Is Psychoanalytic Psychotherapy Effective?

High-Quality Academic Publications Demonstrating
Psychodynamic Psychotherapy Efficacy (2015-2025)
(source: Perplexity Pro AI)
These studies represent the highest-quality evidence from the past decade demonstrating the efficacy of psychodynamic psychotherapy across multiple mental health conditions. The evidence consistently shows that psychodynamic therapy is not only effective but often equivalent to or superior to other established treatments, with the additional benefit of sustained and sometimes increasing effects over time.
1. The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders – an umbrella review based on updated criteria

Authors: Leichsenring, F., Abbass, A., Heim, N., Keefe, J.R., Kisely, S., Luyten, P., Rabung, S., Steinert, C.
Journal & Year: World Psychiatry, 2023
Study Type: Umbrella Review (Meta-analysis of Meta-analyses)
Summary of Findings on Efficacy:
- High quality evidence shows psychodynamic therapy is superior to inactive and active control conditions for depressive and somatic symptom disorders with clinically meaningful effect sizes
- Moderate quality evidence demonstrates efficacy for anxiety and personality disorders
- Psychodynamic therapy is as efficacious as other active therapies (including CBT) in common mental disorders
- Evidence supports "strong" recommendation for psychodynamic therapy treatment according to updated empirically supported treatment criteria1

2. Efficacy of short-term psychodynamic psychotherapy (STPP) in depressive disorders: A systematic review and meta-analysis

Authors: Caselli, I., Ielmini, M., Bellini, A., Zizolfi, D., Callegari, C.
Journal & Year: Journal of Affective Disorders, 2023
Study Type: Systematic Review and Meta-analysis
Summary of Findings on Efficacy:
- STPP demonstrated significant superiority over no interventions with effect size of -0.91 for depressive symptom severity
- Clinical improvement effect size was -0.78 favoring STPP over control conditions
- STPP showed mild superiority over supportive psychotherapy and slight superiority over cognitive-behavioral therapy
- Findings confirm STPP efficacy in depressive disorders and endorse NICE guidelines recommendations2

3. The efficacy of psychodynamic psychotherapy for young adults: A systematic review and meta-analysis

Authors: Riva Crugnola, C., Bottini, M., Madeddu, F., Preti, E., Ierardi, E.
Journal & Year: Frontiers in Psychology, 2024
Study Type: Systematic Review and Meta-analysis of 22 studies (14 RCTs)
Summary of Findings on Efficacy:
- Significant effect of psychodynamic psychotherapy when compared to control conditions (Hedges' g = -1.24, p < 0.001)
- Effects remained statistically significant at follow-up (g = -0.75, p < 0.001)
- Significant improvements in general psychopathological symptoms, personality functioning, and interpersonal relationships
- Particularly effective for young adults with borderline personality disorder, showing decreased suicidal episodes and psychiatric admissions3

4. Effectiveness of Long-term Psychodynamic Psychotherapy: A Meta-analysis

Authors: Leichsenring, F., Rabung, S.
Journal & Year: Journal of the American Medical Association (JAMA), 2008 (updated analysis 2015)
Study Type: Meta-analysis of 23 studies (11 RCTs, 12 observational studies)
Summary of Findings on Efficacy:
- Long-term psychodynamic psychotherapy showed significantly higher outcomes than shorter therapies with between-group effect size of 1.8 for overall effectiveness
- Patients with complex mental disorders were better off than 96% of patients in comparison groups
- Effect sizes increased from treatment completion to follow-up across all five outcome domains
- Particularly effective for complex mental disorders including personality disorders and chronic conditions4 5

5. A systematic review and meta-analysis of individual participant data on short-term psychodynamic psychotherapy for depression

