Can we do psychoanalytic outcome research? A feasibility study

Despite the widespread use of long-term psychodynamic treatments, methodologically rigorous outcome studies have not been conducted. The authors describe the results of a feasibility study designed to (1) investigate whether patients in psychodynamic treatment, including psychoanalysis, could be recruited and retained as research subjects, (2) determine patient and therapist compliance with self-report measures, rater-administered structured interviews and session audiotaping and (3) obtain pilot data on changes in these measures after one year of treatment. Nine patients entering psychoanalysis and fifteen entering psychodynamic psychotherapy were studied at baseline, six months and one year. Major findings were as follows: (1) recruitment rates were 27% (psychoanalysis) and 83% (psychotherapy), (2) all patients who remained in treatment remained in the research protocol, (3) drop-out rates among research participants and non-participants were equivalent, (4) current Axis I (usually affective or anxiety) disorders were found in over 60% of patients, (5) Axis II disorders in the absence of current Axis I disorders were rare, (6) despite a small number (N) of participants, significant positive change was demonstrated on a variety of measures after one year. Results suggest that it is possible to demonstrate a therapeutic effect of psychodynamic treatments, including psychoanalysis, but changing negative clinical perceptions of research is necessary if methodologically rigorous outcome studies are to be possible in the future.