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The early impact of therapeutic alliance in brief psychodynamic psychotherapy
Marcolino, José Alvaro Marques;Iacoponi, Eduardo;
Revista Brasileira de Psiquiatria , 2003, DOI: 10.1590/S1516-44462003000200006
Abstract: introdction: therapeutic alliance is a key component of the psychotherapeutic process. this study estimated the impact of the therapeutic alliance as measured by calpas-p in an individual brief psychodynamic psychotherapy program. methods: to study the impact of the therapeutic alliance patients in psychotherapy answered to the calpas-p at the first and third session and to the self-report questionnaire (srq-20), to the beck depression inventory (bdi) and to the hamilton anxiety scale at the beginning and at the end of psychotherapy. results: the study of the impact of the therapeutic alliance in brief psychodynamic psychotherapy showed that higher tui scores in the first session were significantly associated to the improvement on the bdi. patients with best scores in the working alliance, measured at the third pwc session had also significant symptomatic changes. discussion: the study of the impact of the therapeutic alliance in brief psychotherapy indicated that patients who perceived that their therapists had the best capability to understand and to be involved in their issues had best results in reducing depressive symptoms and patients with higher capability to form the working alliance reached the best psychotherapy outcomes.
The early impact of therapeutic alliance in brief psychodynamic psychotherapy
Marcolino José Alvaro Marques,Iacoponi Eduardo
Revista Brasileira de Psiquiatria , 2003,
Abstract: INTRODCTION: Therapeutic alliance is a key component of the psychotherapeutic process. This study estimated the impact of the therapeutic alliance as measured by CALPAS-P in an individual brief psychodynamic psychotherapy program. METHODS: To study the impact of the therapeutic alliance patients in psychotherapy answered to the CALPAS-P at the first and third session and to the Self-report Questionnaire (SRQ-20), to the Beck Depression Inventory (BDI) and to the Hamilton Anxiety Scale at the beginning and at the end of psychotherapy. RESULTS: The study of the impact of the therapeutic alliance in brief psychodynamic psychotherapy showed that higher TUI scores in the first session were significantly associated to the improvement on the BDI. Patients with best scores in the working alliance, measured at the third PWC session had also significant symptomatic changes. DISCUSSION: The study of the impact of the therapeutic alliance in brief psychotherapy indicated that patients who perceived that their therapists had the best capability to understand and to be involved in their issues had best results in reducing depressive symptoms and patients with higher capability to form the working alliance reached the best psychotherapy outcomes.
Affect-focused psychodynamic psychotherapy for depression and anxiety through the Internet: a randomized controlled trial
Robert Johansson,Martin Bj?rklund,Christoffer Hornborg,Stina Karlsson
PeerJ , 2013, DOI: 10.7717/peerj.102
Abstract: Background. Psychodynamic psychotherapy is a psychological treatment approach that has a growing empirical base. Research has indicated an association between therapist-facilitated affective experience and outcome in psychodynamic therapy. Affect-phobia therapy (APT), as outlined by McCullough et al., is a psychodynamic treatment that emphasizes a strong focus on expression and experience of affect. This model has neither been evaluated for depression nor anxiety disorders in a randomized controlled trial. While Internet-delivered psychodynamic treatments for depression and generalized anxiety disorder exist, they have not been based on APT. The aim of this randomized controlled trial was to investigate the efficacy of an Internet-based, psychodynamic, guided self-help treatment based on APT for depression and anxiety disorders. Methods. One hundred participants with diagnoses of mood and anxiety disorders participated in a randomized (1:1 ratio) controlled trial of an active group versus a control condition. The treatment group received a 10-week, psychodynamic, guided self-help treatment based on APT that was delivered through the Internet. The treatment consisted of eight text-based treatment modules and