. Research design in clinical psychology. 3rd ed. Boston: Allyn & Bacon; 1998. p. 80.

    Google Scholar 

  14. Keller MB, Hirschfeld RMA, Hanks D. Double depression: a distinctive subtype of unipolar depression. J Affect Disord. 1997;45:65–73.

    Article  PubMed  CAS  Google Scholar 

  15. Mason MJ. A review of procedural and statistical methods for handling attrition and missing data. Meas Eval Couns Dev. 1999;32:111–18.

    Google Scholar 

  16. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  17. Hiller W, Zaudig M, Mombour W. IDCL - Internationale Diagnosen Checklisten für ICD-10 und DSM- IV (Manual und 32 Checklisten nach ICD-10 als Bestandteil des Gesamtpaketes der ICD-10-Checklisten der WHO) International Diagnostic Checklists for ICD-10 and DSM-IV (Manual and 32 checklists as part of the WHO ICD-10-Checklists package). Bern, 1995.

    Google Scholar 

  18. Huber D, Klug G, Wallerstein RS. Skalen psychischer Kompetenzen (SPK). Ein Messinstrument für therapeutische Veränderung in der psychischen Struktur. Incl. Manual und Interviewleitfaden (The Scales of Psychological Capacities (SPC) A measure for therapeutic change in psychic structure. Manual and interview guideline). Stuttgart: Kohlhammer, 2006

    Google Scholar 

  19. DeWitt KN, Hartley D, Rosenberg SE, Zilberg NJ, Wallerstein RS. Scales of psychological capacities: development of an assessment approach. Psychoanal Contemp Thought. 1991;14:334–43.

    Google Scholar 

  20. Zilberg NJ, Wallerstein RS, DeWitt KN, Hartley D, Rosenberg SE. A conceptual analysis and strategy for assessing structural change. Psychoanal Contemp Thought. 1991;14:317–42.

    Google Scholar 

  21. Sundin M, Armelius BA, Nilsson T. Reliability studies of scales of psychological capacities: a new method to assess psychological change. Psychoanal Contemp Thought. 1994;17:591–615.

    Google Scholar 

  22. DeWitt KN, Milbrath C, Wallerstein RS. Scales of psychological capacities: support for a measure of structural change. Psychoanal Contemp Thought. 1999;22:453–80.

    Google Scholar 

  23. Huber D, Brandl T, Klug G. The Scales of Psychological Capacities (SPC): measuring beyond symptoms. Psychother Res. 2004;14:89–106.

    Article  PubMed  Google Scholar 

  24. Huber D, Henrich G, Klug G. The scales of psychological capacities: measuring change in psychic structure. Psychother Res. 2005;15:445–56.

    Article  Google Scholar 

  25. Kiresuk TJ, Sherman RE. GAS: a general method for evaluating comprehensive community mental health programs. Community Ment Health J. 1968;4:443–53.

    Article  Google Scholar 

  26. Kiresuk TJ, Smith A, Cardillo JE. Goal attainment scaling: applications, theory, and measurement. Hillsdale: Lawrence Erlbaum Associates; 1994.

    Google Scholar 

  27. Galatzer-Levy RM, Bachrach H, Skolnikoff A, Waldron S. Does psychoanalysis work? New Haven: Yale University Press; 2000. p. 138–40.

    Google Scholar 

  28. Levy KN. Psychotherapies and lasting change. Am J Psychiatry. 2008;165:556–9.

    Article  PubMed  Google Scholar 

  29. Derogatis LR, Lipman RS, Covi L. SCL 90. An outpatient psychiatric rating scale. Psychopharmacol Bull. 1975;9:13–28. German version: Franke G, Die Symptom-Checkliste von Derogatis. Deutsche Version. Manual. Goettingen: Beltz; 1995.

    Google Scholar 

  30. Beck AT, Ward CH, Mendelsohn M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry.. 1961;4:561–71. German version: Hautzinger M, Bailer M, Worall H, Keller F. Das Beck-Depressions-Inventar (BDI). Goettingen: Hogrefe; 1995.

