On 2 Mar 2006 at 11:00, Scott Lilienfeld wrote: > As for the claim regarding short-term > psychodynamic treatments, several recent meta-analyses have shown > promising research support [snipped hedges following this statement] > > One recent meta-analysis on this front is by Leichsenring et al. > (2004, Archives of General Psychiatry: The efficacy of short-term > psychodynamic therapy in specific psychiatric disorder: A > meta-analysis). The Abstract is reproduced below...
I thought I'd take a quick look (which means you can't criticize me because I have an excuse). I discovered that I have full access to ithe article, not sure why. You can try at: http://archpsyc.ama-assn.org/cgi/reprint/61/12/1208 Anyway, the most significant bit is in the abstract. First, the description of "short-term psychodynamic therapy" [STPP] includes this: "The focus is on the patients' experiences here and now, including their symptoms". Shades of Hans Eysenck! If I was taught that there was one difference [ok, two] which distinguished behaviour therapy from psychodynamic therapy it was that behaviour therapy emphasized the here and now and treated the symptom, not the allegedly deep-seated underlying cause. So this certainly supports Scott's suspicion that STPP incorporates behaviour therapy principles. A classic psychodynamicist would sooner marry his mother than do that, knowing how dangerous mere symptomatic treatment is. But the real kicker is how the data were analyzed. The clue is that the 17 studies included in the meta-analysis were "randomized controlled trials", not "randomized, placebo-controlled trials", a significant difference. In fact, their large effect size for target problems (1.39) was based on before-after comparisons, not comparison with an equally-credible placebo treatment. So while their meta-analysis may have shown that STPP works, it provides no evidence that it works better than a placebo. In place of a placebo group, they identified four of the studies as having a wait-list (i.e. do nothing) control. Sadly, this number was too small for statistical analysis, although the effect sizes before and after no treatment (paradoxical 'tho that may be), although positive, were small. So it appears that STPP works better than doing nothing (something I've never disputed). But it hasn't gone mano a mano with a real placebo, and as far as I'm aware, those that have, have failed to show that they're better. So STPP doesn't seem too promising to me. At this point, I'd also like to mention that I agree with Jim Guinee, who noted in a recent post (quoting Hans Strupp), that even if psychoanalysis is no better than listening to a friend, at least it provides (at some price!) that friendship. I have no problem with that either. I recall a book some years ago with the revealing title, "Psychotherapy: the Purchase of Friendship". But what gets me is that no psychoanalyst would ever admit this, claiming instead that it is their arcane knowledge and profound insight into the workings of the human psyche that uniquely qualifies them to do psychotherapy. Then they write stuff like that silly piece in the NY Times we've been discussing. Stephen ----------------------------------------------------------------- Stephen L. Black, Ph.D. Department of Psychology Bishop's University e-mail: [EMAIL PROTECTED] Lennoxville, QC J1M 1Z7 Canada Dept web page at http://www.ubishops.ca/ccc/div/soc/psy TIPS discussion list for psychology teachers at http://faculty.frostburg.edu/psyc/southerly/tips/index.htm ---------------------------------------------------------------------- --- You are currently subscribed to tips as: [email protected] To unsubscribe send a blank email to [EMAIL PROTECTED]