included therapist contact (9.5 min per client and week, on average) in a secure online environment. Participants in the control group also received online therapist support and clinical monitoring of symptoms, but received no treatment modules. Outcome measures were the 9-item Patient Health Questionnaire Depression Scale (PHQ-9) and the 7-item Generalized Anxiety Disorder Scale (GAD-7). Process measures were also included. All measures were administered weekly during the treatment period and at a 7-month follow-up. Results. Mixed models analyses using the full intention-to-treat sample revealed significant interaction effects of group and time on all outcome measures, when comparing treatment to the control group. A large between-group effect size of Cohen’s d = 0.77 (95% CI: 0.37–1.18) was found on the PHQ-9 and a moderately large between-group effect size d = 0.48 (95% CI: 0.08–0.87) was found on the GAD-7. The number of patients who recovered (had no diagnoses of depression and anxiety, and had less than 10 on both the PHQ-9 and the GAD-7) were at post-treatment 52% in the treatment group and 24% in the control group. This difference was significant, χ2(N = 100, d f = 1) = 8.3, p < .01. From post-treatment to follow-up, treatment gains were maintained on the PHQ-9, and significant improvements were seen on the GAD-7. Conclusion. This study provi
Psychodynamic psychotherapy for complex trauma: targets, focus, applications, and outcomes
Deborah Spermon, Yvonne Darlington, Paul Gibney
Psychology Research and Behavior Management , 2010, DOI: http://dx.doi.org/10.2147/PRBM.S10215
Abstract: ychodynamic psychotherapy for complex trauma: targets, focus, applications, and outcomes Review (4432) Total Article Views Authors: Deborah Spermon, Yvonne Darlington, Paul Gibney Published Date December 2010 Volume 2010:3 Pages 119 - 127 DOI: http://dx.doi.org/10.2147/PRBM.S10215 Deborah Spermon1, Yvonne Darlington1, Paul Gibney2 1School of Social work and Human Services, The University of Queensland, St. Lucia, QLD, Australia; 2Private Practice, Brisbane, QLD, Australia Abstract: Complex trauma describes that category of severe, chronic interpersonal trauma usually originating in the formative years of a child. In the adult, this can result in global dissociative difficulties across areas of cognitive, affective, somatic, and behavioral functions. Targeting this field of traumatic pathology, this article reviews the contributions and developments within one broad approach: psychodynamic theory and practice. Brief descriptions of aspects of analytical, Jungian, relational, object relations, and attachment therapeutic approaches are given, along with understandings of pathology and the formulation of therapeutic goals. Major practices within client sessions are canvassed and the issues of researching treatment outcomes are discussed.
The Effect of Interpersonal Psychotherapy and other Psychodynamic Therapies versus ‘Treatment as Usual’ in Patients with Major Depressive Disorder  [PDF]
Janus Christian Jakobsen,Jane Lindschou Hansen,Erik Simonsen,Christian Gluud
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0019044
Abstract: Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Interpersonal psychotherapy and other psychodynamic therapies may be effective interventions for major depressive disorder, but the effects have only had limited assessment in systematic reviews.
Efficacy of psychodynamic short-term psychotherapy for depressed breast cancer patients: study protocol for a randomized controlled trial  [cached]
Zwerenz Rüdiger,Beutel Manfred E,Imruck Barbara H,Wiltink J?rg
BMC Cancer , 2012, DOI: 10.1186/1471-2407-12-578
Abstract: Background There is a lack of psychotherapeutic trials of treatments of comorbid depression in cancer patients. Our study determines the efficacy of a manualized short-term psychodynamic psychotherapy and predictors of outcome by personality and quality of the therapeutic relationship. Methods/design Eligible breast cancer patients with comorbid depression are assigned to short-term psychodynamic psychotherapy (up to 20 + 5 sessions) or to treatment as usual (augmented by recommendation for counseling center and physician information). We plan to recruit a total of 180 patients (90 per arm) in two centers. Assessments are conducted pretreatment, after 6 (treatment termination) and 12 months (follow-up). The primary outcome measures are reduction of the depression score in the Hospital Anxiety and Depression Scale and remission of depression as assessed by means of the Structured Clinical Interview for DSM IV Disorders by independent, blinded assessors at treatment termination. Secondary outcomes refer to quality of life. Discussion We investigate the efficacy of short-term psychodynamic psychotherapy in acute care and we aim to identify predictors for acceptance and success of treatment. Trial registration ISRCTN96793588