    Article  PubMed  CAS  Google Scholar 

  31. Horowitz LM, Alden LE, Wiggins JS, Pincus AL. Inventory of interpersonal problems manual. San Antonio: Psychological Corporation; 2000.

    Google Scholar 

  32. Hentschel U. Fragebogen zu Konfliktbewältigungsstrategien. Goettingen: Hogrefe; 1998.

    Google Scholar 

  33. Huber D, Henrich G, Herschbach P. Measuring the quality of life: a comparison between physically and mentally chronically ill patients and healthy persons. Pharmacopsychiatry. 1988;21:453–5.

    Article  PubMed  CAS  Google Scholar 

  34. Sommer G, Fydrich T. Entwicklung und Überprüfung eines Fragebogens zur sozialen Unterstützung (F-SozU). Diagnostica. 1991;37:160–78.

    Google Scholar 

  35. Alexander LB, Luborsky L. The penn helping alliance scales. In: Greenberg LS, Pinsof W, editors. The psychotherapeutic process: a research handbook. New York: Guilford Press; 1986. p. 325–66. German version: Bassler M, Potratz B, Krauthauser H. Der Helping Alliance Questionnaire (HAQ) von Luborsky. Psychotherapeutics 1995;40:23–32.

    Google Scholar 

  36. Sandell R, Carlsson J, Schubert J, Broberg J, Lazar A, Grant J. Therapist attitudes and patient outcome: I. Development and validation of the Therapeutic Attitudes Scales (TASC-2). Psychother Res. 2004;14:469–84.

    Article  Google Scholar 

  37. Sandell R, Lazar A, Grant J, Carlsson J, Schubert J, Broberg J. Therapist attitudes and patient outcomes: II. Therapist attitudes influence change during treatment. Psychother Res. 2007;17:196–204.

    Article  Google Scholar 

  38. Klug G, Henrich G, Kaechele H, Sandell R, Huber D. Die Therapeutenvariable. Immer noch ein dunkler Kontinent? Psychotherapeutics. 2008;53:83–91.

    Article  Google Scholar 

  39. Zielke M, Kopf-Mehnert C. Veränderungsfragebogen des Erlebens und Verhaltens, VEV. Beltz: Weinheim; 1978.

    Google Scholar 

  40. Frank E, Prien RF, Jarrett RB, Keller MB, Kupfer DJ, Lavori PW, Rush AJ, Weissman MM. Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Arch Gen Psychiatry. 1991;48:851–5.

    Article  PubMed  CAS  Google Scholar 

  41. Beenen F, Stoker J. Periodical rating scale for psychoanalytic treatment. Amsterdam: Netherlands Psychoanalytic Institute; 1996.

    Google Scholar 

  42. Greenberg LS, Pinsof WM. Process research: current trend and future perspective. In: Greenberg LS, Pinsof WM, editors. The psychotherapeutic process: a research handbook. New York: The Guilford Press; 1968. p. 3–20.

    Google Scholar 

  43. Rueger U, Dahm A, Kallinke D. The Faber-Haarstick Commentary on psychotherapy guidelines. Muenchen/Jena: Urban and Fischer; 2003.

    Google Scholar 

  44. Fonagy P, Kaechele H. Psychoanalysis and other long-term dynamic psychotherapies. In: Gelder MG, Lopez-Ibor JJ, Andreasen N, editors. New Oxford textbook of psychiatry, vol. 2. 2nd ed. Oxford: Oxford University Press; 2009. p. 1337–49.

    Google Scholar 

  45. Gabbard GO. Long-term psychodynamic psychotherapy. Washington, DC: American Psychiatric Publishing; 2004. p. 2.

    Google Scholar 

  46. Cuijpers P, van Straten A, Andersson G, van Oppen P. Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. J Consult Clin Psychol. 2008;76:909–22.

    Article  PubMed  Google Scholar 

  47. Hollon SD, Beck AT. Cognitive and cognitive behavioral therapies. In: Lambert MJ, editor. Handbook of psychotherapy research und behavior change. 5th ed. New York: Wiley; 2004. p. 447–92.

