Short-term psychodynamic psychotherapies for common mental disorders

Context

Short-term psychodynamic psychotherapy (STPP) is a brief talking therapy. It lasts less than 40 hours in total and is delivered one to one. It looks at how past relationships and hidden feelings shape present problems. Over 40 years, researchers have developed and tested it for many mental and physical problems. Four earlier meta-analyses examined STPP. They used different methods and different samples. They reached conflicting results. This Cochrane review set out to settle that question. It compared STPP with minimal treatment and with no treatment. The authors included only adults with common mental disorders. The search ran in April 2005 and covered the main medical and psychology databases.

Findings

The authors included 23 randomised controlled trials. Together these trials randomised 1431 patients. The trials tested STPP for general symptoms, physical (somatic) symptoms, anxiety, depression, and social adjustment. For most of these problem areas, treated patients improved significantly more than control patients. These gains were generally still present at medium-term and long-term follow-up. So the benefits often lasted after therapy ended. The authors described the gains as modest to moderate. Several limits weaken these findings. Only a small number of studies provided data for each problem area. The studies also differed a lot from one another, which is called heterogeneity. When the authors ran sensitivity analyses, the results did not always hold. Sensitivity analyses re-run the numbers under different assumptions. The authors checked for publication bias using a funnel plot. Treatment delivery and treatment quality varied across the studies. That variation may limit how reliable the effect estimates are.

Implications

STPP shows promise for a range of common mental disorders. The authors concluded that gains are modest to moderate and often sustained. They also urged caution in interpreting the findings. The limited data and the differences between studies are the main reasons. For your practice, this review supports brief psychodynamic work as a reasonable option. It does not show that STPP beats other active therapies. The control groups here received minimal treatment or no treatment. They did not receive another therapy. So you cannot conclude from this review that STPP is better than CBT or other approaches. The review also cannot tell you which clients will benefit most. The authors call for larger studies of higher quality. They also want future trials to focus on specific diagnoses. Until those trials exist, present STPP as a promising option, not a proven first choice for every client.

Co nepřeceňovat

Do not tell clients that STPP is proven better than other therapies. The comparison groups received no treatment or minimal treatment, not CBT or another active therapy. Do not promise results. Only a few studies covered each disorder, the studies disagreed with each other, and the results did not always survive sensitivity analyses. Do not claim it works for every diagnosis or every client.

Short-term psychodynamic psychotherapies for common mental disorders

Ve zkratce

Context

Findings

Implications

Co nepřeceňovat

Zdroje

Témata

Dostávej nové studie e-mailem

Témata

Z jakých terapeutických směrů