Cognitive Behavioral Therapy versus Short Psychodynamic Supportive Psychotherapy in the outpatient treatment of depression: a randomized controlled trial
Ellen Driessen, Henricus L Van, Robert A Schoevers, Pim Cuijpers, Gerda van Aalst, Frank J Don, Mari?lle Hendriksen, Simone Kool, Pieter J Molenaar, Jaap Peen, Jack JM Dekker
BMC Psychiatry , 2007, DOI: 10.1186/1471-244x-7-58
Abstract: Adult outpatients with a main diagnosis of major depressive disorder or depressive disorder not otherwise specified according to DSM-IV criteria and mild to severe depressive symptoms (Hamilton Depression Rating Scale score ≥ 14) are randomly allocated to Short Psychodynamic Supportive Psychotherapy or Cognitive Behavioral Therapy. Both treatments are individual psychotherapies consisting of 16 sessions within 22 weeks. Assessments take place at baseline (week 0), during the treatment period (week 5 and 10) and at treatment termination (week 22). In addition, a follow-up assessment takes place one year after treatment start (week 52). Primary outcome measures are the number of patients refusing treatment (acceptability); the number of patients terminating treatment prematurely (feasibility); and the severity of depressive symptoms (efficacy) according to an independent rater, the clinician and the patient. Secondary outcome measures include general psychopathology, general psychotherapy outcome, pain, health-related quality of life, and cost-effectiveness. Clinical predictors of treatment outcome include demographic variables, psychiatric symptoms, cognitive and psychological patient characteristics and the quality of the therapeutic relationship.This study evaluates Short Psychodynamic Supportive Psychotherapy as a treatment for depressed outpatients by comparing it to the established evidence-based treatment Cognitive Behavioral Therapy. Specific strengths of this study include its strong external validity and the clinical relevance of its research aims. Limitations of the study are discussed.Current Controlled Trails ISRCTN31263312Depressive disorders constitute a major health problem in today's world. According to the World Health Organization, in the year 2000 depressive disorders were the leading cause of disability around the world and the fourth leading contributor to the global burden of disease. It is estimated that by the year 2020 depression will compris
Is psychodynamic psychotherapy an effective intervention for individuals at ultra-high risk (UHR) of psychosis?: a case report
Martins, Paula A.;Gon?alves, Priscila Dib;Arcuri, Silvia Maria;Leite Netto, Oswaldo F.;Macedo, Gamaliel;Louz?, Mario;
Jornal Brasileiro de Psiquiatria , 2012, DOI: 10.1590/S0047-20852012000400011
Abstract: objective: to report a case and to discuss the use of psychodynamic psychotherapy (pd-p) to treat individuals at ultra-high risk (uhr) of psychosis. methods: an individual at uhr was followed up for 24 months. the baseline evaluation included a psychiatric interview, the structured interview for prodromal symptoms (sips), the scale of prodromal symptoms (sops), and neuropsychological assessment. he underwent weekly sessions of pd-p for 12 months and was followed up for 12 months after the end of pd-p. the evaluations were at baseline, after 6-, 12-, and 24-month follow-up. no medication was prescribed during the 24-month follow-up. results: the prodromal symptoms remitted. the initial total score on the sips/sops was 37 points. after the first 12 months of pd-p, there was a reduction to 12 points on the sips/sops score, which stabilized in the 24-month follow-up. there was also a slight improvement in his performance on the neuropsychological evaluations. conclusion: this case report suggests that pd-p can reduce prodromal symptoms; nevertheless, a better understanding of the specificity and efficacy of pd-p as an option of treatment for uhr individuals is needed.
