Psychodynamic Psychotherapy
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What is it?
Psychodynamic psychotherapy encompasses a range of different therapies which focus on understanding the unique internal dynamics within a person which impact on their feelings, behaviour and relationships. Dynamics may include conflicts within the self between different motivations and patterns of relating, which arise from early interactions with parent figures, for example. People are often unaware of these inner processes, and psychotherapy can assist in revealing and illuminating these.
How does it work?
Psychodynamic psychotherapy adopts the view that insight or self-knowledge is an essential condition for lasting recovery and change. A trusting, consistent relationship with the therapist allows the individual to gradually reveal the patterns in their emotional and behavioural reactions that are causing problems. The therapist helps the client to explore and understand these problems.
Is it effective?
Studies have shown that short-term psychodynamic therapy (7-40 sessions) works better than no treatment for depression. In general, the therapy produces similar improvements to other psychological treatments.
Studies of long term psychotherapy (more than 50 sessions) have focused on people with more complicated or long lasting problems. For example, there have been studies of the effectiveness of long term therapy for people suffering from both depression and personality or anxiety disorders. There is evidence that in such cases, long-term therapy is more helpful than short-term psychodynamic therapy.
Are there any disadvantages?
Psychodynamic psychotherapy will involve weekly sessions for many months. This can be expensive, however in Australia psychiatrists are covered by Medicare, and rebates are now provided for visits to clinical psychologists.
Where do you get it?
Psychodynamic psychotherapy is offered by some counsellors, clinical psychologists and psychiatrists. Counsellors and clinical psychologists are listed in the Yellow Pages. To see a psychiatrist, you would need a referral from a GP.
Recommendation
Psychodynamic psychotherapy is a helpful treatment for depression, but has not been as well researched as cognitive behaviour therapy.
Key references
Leichsenring F. Effectiveness of long-term psychodynamic psychotherapy: a meta-analysis. JAMA 2008; 300: 1551-1565.
Lewis AJ, Dennerstien M, Gibbs PM. Short-term psychodynamic psychotherapy: review of recent process and outcome studies. Australian and New Zealand Journal of Psychiatry 2008; 42: 445-455.