You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
I thank the discussants for their valuable insights and questions regarding the manualized psychodynamic treatments and studies addressed in this volume. Dr. Kächele raises a concern about the lack of questions the clinical researchers in this volume ask about manualized treatments. However, when it comes to psychoanalysts, it is more remarkable that these manuals and studies were completed than what questions are being asked. We can count on psychoanalysts to raise questions, although Dr. Kächele provides a useful reminder that we should think about how manuals and studies should be employed in the mental health community. His view that manualized treatments are now broadly accepted has not been consistent with the experience of many clinical researchers (Busch and Milrod, 2010).
Dr. Kächele raises the question of whether experience is of greater value than the actual techniques employed in specific manualized approaches and how to best transport manualized approaches to other mental health professionals. Our work with manualized approaches to panic and other anxiety disorders is of interest in this regard. Some experienced therapists were able to parlay their skills into a broader and more effective employment of the techniques in the manual. However, others encountered difficulties with these interventions, having trouble adjusting to the panic focus and increased activity involved in the manualized approach. Clinical observations suggest that the focus and activity levels are important factors in the rapid relief of symptoms found in panic focused psychodynamic psychotherapy (PFPP), although this has not been systematically assessed (Busch et al., 2009). Other problems and symptoms may respond better to a more traditional psychoanalytic stance.
The question of how to communicate manualized treatments to the mental health community has also been a consideration of the PFPP group. Videotaped treatments of PFPP have been of great value in teaching psychiatric residen