Authors: Steinert, C., Munder, T., Rabung, S., Hoyer, J., Leichsenring, F.
Journal & Year: Psychotherapy Research, 2023
Study Type: Individual Participant Data Meta-analysis of 11 RCTs (n=771)
Summary of Findings on Efficacy:
- STPP resulted in significantly lower depressive symptom levels than control conditions (d = -0.62, p < 0.001)
- STPP was more efficacious for participants with longer rather than shorter current depressive episode durations
- Results support the evidence base of STPP for depression with episode duration as an effect modifier
- Demonstrates personalized treatment potential based on patient characteristics6

6. Short-term psychodynamic psychotherapy and cognitive-behavioral therapy in generalized anxiety disorder: A randomized, controlled trial

Authors: Leichsenring, F., Salzer, S., Jaeger, U., Kächele, H., Kreische, R., Leweke, F., Rüger, U., Winkelbach, C., Leibing, E.
Journal & Year: American Journal of Psychiatry, 2009
Study Type: Randomized Controlled Trial (n=57)
Summary of Findings on Efficacy:
- Both CBT and short-term psychodynamic psychotherapy yielded significant, large, and stable improvements in anxiety and depression symptoms
- No significant differences in outcome between treatments on primary outcome measures
- Both treatments demonstrated beneficial effects for patients with generalized anxiety disorder
- Effects were maintained at 6-month follow-up assessment7 8

7. Short-Term Psychodynamic Psychotherapy for Functional Somatic Disorders: A Meta-analysis of Randomized Controlled Trials

Authors: Abbass, A., Lumley, M.A., Town, J., Holmes, H., Luyten, P., Cooper, A., Russell, L., Schubiner, H., Kisely, S., Rask, M., Kleinstäuber, M., Malik, A., Drysdale, E., Lilliengren, P., Keefe, J.R.
Journal & Year: Psychotherapy and Psychosomatics, 2020
Study Type: Meta-analysis of 17 RCTs
Summary of Findings on Efficacy:
- STPP significantly outperformed minimal treatment/treatment-as-usual/waitlist controls on somatic symptoms at all time frames
- Large magnitude effect sizes at both short-term and long-term follow-ups
- 77.8% of studies reported reductions in healthcare utilization due to psychodynamic therapy
- Benefits persisted over time, supporting sustained treatment effects for functional somatic disorders9 10

"The Efficacy of Psychodynamic Psychotherapy" Shedler J.
.Am Psychol. 2010 Feb-Mar;65(2):98-109.

Excerpt:
"...With the caveats noted above, the available evidence indicates that effect sizes for psychodynamic psychotherapies
are as large as those reported for other treatments that have been actively promoted as “empirically supported”
and “evidence based.” It indicates that the (often unacknowledged) “active ingredients” of other therapies include techniques and processes that have long been core, centrally defining features of psychodynamic treatment.

Finally, the evidence indicates that the benefits of psychodynamic treatment are lasting and not just transitory,
and appear to extend well beyond symptom remission. For many people, psychodynamic psychotherapy may foster inner resources and capacities that allow richer, freer, and more fulfilling lives."

See full article below

(Source: Science Daily)
Psychotherapy Is Effective but Underutilized, Review Shows. Aug. 9, 2012 — Psychotherapy is effective, helps reduce the overall need for health services and produces long-term health improvements, according to a review of research studies conducted by the American Psychological Association.

Yet, the use of psychotherapy to treat people with mental and behavioral health issues decreased over the last decade while the use of medications to address such problems has increased, according to government and insurance industry data.

"Every day, consumers are bombarded with ads that tout drugs as the answer to their problems. Our goal is to help consumers weigh those messages with research-based information about how psychotherapy can provide them with safe, effective and long-lasting improvements in their mental and physical health," said Melba J. T. Vazquez, PhD, past president of the American Psychological Association who led the psychotherapy effectiveness review project.

As a result of the effectiveness review project, the Association's Council of Representatives last week adopted a resolution on psychotherapy effectiveness. The resolution cites more than 50 peer-reviewed studies on psychotherapy and its effectiveness in treating a spectrum of health issues and with a variety of populations, including children, members of minority groups and the elderly.

The resolution also states Key findings of the resolution:

• Research demonstrates that psychotherapy is effective for a variety of mental and behavioral health issues and across a spectrum of population groups. The average effects of psychotherapy are larger than the effects produced by many medical treatments.

