Psychodynamic psychotherapy: developing the evidence base

Psychodynamic psychotherapy has been belea­ guered in recent times. Accusations that it is based on outdated principles of psychoanalysis, that it lacks an empirical research base and that its emphasis on longer­term treatments by highly trained pro fessionals makes it less cost­ effective than other psychological treatments have contributed to the dismantling of psychodynamic psychotherapy services within the National Health Service (NHS) in favour of more ‘evidence­based’ interventions. Although the economic recession has been a challenge to all mental health services forced to make financial savings, reports suggest that psycho dynamic psycho therapy provision within the public health sector has been disproportionately reduced compared with other treatment modalities (British Psychoanalytic Council 2013). In this article I will outline recent develop ments in the field of psychodynamic psychotherapy research that go some way in refuting these criticisms. Contrary to the beliefs of some detractors of psychodynamic psychotherapy, there is now a convincing body of empirical evidence from well­designed outcome studies to support its efficacy. Moreover, process–outcome research linking specific psychodynamic interventions to therapeutic outcomes within a theoretical framework based on attachment has facilitated better understanding of the processes of change and enabled therapeutic technique to be adapted and refined, with the development of tailored psycho dynamic psychotherapies for specific conditions.