Psychodynamic Psychotherapy: An Effectiveness Study
Roseborough, D. J., McLeod, J. T., & Bradshaw, W. H. (2011). Psychodynamic psychotherapy: A quantitative, longitudinal perspective. Research on Social Work Practice, 16(2), 166-175.
This effectiveness study examined the course of treatment longitudinally and outcomes associated with psychodynamic psychotherapy for a sample of 1,050 people undertaking this treatment in a community setting, over the course of 4 years, at 3-month intervals, using the Outcome Questionnaire (OQ)-45.2. The authors used multilevel modeling to look at the nature of change over time and at potentially meaningful moderating variables. Results show a robust general improvement, though a more moderate one than described in recent meta-analyses including primarily prospective studies. The treatment was followed by broad improvements, over time, with a general trend and few notable interaction effects. The treatment involved little deterioration, particularly in the first year. Subgroup analysis suggested that (a) clients with more initial symptom severity showed greater improvement and a unique course of recovery with (b) clients who stayed over a year constituting a potentially unique subgroup.
Bradshaw, B., Roseborough, D., Pahwa, R., & Jordan, J. (2009). Evaluating psychodynamic psychotherapy in a community mental health clinic. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 37(4), 665-682.
This study describes an evaluation of the effectiveness of psychodynamic psychotherapy provided in an outpatient community mental health clinic. The study used a single group pretest-posttest design involving 78 clients. Clinical outcomes included overall psychosocial functioning and quality of life, level of subjective distress, interpersonal functioning and role functioning, measured by the Outcome Questionnaire (Lambert, Hansen, Umpress, Lunnen Okilshi, & Burlingame, 2000). Clients showed statistically significant improvement from pretest (first sessions) to completion of treatment in overall functioning, and quality of life, level of subjective distress, interpersonal functioning and role functioning. Eighty-five percent of clients made statistically and clinically significant change. Calculation of effect sizes for each outcome found moderate to strong change effects ranging from d = .4 to .9. The study illustrates a method of intervention research that therapists and agencies can use to integrate practical evaluation methods into their clinical services in order to improve mental health service to clients, to demonstrate the effectiveness of interventions, and to provide data to support coverage for needed services for clients.
Roseborough, D. (2006) Psychodynamic psychotherapy: An effectiveness study. Research on Social Work Practice 16(2), 166-175.
Objective: Both the National Institute of Mental Health and the American Psychological Association have called upon psychodynamic practitioners to start demonstrating their outcomes. This effectiveness study attempted to begin to answer these calls. Method: The study was a secondary analysis of data from a multidisciplinary, psychodynamic mental health clinic. It used a single-group, within-subjects longitudinal design. The psychometrically validated Outcome Questionnaire was used as a measure of change. A linear mixed and random effects model was used to analyze the data. The aims of this study were (a) to look at whether patients improve and (b) if so, at what variables moderate outcome. Results: Findings suggest that psychodynamic treatment, provided within this practice configuration, is effective over time, producing moderate effect sizes, and points to the particular importance of the first 3 months. Conclusions: Findings suggest a common course of recovery, with some between-group variability.