AN OPEN DOOR REVIEW OF CLINICAL, CONCEPTUAL, PROCESS AND OUTCOME RESEARCH IN PSYCHOANALYSIS IV
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The Berlin Jungian Study: On the effectiveness and efficacy of outpatient(Jungian) psychoanalysis and psychotherapy -a catamnestic study
Keller W, Dilg R, Westhoff R, Rohner R & Studt HH (1997) Zur Wirksamkeit ambulanter jungianischer Psychoanalysen und Psychotherapien – eine katamnestische Studie. in: Leuzinger-Bohleber, M &
Stuhr, U (eds) Psychoanalysen im Rückblick-Methoden, Ergebnisse und Perspektiven. Psychosozial, Giessen, 432-453
The main objective of the study aimed at proving the effectiveness of long-term Jungian analyses lasting more than 100 sessions in the treatment practice and examining the stability of treatment results by a follow-up study 6 years after the end of therapy. The results show impressive improvements in both subjective and objective measures. There was a measurable improvement in health insurance claims and improvements on standardised measures of psychological distress (SCL¬90). The pre-treatment data are however not sufficiently reliable for subjective measures to permit comparison.
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The Boston Psychoanalytic Institute Study
Sashin, J., Eldred, S., & Van Amerowgen, S. T. (1975). A search for predictive factors in institute supervised cases: a retrospective study of 183 cases from 1959-1966 at the Boston Psychoanalytic Society and Institute. International Journal of Psycho-Analysis, 56, 343-359.
This was a study monitoring the outcome of significant number (N=130) of patients treated by trainee analysts under supervision. The patients were selected as good training cases and are therefore not necessarily representative of psychoanalytic cases in general. The large majority of patients were rated as improved although a significant minority terminated before the analyst indicated that this was appropriate. Spin off studies demonstrated that trainees used a variety of techniques and that some improvements were not maintained on follow-up.
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The Dührssen study
Dührssen, A. (1962) Katamnestische Ergebnisse bei 1004 Patienten nach analytischer Psychotherapie. Zeitschrift fuer Psychosomatrische Medizin 8, 94-113
Dührssen AM & Jorswieck E (1965) Eine empirisch-statistische Untersuchung zur Leistungsfähigkeit psychoanalytischer Behandlung. Nervenarzt 36: 166-169
Dührssen (1962) supported the inclusion of psychoanalytic oriented treatment of neurotic disturbance in insurance coverage in Germany by her pioneering analysis of the follow-up of 1,004 patients who had received analytic psychotherapy at the "Central Institute for Psychogenic Disorders" in Berlin, in which she showed the effectiveness and efficiency of the treatment (A. M. Dührssen & E. Jorswieck, 1965). All but 15% of patients showed improvement, the largest group showing very considerable improvement maintained at follow-up. A substantial reduction in insurance claims for physical problems was associated with psychoanalytic treatment in the 5 year period following therapy.
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The German Psychoanalytical Association Study: Longterm effects of psychoanalyses and psychoanalytic therapies -a representative follow-up study
Leuzinger-Bohleber M, Stuhr U, Rüger B & Beutel M (2003) How to study the quality of psychoanalytic treatments and their long term effects on patients well-being. A representative multiperspective follow-up study. International Journal of Psychoanalysis 84, 263-290
The major aim of the project is to study retrospectively patients’ views of their psychoanalytic experiences and the effects of psychoanalytic treatment at least four years after the end of psychoanalysis or long-term psychoanalytic treatment. Do the subjective views of the former patients correspond to those of their former analysts, to those of independent observers and to the results of tests and questionnaires used in psychotherapy-research? The study approached all members from the German Psychoanalytic Association (DPV) to ask their readiness to participate in a follow-up study. 91% of the therapists approached responded. A great majority (89%) was in favour of the study. 401 of the 453 patients in long term psychoanalytic treatment who finished their treatments with DPV members between January 1990 and December 1993 and who were contacted by their analysts about the study agreed to participate. The samples formed have been demonstrated to be representative. The study has assessed 194 former patients by two long psychoanalytic follow-up interviews and 154 patients by standardised questionnaires. Data were analysed using both qualitative and quantitative methods.
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The Oslo I Study: Schjeldrup (1955): An early proponent of combined questionnaire and personal follow-up interview
Schjeldrup, H. (1955). Lasting effects of psychoanalytic treatments. Psychiatry, 18, 109-133
Schjelderup, a psychoanalyst, treated 28 cases between 1926 until 1943. After the war a questionnaire was sent to his patients; after the questionnaire had been returned an open personal interview was administered "in which the answers were discussed in great detail and necessary additional information ...was obtained".
In nine of these cases the follow-up shows a lasting symptomatic cure, and in an additional 14 a substantial improvement was noted. The most frequent lasting personality changes found were changes in interpersonal relationships (25 cases) and in the capacity for work and the enjoyment of work (22 cases). Changes in capacity for sexual adjustment and in a more realistic perception of reality were also quite common. The results obtained by this early empiricist have been replicated by more recent and systematic investigators.
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The Stuttgart Psychotherapeutic Hospital Follow-Up Study
Teufel, R., & Volk, W. (1988). Erfolg und Indikation stationärer psychotherapeutischer Langzeittherapie. In W. Ehlers, H. C. Traue, & D. Czogalik (Eds.), Bio-psycho-soziale Medizin (pp. 331-346). Berlin: Springer-PSZ.Drucke.
The Stuttgart Psychotherapeutic Hospital is an exclusively psychoanalytically oriented inpatient treatment facility which since 1967 has had 102 beds and has treated about 300 patients per year. A planned follow-up study of 248 patients identified 147 patients who could be interviewed 3.9 years
after termination of treatment. Four dimension of outcome were evaluated: (a) attainment of treatment goals, (b) symptom reduction, (c) general well-being and (d) capacity for work. The results indicated that capacity for work and the attainment of treatment goals defined in the opening phase of treatment showed the greatest change. General well being and symptom reduction showed more modest improvements. Importantly, the study was carried out at a time when pharmacological treatments were less readily offered on an adjunctive basis.
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