    Google Scholar 

  48. Jones EE. Therapeutic action. Northvale: Jason Aronson; 2000.

    Google Scholar 

  49. Akhtar S. Comprehensive dictionary of psychoanalysis. London: Karnac; 2009.

    Google Scholar 

  50. Cohen J. Statistical power analysis for behavioral sciences. Hillsdale: Lawrence Erlbaum Associates; 1988.

    Google Scholar 

  51. Jacobson NS, Truax P. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol. 1991;59:12–19.

    Article  PubMed  CAS  Google Scholar 

  52. Kendall PC, Holmbeck G, Verduin T. Methodology, design, and evaluation in psychotherapy research. In: Lambert MJ, editor. Handbook of psychotherapy research und behavior change. 5th ed. Chicago: Wiley; 2004. p. 28–9.

    Google Scholar 

  53. Methodenpapier des Wissenschaftliche Beirat Psychotherapie nach § 11 PsychThG; 2009. www.wbpsychotherapie.de.

  54. Crits-Christoph P, Barber JP. Long-term psychotherapy. In: Snyder CR, Ingram RE, editors. Handbook of psychological change. New York/Chichester/Weinheim/Brisbane/Singapore/Toronto: Wiley; 2000. p. 455–73.

    Google Scholar 

  55. Thomae H, Kaechele H. Wissenschaftstheoretische und methodologische Probleme der klinisch-psychoanalytischen Forschung (1973) – wiedergelesen und ergänzt 30 Jahre später. In: Thomä H, Kaechele H, editors. Psychoanalytische Therapie. Forschung. Heidelberg: Springer; 2006.

    Google Scholar 

  56. Sandell R. Langzeitwirkung von Psychotherapie und Psychoanalyse. In: Leuzinger-Bohleber M, Stuhr U, editors. Psychoanalysen im Rueckblick. Giessen: Psychosozial Verlag; 1997. p. 349.

    Google Scholar 

  57. Kocsis JH, Leon AC, Markowitz JC, Manber R, Arnow B, Klein DN, Thase ME. Patient preference as a moderator of outcome for chronic forms of major depressive disorder treated with Nefazodone, Cognitive Behavioral Analysis System of Psychotherapy, or their combination. J Clin Psychiatry. 2009;70:354–61.

    Article  PubMed  CAS  Google Scholar 

  58. Swift JK, Callahan JL. The impact of client treatment preferences on outcome: a meta-analysis. J Clin Psychol. 2009;65:368–81.

    Article  PubMed  Google Scholar 

  59. Hill CE, Lambert MJ. Methodological issues in studying psychotherapy processes and outcomes. In: Lambert MJ, editor. Handbook of psychotherapy research und behavior change. 5th ed. New York: Wiley; 2004. p. 84–135.

    Google Scholar 

  60. Lambert MJ, Ogles BM. The efficacy and effectiveness of psychotherapy. In: Lambert MJ, editor. Handbook of psychotherapy research und behavior change. 5th ed. New York: Wiley; 2004. p. 139–93.

    Google Scholar 

  61. Luborsky L, Singer J, Luborsky L. Comparative studies of psychotherapy. Arch Gen Psychiatry. 1975;32:995–1008.

    Article  PubMed  CAS  Google Scholar 

  62. Luborsky L, Diguer L, Seligman DA, Rosenthal R, Krause ED, Johnson S, Halperin G, Bishop M, Berman JS, Schweizer E. The researcher’s own therapy allegiance: a “wild card” in comparisons of treatment efficacy. Clin Psychol Sci Pract. 1999;6:95–106.

    Article  Google Scholar 

  63. Williams JW, Noel PH, Cordes JA, Ramirez G, Pignone M. Is this patient clinically depressed? JAMA. 2002;287:1160–70.

    Article  PubMed  Google Scholar 

  64. Schauenburg H, Strack M. Measuring psychotherapeutic change with the Symptom Checklist SCL-90-R. Psychother Psychosom. 1999;68:199–206.

    Article  PubMed  CAS  Google Scholar 

  65. Geiser F, Imbierowicz K, Schilling G, Conrad R, Liedtke R. Differences in 2 diagnostic groups of psychosomatic patients on the Symptom Checklist 90-R (SCL-90-R). Consequences for using SCL-90-R in follow-up research. Psychother Psychosom Med Psychol. 2000;50:447–53.

