Research in Dynamic Psychotherapy

The National Institute of Mental Health has been concerned about the imbalance between the orientation of psychotherapy largely practiced in this country, largely psychodynamic and its psychotherapy research portfolio, largely behavioral. This imbalance clearly reflects the greater ease in operationalizing behavioral concepts and the relative simplicity and brevity of behavioral treatments that make it easier to design and execute research projects. The special requirements of a relationship—dependent therapy such as dynamic psychotherapy or psychoanalysis are also inconsistent with the simple clinical trial research paradigm, loosely drawn from psychopharmacology, which is far more suitable for behavior therapy than for dynamic psychotherapy.

The Psychosocial Treatments Branch of NIMH held two conferences during 1982 and 1983 at which groups of experts in dynamic psychotherapy and research examined the feasibility of mounting a special research program on dynamic psychotherapy. The consensus was that such a research program would be possible but that methods would need to be developed to describe and measure the key variables in dynamic psychotherapy including transference, therapeutic alliance and resistance and to develop outcome measures related to interpersonal functioning. Patients for such research could not be defined by DSM III criteria alone but should have interpersonal or psychosomatic difficulties that particularly require this form of treatment. The work of skilled therapists, not beginners, should be studied.

A further recommendation by the panel of experts was that the research be focused on long-term as well as short-term and time-limited psycho-therapies and that programmatic support be offered for the development of research centers in dynamic psychotherapy. In such centers, the needed critical mass of researchers, therapists, and patients could be concentrated. In them new generations of psychotherapy researchers could also be trained.

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