Psychodynamic Psychotherapy Research

Before the 1960s, psychoanalysis and psychodynamic psychotherapy were the dominant modes of treatment within psychiatry. These treatments have faced increasing scrutiny and skepticism as the movement towards evidence-based treatments has intensified and the mental health field has been asked to treat increasingly ill and severely character-disordered patients. Psychodynamic psychotherapy has lost status within the mental health field as other forms of treatment have developed a strong and well-funded research base. At the same time, the exciting bursts of knowledge about the functioning of the brain and the subsequent development of psychopharmacologic treatments have added to treatment alternatives. This development has served to help patients but also to decrease the frequency with which dynamic treatments are indicated. Criticisms of psychoanalytic treatments, which are grounded in elaborate theories of the mind that have been evolving since the late 19th century, have been valid to the extent that a scientific basis for the work was missing.

Recently, however, there has been an explosion in empirical research on psychoanalytic theories and treatments. There have been more than 70 randomized controlled trials of psychodynamic psychotherapy and psychoanalysis, and much more research supporting psychodynamic principles and specific psychodynamic treatments for many diagnostic categories.

In this volume of Psychodynamic Psychotherapy Research: Evidence-Based Practice and Practice-Based Evidence we demonstrate the relevance of and scientific support for psychodynamic treatment across a wide range of diagnostic categories and treatment strategies. One of the difficulties in the field of psychodynamic psychotherapy is that researchers and clinicians have not embraced one another. Clinicians have felt that researchers are ivory tower academics not on the front lines of clinical care, and researchers have felt that clinicians have little appreciation for the value of empirical research or the evidence that certain treatment principles are more effective with specific diagnostic populations. This volume presents the integration of clinical work and research through the scientist-practitioner model. Almost every author who has committed to write a chapter is an active clinician-researcher.

The chapters and researchers we have selected all emphasize the relevance of their studies for clinical work by including clinical vignettes with discussion of the influence of their research on treatment. We have asked authors to keep this integrative principle in mind throughout their chapters. Once again, there is a section on Efficacy and Effectiveness Studies. Within this section, there are three chapters that review evidence-based psychodynamic treatments including long-term psychotherapy and treatments for depression and anxiety disorders. In addition, there is a section on the role of the single case study in psychodynamic psychotherapy and psychoanalysis, and once again, there is a section on diagnostic and outcome measures particularly relevant to studying psychodynamic psychotherapy.

In this second volume, we also plan to include an expanded section on Neurobiology and Psychotherapy and have proposed six potential chapters. Modern psychiatry reflects the advances in neuroimaging technology, and research findings using this method, which will be highlighted in this section, are particularly powerful in the field at this point in time.

Finally, there is a section in which eminent psychodynamic psychotherapy researchers will write their thoughts about the value of psychotherapy research over time for clinical work. They respond to the question, "What have we learned from psychodynamic psychotherapy research that has proven to be clinically useful?"