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Three interacting challenges are facing all aspects of health care in the United Kingdom: financial restraint in the context of a global economic downturn; a move to services being commissioned and decommissioned by primary care Clinical Commissioning Groups; and a need to provide evidence based practice through ‘payment by results’. Psychoanalytic psychotherapy faces more difficulty than most services in mental health, with long and frequent criticisms of it being expensive and under-researched; and it is not as well understood by GPs as cognitive behavioural therapy, with which it is frequently unfavourably compared. This review provides an overview of the existing evidence for psychoanalytic psychotherapy, identifying strengths and areas that are under
KAYLEIGH M. BROWN BA (Oxon) MSc is an Assistant Psychologist within South London and Maudsley NHS Foundation Trust, London. She works with adults with complex needs and histories of complex trauma, using mentalization and psychodynamic approaches. She has previously worked in forensic settings using CBT interventions, as a tutor for children with autistic spectrum disorders and as an assistant psychologist, working with adults with diagnoses of psychosis. Her research interests include homelessness and psychopharmacology and she has published research in this field. Address for correspondence: Cognition, Schizophrenia and Imaging Laboratory, Department of Psychosis Studies, the Institute of Psychiatry, King's College London, UK. []
DEREK K. TRACY MB BCh BAO MSc MRCPsych is a Consultant Psychiatrist at Oxleas NHS Foundation Trust, London. He runs a specialist MSc module in psychopharmacology at the Institute of Psychiatry and has published research in this field. His other research interests include fMRI in schizophrenia and grant-awarded work on repetitive Transcranial Magnetic Stimulation in the treatment of auditory hallucinations. As well as publishing on these topics, he has written chapters on neuroanatomy, neurophysiology and psychopharmacology for a forthcoming Oxford University Press textbook for trainee psychiatrists, a book chapter of neuropsychiatry, and is currently writing a commissioned book chapter on treatment resistance in schizophrenia.
explored. We also argue that psychoanalytic psychotherapy has a unique clinical role but this will need to be clearly stated in the future, and promoted by clinicians to encourage future commissioning in the UK.