Short-Term Psychodynamic Therapy for Depression

Status: Modest Research Support

Description

In general, brief dynamic therapies for depression focus on increasing patients' awareness and insight about problematic patterns and core relational themes related to depression. Different types of psychodynamic therapy have been studied in clinical trials, but all do not use treatment manuals and some of the therapies are not designed specifically to treat depression. However, data are accumulating to suggest that short-term therapies in this class are efficacious. Some common themes across the different forms of brief dynamic therapy for depression include a focus on: 1) how past experiences influence current functioning, 2) affect and the expression of emotion, 3) the therapeutic relationship, 4) facilitation of insight, 5) avoidance of uncomfortable topics, and 6) the identification of core conflictual relationship themes. Therapy is time-limited and includes approximately 16 to 20 sessions. These therapies have also been developed for geriatric populations.

Key References (in reverse chronological order)

• G. O Gabbard, G. O., & Bennett, T. J. (2006). Psychoanalytic and psychodynamic psychotherapy for depression and dysthymia. In D. J. Stein, D. J. Kupfer, A. F, Schatzberg (Eds.) Textbook of mood disorders. (pp. 389-405). Washington, DC: American Psychiatric Publishing. (review)
• Leichsenring, F., & Leibing, E. (2007). Psychodynamic psychotherapy: A systematic review of techniques, indications and empirical evidence. Psychology and Psychotherapy: Theory, Research and Practice, 80, 217-228.
• Scogin, F, Welsh, D., Hanson, A. Stump, J. & Coates, A. (2005). Evidence-based psychotherapies for depression in older adults. Clinical Psychology: Science and Practice, 12, 222-237. (review)
• Hilsenroth, M. J., Ackerman, S. J., Blagys, M. D., Baity, M. R., & Mooney, M. A. (2003). Short-term psychodynamic psychotherapy for depression: An examination of statistical, clinically significant, and technique-specific change. Journal of Nervous and Mental Disease, 191, 349-357.
• Simpson, S., Corney, R., Fitzgerald, P., & Beecham, J. (2003). A randomized controlled trial to evaluate the effectiveness and cost-effectiveness of psychodynamic counseling for general practice patients with chronic depression. Psychological Medicine, 33, 229-239.
• Leichsenring, F. (2001). Comparative effects of short-term psychodynamic psychotherapy and cognitive-behavioral therapy in depression: A meta-analytic approach. Clinical Psychology Review, 21, 401-419.
• Diguer, L., Barber, J.P., Luborsky, L. (1993). Three concomitants: Personality disorders, psychiatric severity, and outcome of dynamic psychotherapy of major depression. American Journal of Psychiatry, 150, 1246-1248.

Clinical Resources

• Book, H. E. (1998). How to practice brief psychodynamic psychotherapy: The core conflictual relationship theme method. Washington, DC: APA
• Barber, J. P., & Crits-Christoph (1995). Dynamic therapies for psychiatric disorders: Axis I. New York: Basic Books.
• Luborsky, L., Mark, D., Hole, A., Popp, C., Goldsmith, B., & Cacciola, J. (1995) Supportive-expressive dynamic psychotherapy of depression: A time-limited version. In J. Barber & P. Crits-Christoph (Eds). Dynamic therapies for the psychiatric disorders: Axis I. NY: Basic Books.
• Shapiro, D. A. & Firth, J. A. (1985). Exploratory therapy manual for the Sheffield Psychotherapy Project. (SAPU, Memo 733). Sheffield, England, University of Sheffield.
• Luborsky, L. (1984). Principles of psychoanalytic psychotherapy: Manual for supportive/expressive therapy. NY: Basic Books.
• Mann, J. (1973). Time-limited psychotherapy. Cambridge, MA. Harvard University Press.

Geriatric Depression (brief dynamic therapy principles used in clinical trials)

• Rose, J., & Del Maestros, S. (1990). Separation-individuation conflict as a model for understanding distressed caregivers: Psychodynamic and cognitive case studies. Gerontologist, 30, 693-697.
• Horowitz, M. & Kaltreider, N. (1979). Brief psychotherapy of the stress response syndrome. Psychiatric Clinics of North America, 2, 365-377.

Training Opportunities

Resources for training in Supportive-Expressive Therapy for Depression can be found at the Center for Psychotherapy Research at the University of Pennsylvania(Dr. Paul Crits-Critstoph and Jacques Barber).