Psychodynamic and psychoanalytic psychotherapy has lagged way behind other forms of therapy (such as Cognitive Behavioural Therapy) in researching the outcomes of treatment. This has been partly due to inertia and funding difficulties (particularly as the majority of psychodynamic practitioners work in private practice), the relative ease of carrying out studies on shorter term treatments, and the length of time needed to properly assess psychoanalytic psychotherapy. Now a robust and rigorous study has been carried out by some of the foremost researchers in the field.
The Tavistock Adult Depression Study (TADS), undertaken by a team from University College London, the Tavistock and Portman NHS Foundation Trust, and others and lead by Professor Peter Fonagy, has published their findings into the effectiveness of long-term psychoanalytic psychotherapy for people with depression for whom two previous forms of treatment had failed - known as 'treatment-resistant depression'. The fact that the study is rigorous is important as some studies comparing treatments against psychodynamic psychotherapy have used 'psychodynamic psychotherapists' who were not trained or experienced in the field but rather were students who had undergone a two day training and were not allowed to ask questions about the particular situation that had brought the clients to seek treatment - no wonder they were ineffective (see Shedler 2015, download here).
The Tavistock Adult Depression Study had 129 people enter the trial who were divided between a control group, who received 'treatment as usual' as part of their NHS care (which included referral for other therapeutic interventions), and those having long-term psychoanalytic psychotherapy (LTPP). Complete remission of the depression was infrequent in both groups at the end of treatment (9.4% in the LTPP group compared with 6.5% in the control group), whilst partial remission was not statistically significantly different (statistically speaking) either (32.1% for LTPP compared with 23.9% for the control group).
The significant differences came after the end of treatment when follow-ups were carried out two years, two and a half years, and three and a half years later. At 24 months 38.8% had shown significant improvement compared to 19.2% in the control group; at 30 months 34.7% showed improvement compared to 12.2%, and at 42 months 30.0% compared to 4.4%. These figures reinforce the findings of some earlier studies and suggest that, for example, the process of psychotherapy operates on a number of levels - cognitively, emotionally, somatically and relationally - which continue to be effective for the individual in fostering a beneficial attitude toward themselves and others which not only remains but continues to develop long after the therapy is finished.