Psychodynamic Psychotherapy

Our rating
 2 smilies: This treatment is useful. It is supported by scientific evidence as effective, but the evidence is not as strong.

 

The rating system

  • 3 smiliesThese treatments are very useful. They are strongly supported as effective by scientific evidence.
  • 2 smiliesThese treatments are useful. They are supported by scientific evidence as effective, but the evidence is not as strong.
  • 1 smileyThese treatments are promising and may be useful. They have some evidence to support them, but more evidence is needed to be sure they work.
  • No smiley On the available evidence, these treatments do not seem to be effective.
  • Question markThese treatments have not been properly researched. It is not possible to say whether they are useful or not.
  • Exclamation MarkSafety or other concerns have been raised for the use of these treatments.

What is it?

Psychodynamic psychotherapy (or psychodynamic therapy) is a type of talking therapy done with the help of a trained therapist. During this therapy, the therapist and the client aim to identify the client's internal conflicts and how they may impact their feelings, behaviour and relationships. These conflicts are believed to stem from childhood experiences, and people are often unaware of them. Psychodynamic psychotherapy aims to uncover and explain these internal conflicts, in order to less their impact on everyday life.

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 client to gradually reveal emotional and behavioural issues which are causing them problems. Sometimes, these issues are linked to past events. One goal of therapy is to recognise these problematic past events, and move on from them so the client can live more in the present. By identifying and talking through problems, psychodynamic therapy aims to help the client understand themselves better, develop good coping skills, have better relationships with others and improve their self-esteem.

Is it effective?

There is some good scientific evidence on psychodynamic psychotherapy for the treatment of depression. Studies have shown that psychodynamic therapy is more effective than no treatment at reducing symptoms of depression, and is similarly effective to other psychological treatments such as cognitive behaviour therapy. Psychodynamic therapy can also be combined with antidepressant medication.

Are there any disadvantages?

Psychodynamic psychotherapy involves weekly sessions for many months. A session usually lasts around 45 minutes. This can be expensive, however in Australia Medicare provides rebates for visits to some therapists under the Better Access to Mental Health Care scheme. Psychodynamic therapy may also be covered by some private health insurance funds.

Where do you get it?

Psychodynamic psychotherapy is offered by some counsellors, psychologists and psychiatrists (see Psychologists and other therapists). To see a psychiatrist, you would need a referral from a GP.

Recommendation

Psychodynamic psychotherapy appears to be an effective treatment for depression.

Key references

  • Abbass AA, Kisely SR, Town JM, Leichsenring F, Driessen E, De Maat S, et al. Short‐term psychodynamic psychotherapies for common mental disorders. Cochrane Database of Systematic Reviews. 2014(7).
  • Driessen E, Cuijpers P, C.M. de Maat S, Abbass AA, de Jonghe F, J.M. Dekker J. The efficacy of short-term psychodynamic psychotherapy for depression: A meta-analysis. Clinical Psychology Review 2010; 30: 25–36.
  • Leichsenring F. Effectiveness of long-term psychodynamic psychotherapy: a meta-analysis. JAMA 2008; 300: 1551-1565.
  • Steinert C, Munder T, Rabung S, Hoyer J, Leichsenring F. Psychodynamic Therapy: As Efficacious as Other Empirically Supported Treatments? A Meta-Analysis Testing Equivalence of Outcomes. The American Journal of Psychiatry. 2017; 174(10): 943-53.

Last reviewed and updated: 1 November 2019