    Article  PubMed  CAS  Google Scholar 

  66. Fava GA, Ruini C, Belaise C. The concept of recovery in major depression. Psychol Med. 2007;37:307–17.

    Article  PubMed  Google Scholar 

  67. Vittengl JR, Clark LA, Jarrett RB. Deterioration in psychosocial functioning predicts relapse/recurrence after cognitive therapy for depression. J Affect Disord. 2009;112:135–43.

    Article  PubMed  Google Scholar 

  68. Jarrett RB, Kraft D, Doyle J, Foster BM, Eaves GG, Silver PC. Preventing recurrent depression using cognitive therapy with and without a continuation phase: a randomized clinical trial. Arch Gen Psychiatry. 2001;58:381–8.

    Article  PubMed  CAS  Google Scholar 

  69. Taylor DJ, Walters HM, Vittengl JR, Krebaum S, Jarrett RB. Which depressive symptoms remain after response to cognitive therapy of depression and predict relapse and recurrence? J Affect Disord. 2010;123:181–7.

    Article  PubMed  Google Scholar 

  70. Puschner B, Kraft S, Kaechele H, Kordy H. Course of improvement over 2 years in psychoanalytic and psychodynamic outpatient psychotherapy. Psychol Psychother Theory Res Pract. 2007;80:51–68.

    Article  Google Scholar 

  71. Howard KI, Lueger RJ, Maling MS, Martinovich Z. A phase model of psychotherapy outcome: causal mediation of change. J Consult Clin Psychol. 1993;61:678–85.

    Article  PubMed  CAS  Google Scholar 

  72. Pilkonis PA, Imber SD, Lewis P, Rubinsky P. A comparative outcome study of individual, group, and conjoint psychotherapy. Arch Gen Psychiatry. 1984;41:431–7.

    Article  PubMed  CAS  Google Scholar 

  73. Wallerstein RS. Forty-two lives in treatment. A study of psychoanalysis and psychotherapy. New York: Guilford Press; 1986. p. 703.

    Google Scholar 

  74. Vittengl JR, Clark LA, Jarrett RB. Interpersonal problems, personality pathology, and social adjustment after cognitive therapy for depression. Psychol Assess. 2003;15:29–40.

    Article  PubMed  Google Scholar 

  75. Kiesler DJ. Some myths of psychotherapy research and the search for a paradigm. Psychol Bull. 1966;65:110–36.

    Article  Google Scholar 

  76. Stiles WB, Shapiro DA. Abuse of the drug metaphor in psychotherapy process-outcome research. Clin Psychol Rev. 1989;9:521–43.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Clinical Psychology and Psychosomatics, International Psychoanalytic University, Berlin, Germany

    Dorothea Huber

  2. Clinic for Psychosomatic Medicine and Psychotherapy, Klinikum Harlaching, Munich, Germany

    Dorothea Huber

  3. Department of Psychosomatic Medicine and Psychotherapy, Technical University Munich, Klinikum Rechts der Isar, Munich, Germany

    Gerhard Henrich, Judith Gastner & Guenther Klug

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  1. Dorothea Huber
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  4. Guenther Klug
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Correspondence to Dorothea Huber .

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Editors and Affiliations

  1. Massachusetts General Hospital, Harvard Medical School, Department of Psychiatry, Parkman St., Boston, 02114, Massachusetts, USA

    Raymond A. Levy

  2. Massachusetts General Hospital, Harvard Medical School, Department of Psychiatry, Morrimac Street 101, Boston, 02114, Massachusetts, USA

    J. Stuart Ablon

  3. and Psychoanalysis, International Psychoanalytic University, Department of Clinical Psychology, Stromstr. 3, Berlin, 10555, Germany

    Horst Kächele

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Huber, D., Henrich, G., Gastner, J., Klug, G. (2012). Must All Have Prizes? The Munich Psychotherapy Study. In: Levy, R., Ablon, J., Kächele, H. (eds) Psychodynamic Psychotherapy Research. Current Clinical Psychiatry. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-792-1_4

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