Fonagy, P., Rost, F., Carlyle, J-a., McPherson, S., Thomas, R., Fearon, R. M. P., Goldberg, D., & Taylor, D. (2015).
Pragmatic randomized controlled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: the Tavistock Adult Depression Study (TADS). World Psychiatry, 14: 312-321. doi: 10.1002/wps.20267
The following is a summary of the abstract of the above:
This study describes a randomised controlled trial to assess the efficacy of treating patients with long-standing, treatment-resistant depression with long-term psychoanalytic psychotherapy (LTPP) combined with “treatment-as-usual” (TAU—as specified by UK national guidelines) compared with using TAU alone. 129 patients referred to primary care were randomly allocated to the two modes of treatment which was given over a period of eighteen months. They were assessed both during the treatment and following it at twenty-four, thirty, and forty-two months. The evaluation used a range of measures: the Hamilton Depression Rating Scale, self-reported depression (Beck Depression Inventory—II), social functioning (Global Assessment of Functioning), subjective well-being (Clinical Outcomes in Routine Evaluation—Outcome Measure), and satisfaction with general activities (Quality of Life Enjoyment and Satisfaction Questionnaire). In both groups, complete remission on ending treatment was infrequent (9.4% in the LTPP group vs. 6.5% in the control group) as it was at the final forty-two month follow-up (14.9% vs. 4.4%). On ending treatment partial remission was not significantly greater for the LTPP than the control group (32.1% vs. 23.9%). Statistically significant differences however were noted during the follow-up period: at twenty-four months: 38.8% vs. 19.2%; at thirty months: 34.7% vs. 12.2%; and at forty-two months: 30.0% vs. 4.4%. In addition, the observer-based and self-reported depression scores and measures of social adjustment indicated more marked improvement in patients receiving LTPP. These findings suggest that the long-term outcome of treatment-resistant depression can be enhanced by long-term psychoanalytic psychotherapy. Moreover, its long-term efficacy may be underestimated by end-of-treatment or short follow-up assessments.
One of the most critical goals for couple psychotherapy is to foster a new relational experience in the session where the couple feels safe enough to reveal more vulnerable emotions and to explore their defensive withdrawal, aggressive attacking, or blaming. The lived intimate experience in the session offers the couple an opportunity to gain integrative insight into their feelings, expectations, and behaviors that ultimately hinder intimacy. The clinical processes that are necessary include empathizing with the couple and facilitating safety within the session, looking for opportunities to explore emotions, ruptures, and unconscious motivations that maintain distance in the relationship, and creating a new relational experience in the session that has the potential to engender integrative insight. These clinical processes will be presented with empirical support. Exerts from a session will be used to highlight how these processes influence the couple and promote increased intimacy.
In this article, we examine the science and policy implications of the common factors perspective (CF; Frank & Frank, 1993; Wampold, 2007). As the empirically supported treatment (EST) approach, grounded in randomized controlled trials (RCTs), is the received view (see Baker, McFall, & Shoham, 2008; McHugh & Barlow, 2012), we make the case for the CF perspective as an additional evidence based approach for understanding how therapy works, but also as a basis for improving the quality of mental health services. Finally, we argue that it is time to integrate the 2 perspectives, and we challenge the field to do so.
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(2016). Abstracts from other Journals. Cpl. Fam. Psychoanal., 6(1):144-145