Patient Characteristics in Psychodynamic Psychotherapies

In Germany, the health insurance system covers different forms of psychotherapeutic treatments, including treatments based on psychoanalytic and psychodynamic thinking. Although there are guidelines for selecting a specific psychodynamic approach for a certain individual, it is currently unclear whether these guidelines inform about the actual allocation of patients to psychodynamic treatments in practice. We investigated whether patients starting therapy in 4 types of psychodynamic approaches differ in sociodemographic and clinical characteristics. Data were derived from 386 cases of the DPG Practice Study, a naturalistic, long-term study that investigates effectiveness and sustainability of psychodynamic psychotherapies in Germany. Hereby, patients' self-reports, therapists' reports, and information from structured clinical interviews were considered. Patients in a treatment approach with longer duration and face-to-face setting were slightly more impaired in personality functioning. Apart from that, patients differed only in the degree of education. In analytical psychotherapies with couch setting, patients were more highly educated than in other treatments. We conclude that only few patient characteristics were empirically associated with specific psychodynamic treatment approaches. As possible reasons, we consider that the applied instruments in this study might not include relevant variables for selecting a specific kind of psychodynamic treatment (e.g., rigid defense mechanisms or capacity for introspection). Additionally, the agreement on a treatment is discussed as a dyadic process that is rather influenced by characteristics of the patient-therapist dyad than by characteristics of the patient per se.