Short-Term Psychodynamic Psychotherapy in Patients with “Male Depression” Syndrome, Hopelessness, and Suicide Risk: A Pilot Study  [PDF]
Gloria Angeletti,Maurizio Pompili,Marco Innamorati,Chiara Santucci,Valeria Savoja,Mark Goldblatt,Paolo Girardi
Depression Research and Treatment , 2013, DOI: 10.1155/2013/408983
Abstract: Objectives and Methods. This was an observational study of the efficacy of short-term psychodynamic psychotherapy (STPP) in a sample of 35 (30 women and 5 men) patients with moderate-to-severe “male depression” (Gotland Scale for Male Depression (GSMD)?≥?13) comorbid with unipolar mood disorder (dysthymia and major depression) or anxiety disorder. Outcome measures were GSMD and BHS (Beck Hopelessness Scale) score changes from baseline. Results. Patients had a strong response to STPP on the GSMD (estimated mean score change ; partial eta squared?? ), but not on the BHS (estimated mean score change ; partial eta squared ? ). BHS score changes were significantly associated with GSMD score changes (Pearson's ; ), even when controlling for the severity of hopelessness at the baseline (partial ; ). Conclusions. STPP proved to be effective in patients suffering from “male depression” although hopelessness was only marginally reduced by this treatment which points to the need to better understand how STPP can be involved in the reduction of suicide risk. 1. Introduction The term “depression” encompasses a wide range of conditions that may occur along a continuum, ranging from milder forms of discomfort to more severe and persistent form, as in the case of major depression. Depression is the leading cause of disability and the 4th leading contributor to the global burden of disease [1, 2] and by the year 2020, it is projected to become the 2nd leading contributor to the global burden of disease in all ages and both sexes [1]. Major depression is the most frequent mental illness in the world [3–6]. For example, in the US, the Epidemiological Catchment Area (ECA) Study indicated a one-month prevalence between 1.7% and 3.4% [7], and more recently, the National Comorbidity Survey Replication (NCS-R) estimated a 12-month prevalence of 6.6% [8]. Nevertheless, prevalence of moderate- to- severe depressive symptoms could be much higher [9–11]. In 2010, the British National Institute for Health and Clinical Excellence (NICE) commissioned the development of an updated version of the guideline on the treatment and management of depression in adults [12]. The NICE guideline pointed out that people who suffer from depression usually prefer psychological treatments to medication [13] and value outcomes beyond symptom reduction [14]. The NICE guideline indicated that it was not possible to demonstrate a consistent picture of any clinically important benefit for short-term psychodynamic psychotherapy (STPP) in depression. While cognitive-behavioral therapy and interpersonal
Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: rationale and design of a randomized controlled trial
Gilles Ambresin, Jean-Nicolas Despland, Martin Preisig, Yves de Roten
BMC Psychiatry , 2012, DOI: 10.1186/1471-244x-12-182
Abstract: The study is a one-month randomized controlled trial with a two parallel group design and a 12-month naturalistic follow-up. A sample of 130 consecutive adult inpatients with unipolar depression and Montgomery-Asberg Depression Rating Scale score over 18 will be recruited. The study is carried out in the university hospital section for mood disorders in Lausanne, Switzerland. Patients are assessed upon admission, and at 1-, 3- and 12- month follow-ups. Inpatient therapy is a manualized brief intervention, combining the virtues of inpatient setting and of time-limited dynamic therapies (focal orientation, fixed duration, resource-oriented interventions). Treatment-as-usual represents the best level of practice for a minimal treatment condition usually proposed to inpatients. Final analyses will follow an intention–to-treat strategy. Depressive symptomatology is the primary outcome and secondary outcome includes measures of psychiatric symptomatology, psychosocial role functioning, and psychodynamic-emotional functioning. The mediating role of the therapeutic alliance is also examined. Allocation to treatment groups uses a stratified block randomization method with permuted block. To guarantee allocation concealment, randomization is done by an independent researcher.Despite the large number of studies on treatment of depression, there is a clear lack of controlled research in inpatient psychotherapy during the acute phase of a major depressive episode. Research on brief therapy is important to take into account current short lengths of stay in psychiatry. The current study has the potential to scientifically inform appropriate inpatient treatment. This study is the first to address the issue of the economic evaluation of inpatient psychotherapy.Australian New Zealand Clinical Trial Registry (ACTRN12612000909820)Depression is the largest contributor to the burden of disease in high-income countries, with further increase expected [1]. Depression may not respond to out
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