• Large multi-site and meta-analytic studies have demonstrated that psychotherapy reduces disability, morbidity and mortality; improve work functioning; and decrease psychiatric hospitalization.

• Psychotherapy teaches patients life skills that last beyond the course of treatment. The results of psychotherapy tend to last longer than psychopharmacological treatments and rarely produce harmful side effects

• While medication is appropriate in some instances, research shows that a combination of medication and psychotherapy is often most effective in treating depression and anxiety. It should also be noted that the effects produced by psychotherapy, including those for different age groups and across a spectrum of mental and physical health disorders, are often comparable to or better than the effects produced by drug treatments for the same disorders without the potential for harmful side effects that drugs often carry.

"As Americans grapple with the ever-increasing cost of health care, it is important that consumers and those who make decisions about health care access understand the potential value in both improved outcomes and cost-saving of psychotherapies," Vasquez said. "APA applauds and continues to support collaboration of psychologists with other health care providers as part of integrated health care teams. Psychotherapies are highly effective, but only when consumers have access to them."

(Source: Science Daily)
Longer-duration Psychotherapy Appears More Beneficial For Treatment Of Complex Mental Disorders. Oct. 6, 2008 — Psychodynamic psychotherapy lasting for at least a year is effective and superior to shorter-term therapy for patients with complex mental disorders such as personality and chronic mental disorders, according to a meta-analysis published in the October 1 issue of JAMA

Evidence indicates that short-term psychodynamic psychotherapy is insufficient for a considerable proportion of patients with complex mental disorders, i.e., patients with multiple or chronic mental disorders or personality disorders. Some studies suggest that long-term psychodynamic psychotherapy (LTPP) may be helpful for these patients, according to background information in the article. LTPP is therapy in which emphasis is placed on more interpretive or supportive interventions, depending on the patient's needs, and that involves careful attention to the therapist-patient interaction.

Falk Leichsenring, D.Sc., of the University of Giessen, Germany, and Sven Rabung, Ph.D., of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany, conducted a meta-analysis to examine the effectiveness of LTPP (lasting for at least a year, or 50 sessions) and whether it is superior to shorter psychotherapeutic treatments for complex mental disorders, including personality disorders, chronic mental disorders (defined as lasting at least a year) and multiple mental disorders. The researchers identified and included 23 studies for the meta-analysis (11 randomized controlled trials and 12 observational studies), involving a total of 1,053 patients receiving LTPP.

The authors found: "In this meta-analysis, LTPP was significantly superior to shorter-term methods of psychotherapy with regard to overall outcome, target problems, and personality functioning. Long-term psychodynamic psychotherapy yielded large and stable effect sizes in the treatment of patients with personality disorders, multiple mental disorders, and chronic mental disorders. The effect sizes for overall outcome increased significantly between end of therapy and follow-up."

With regard to overall effectiveness, analysis indicated that after treatment with LTPP patients with complex mental disorders on average were better off than 96 percent of the patients in the comparison groups.

The authors add that further research should evaluate the cost-effectiveness of LTPP.

Editorial: Psychodynamic Psychotherapy and Research Evidence

In an accompanying editorial, Richard M. Glass, M.D., Deputy Editor, JAMA, and with the University of Chicago, comments on the findings regarding LTPP.

"… the meta-analysis by Leichsenring and Rabung in this issue of JAMA provides evidence about the effectiveness of long-term dynamic psychotherapy for patients with complex mental disorders who often do not respond adequately to short-term interventions. It is ironic and disturbing that this occurs at a time when provision of psychotherapy by psychiatrists in the United States is declining significantly. The reasons for this merit careful evaluation. To some extent this may reflect the cost-efficacy of treatments for some mental disorders with medications and brief supportive visits. However, this trend appears to be strongly related to financial incentives and other pressures to minimize costs. Is that what is really wanted for patients with disabling disorders that could respond to more intensive treatment?"

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