On 1 October 2008 Miguel Roig reported: >From yesterday's New York Times: >"Intensive psychoanalytic therapy, the "talking cure" rooted in the >ideas of Freud, has all but disappeared in the age of drug treatments >and managed care. But now researchers are reporting that the therapy >can be effective against some chronic mental problems, including >anxiety and borderline personality disorder". > http://www.nytimes.com/2008/10/01/health/01psych.html
More information on the meta-analysis in question from the Journal of the American Medical Association website: http://jama.ama-assn.org/cgi/content/short/300/13/1551 Sources: Studies of LTPP published between January 1, 1960, and May 31, 2008, were identified by a computerized search using MEDLINE, PsycINFO, and Current Contents, supplemented by contact with experts in the field. Study Selection: Only studies that used individual psychodynamic psychotherapy lasting for at least a year, or 50 sessions; had a prospective design; and reported reliable outcome measures were included. Randomized controlled trials (RCTs) and observational studies were considered. Twenty-three studies involving a total of 1053 patients were included (11 RCTs and 12 observational studies). Some general points: 1. Was there any discrimination between well-conducted studies and poorly conducted studies? 2. The Abstract says there were 11 randomized controlled trials included in the meta-analysis. I would be interested to know what these "controlled trials" consisted of. It has always been recognized that it is very difficult to find a means of having controls for long-term psychotherapy, and here we are told there 11 such randomized control trials since 1960. 3. We are told there were 12 "observational studies" included in the meta-analysis. From the little I can find on such a methodology, it may not have been appropriate to have mixed them in with randomized controlled studies. http://www-stat.wharton.upenn.edu/~rosenbap/BehStatObs.pdf Before taking this meta-analysis seriously I would want to know if, for each of the 11 randomized controlled studies, there was a control group who received regular non-psychodynamic psychotherapy (or counselling) over an equivalent period. It should be obvious (as has been so often pointed out) that there has to some evidence that the *psychodynamic aspects* of psychodynamic psychotherapy play a significant role, over and above the effects of regular psychotherapy (or counselling) with a sympathetic listener. (I omit the inclusion of auxillary relaxation techniques that could possibly enhance the psychotherapy.) I would also be interested to know more precisely what kind of psychodynamic psychotherapy was involved in the studies. This term can include something close to orthodox Freudian therapy (Oedipus complex et al.) to a much vaguer psychotherapy in which specifically Freudian notions play no role. (Does it not matter which of the various - and sometimes incompatible - psychoanalytic schools of thought inform the psychodynamic psychotherapies included in the meta-analysis?) Allen Esterson Former lecturer, Science Department Southwark College, London http://www.esterson.org --- To make changes to your subscription contact: Bill Southerly ([EMAIL PROTECTED])
