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Few expressions stir the blood of most psychoanalytically oriented child therapists more than “evidence-based practice.” The term conjures images of private insurance gatekeepers questioning our methods, and of colleagues or administrators puzzled by our allegiance to an “unproven,” discredited practice. The challenge has sometimes made needed treatment harder to deliver, to be sure, but it has also stirred psychoanalytic therapists from a dangerous complacency. Even therapists who ground their work in the insights of the great psychoanalytic innovators and synthesizers, and who see little need for empirical support for what practical wisdom upholds every day in their work with patients, have come to understand that research into the process and efficacy of psychodynamic treatment is essential if psychoanalysis is going to maintain, and hopefully gain, in relevance and clinical currency. For some this is a purely practical awareness: psychoanalysis has to be able to talk persuasively to the world it inhabits, sometimes in the language of research, confident that what it already knows will be confirmed (and perhaps refined) by such interchange. For others, there is an assumption that in time psychoanalysis will be subsumed by a truer and more causally explanatory scientific understanding—a comprehensive explanation of the neuro-scientific underpinnings of human psychology, for example, for which psychoanalysis has been (for these hundred-odd years) but an interesting placeholder.
The past 20 years have seen a gradual but steadily increasing response from psychoanalytically oriented researchers. A cursory look at the available psychodynamic literature shows a multitude of studies (start with the research chapters in The Psychodynamic Diagnostic Manual, 2006), and multiple overviews of outcome research and efficacy studies (e.g., Leichsenring, 2005; Fonagy, 2002; Bucci, 2001; Sandell et al., 2000; Doidge, 1997; Shapiro & Emde, 1995). Nonetheless, though it is no longer