Magazine article Clinical Psychiatry News

Psychodynamic Therapy Recognized in Germany

Magazine article Clinical Psychiatry News

Psychodynamic Therapy Recognized in Germany

Article excerpt

ASPEN, COLO. -- Short-term psychodynamic psychotherapy demonstrated persuasive evidence of efficacy for a wide range of psychiatric disorders in a new metaanalysis, Falk Leichsenring, Ph.D., said at a psychiatry conference sponsored by the University of Colorado.

Based upon these findings, the German Scientific Council of Psychotherapy recently announced that by year's end it will formally certify psychodynamic psychotherapy as "empirically supported." This declaration is of great significance in Germany. Under a 5-year-old law, only techniques certified by the council as empirically supported can be taught in German psychotherapy institutes.

Psychodynamic psychotherapy will join cognitive-behavioral therapy and client-centered psychotherapy as the only methods of psychotherapy so designated, explained Dr. Leichsenring, professor of psychotherapy and psychoanalysis at the University of Gottingen, Germany.

He conducted a literature search for randomized controlled trials of short-term psychodynamic psychotherapy reported during 1960-2004. He restricted the metaanalysis to studies using a manual-based psychotherapy approach backed by supporting evidence showing therapists had adhered to manual protocols. Trials that used drug therapy were ineligible.

He ended up including 23 randomized controlled trials in which 7-40 sessions of short-term psychodynamic psychotherapy (STPP) were used to treat specific psychiatric disorders.

Here's what he found:

* Depressive disorders. Four randomized trials have compared STPP with cognitive-behavioral therapy (CBT), which is widely recognized as effective in treating depression. Each of the four trials concluded the two forms of psychotherapy were equally effective.

* Somatoform disorders. In one randomized trial involving patients with irritable bowel syndrome, STPP plus treatment as usual was significantly more effective than treatment as usual.

In another study, STPP proved significantly better than supportive therapy for functional dyspepsia, and in a group of patients with chronic somatoform pain disorder, Norwegian investigators found STPP more beneficial to an untreated control group than randomization, Dr. Leichsenring said.

* Anxiety disorders. Here, the evidence for STPP is quite weak, he noted. There has been only a single randomized trial, a Dutch study still in press, in which STPP and CBT proved equally effective in patients with social phobia. …

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