Can we differentiate between psychoanalytic and psychodynamic psychotherapy? - An empirical investigation of therapists' self-reports.

Therapy differentiation is a crucial component of psychotherapy research. It refers to whether inspected treatments differ from one another. In the history of psychoanalysis, the differentiation between psychodynamic and analytic psychotherapy was often discussed but seldom inspected empirically. In this study, we propose a set of items which should in theory offer the possibility to differentiate between psychodynamic and analytic psychotherapy on session level. We inspect these items using therapists' self-reports concerning N = 295 cases of different psychodynamic and analytic therapies. Results of an exploratory factor analysis and subsequent inspections of the psychodynamic and analytic items in different forms of therapies strengthen the usability of these items for differentiating between psychodynamic and analytic therapy. However, further studies using different perspectives (e. g., observer ratings) are essential. The presented items are a promising step towards the development of an instrument for treatment differentiation which could later be used in treatment comparison studies.

Insight and Outcome in Long-Term Psychotherapies of Depression.

Objectives: In different therapeutic approaches, insight is acknowledged as an important part of patient's therapeutic change process. We examined whether the level of insight (1) differs between psychoanalytic (PA), psychodynamic (PD) and cognitive-behavioral therapy (CBT), and (2) predicts long-term symptomatic outcome. Methods: A completer sample of 67 depressed patients from the Munich Psychotherapy Study was analyzed. Symptoms were assessed with Beck Depression Inventory (BDI) and Symptom Checklist-Revised (SCL-90-R) at pre-treatment and three-year follow-up. Insight was assessed from 242 sessions of mid-therapy phase with the Experiencing Scale. Results: The general level of insight was higher in PA as compared to CBT, and associated with lower depressive symptoms (BDI) across all three therapeutic modalities at three-year follow-up. Insight was unrelated to general distress (SCL-90-R). Exploratory analyses suggested that patients treated with PA showed higher levels of insight especially in high quality sessions (assessed by therapist). Patients for whom the extent of insight was positively linked to session quality, suffered from more depressive symptoms at three-year follow-up than patients gaining insight when session quality was low. Conclusion: Insight differs between PA and CBT and may be a common change mechanism in long-term psychotherapies.

[Can Psychoanalytic and Psychodynamic Psychotherapy be Reliably Discriminated? - Developement of the "Adherence of Psychoanalytic and Psychodynamic Therapy Scale" (APP Scale)]. / Können analytische und tiefenpsychologisch fundierte Psychotherapie reliabel voneinander getrennt werden?

The study aims at the development of an adherence scale (APP) for psychoanalytic therapy (PA) and psychodynamic therapy (PD) with high discriminant ability to differentiate between these 2 treatments. The development of the APP scale comprises 6 steps. Nine trainees underwent an intensive rater training. After reaching an interrater reliability of ICC [2.1]>0.60, seven trainees participated as raters in the psychometric study. The reliability of the APP Scale was ICC [1.1]=0.58 and ICC [1.3]=0.81 (PA subscale), and ICC [1.1]=0.67 and ICC [1.3]=0.86 (PD subscale) indicating sufficient to excellent reliability. The discriminant ability of the APP Scale based on audiotaped PD- and PA-sessions was d=1.04 (PA subscale) and d=1.48 (PD subscale) indicating large effect sizes, respectively. Thus, the APP scale applied by trained psychology students and postgraduates, discriminates reliably the conceptually overlapping treatments, provided that the raters were trained intensively by experts in PA and PD.