Differential effects of two forms of psychoanalytic therapy: Results of the Heidelberg-Berlin study

This prospective naturalistic quasi-experimental study compares 2 psychodynamic therapy approaches that make up about 65% of all forms of psychotherapy currently financed by the health insurance system in Germany. Psychodynamic therapy (PD) is a focal therapy approach involving supportive elements, whereas psychoanalytic therapy (PA) encourages regressive processes, works with transference, and aims at more extensive changes to the personality (structural changes). PAs take longer and involve more sessions per week. By international standards, both approaches are regarded as long-term forms of therapy. This study investigates 2 groups of diagnostically heterogeneous patients, one PA and the other PD, matched with regard to several important parameters. The success of this matching was tested and comparability checked and substantiated on a wide range of features and scales. Treatment effects measured at end of therapy and at 1-year follow-up were analyzed with reference to the Global Severity Index (GSI) of the Symptom Checklist-90-Revised (SCL-90-R) and the Inventory of Interpersonal Problems (IIP). Both the GSI of the SCL-90-R and the total IIP score showed highly significant main effects in the whole group at end of therapy and at follow-up. A significant interaction effect between the 2 groups indicating higher efficiency for PA was found for the IIP total score with regard to the pre-post changes, with a corresponding trend in the pretherapy-follow-up changes. Evidence shows that a supplementary investigation of the specific effects of psychodynamic therapies (structural changes) is required for an accurate appreciation of their potential.