Psychotherapy: Three approaches evaluated NCBI Bookshelf

Conversely, lack of change in the mean value of a scale score may more rarely be accompanied by clinically beneficial changes in some patients or in a subgroup of patients. Expressing the magnitude of the effect obtained in the "average" subject in the study for people receiving the treatment or its comparator is close to the effect size and is necessary information in addition to the classical statistical tests. To respond to this request, INSERM convened an expert group in a collective expert evaluation procedure. The group consists of psychiatrists, psychologists, epidemiologists, and bio-statisticians. This expert group structured the analysis of the international literature around the following questions. In France, psychotherapies are generally recommended to patients by medical psychiatrists, psychologists, general practitioners, or other healthcare professionals, although spontaneous requests also occur.

  • The therapeutic project involves delineating the areas of competence and performance of the families and persons involved.
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  • This therapy includes individual marital and family functioning in terms of development and maturation processes, collusions and divergent contractual expectations, irrational role assignments, and maladapted relationship rules.
  • 30% of the patients treated with interpersonal psychodynamic psychotherapy no longer had the DSM diagnostic criteria for personality disorder after 1 year, whereas the patients from the control group had not changed.

Several controlled randomised trials have been conducted with dialectic behavioural therapy for borderline personality disorders in women from disadvantaged areas. This therapy involves an eclectic set of techniques based on the behavioural and cognitive principles. A reduction in suicidal and parasuicidal behaviour (35%) was found after 1 year in patients who received DBT compared to 65% linux networking interview questions in patients who received usual treatment . These studies also showed a decrease in pathological anger and days of hospital dmission and improved social adjustment in the group treated with DBT. It has been established for depressive disorders in hospitalised patients that cognitive-behavioural therapies combined with antidepressants have effects on depressive symptoms (1 meta-analysis).

The different techniques in the psychodynamic (psychoanalytical)

The psychodynamic therapies and cognitive-behavioural therapies appear to be effective at 7 months of follow-up for antisocial personality, when the people concerned are also depressed , and at 6 months of follow-up in certain personality disorders (1 meta-analysis and 1 controlled trial). One analysis demonstrated that the CBT approach was more effective than "verbal" therapies in various anxiety syndromes analysed together, and more effective than supportive therapy. One randomised control trial compared the psychodynamic approach to supportive therapy in a sample of patients suffering from various anxiety disorders and found no significant difference in efficacy. Work is now being done to examine the actual scientific proof of the effectiveness of couple and family therapies in major disorders and problems in adults (schizophrenia, mood disorders, drug addiction, etc.) and in children and adolescents (autism, anorexia, conduct disorders, etc.). Different types of "control group" are therefore found in trials, such as the "placebo attention" group, in which the patients have minimal contact with the therapist, who does not use the factors that are assumed to be active in the therapy in question. We also see, as a comparison group, the group of patients still on the waiting list, which only receives simple telephone contact for several months (this may raise ethical problems and often results in drop-outs to another therapy).

  • For panic disorder and agoraphobia, 3 meta-analyses have demonstrated a significant decline in symptoms in response to CBT compared to control conditions.
  • Another meta-analysis found that the CBT was equivalent or better than treatment with serotonin re-uptake inhibitors.
  • From its very origin and through the precise description of psychological effects and the formulation of hypotheses about the subconscious mechanisms underlying them, Freud was intending to integrate psychoanalysis into the scientific approach.
  • In the United States National Institute of Mental Health collaborative programme for the treatment of depression, two trials demonstrated that interpersonal therapy and CBT were effective in the management of depression, although it found no significant difference between these two approaches.
  • Traditional approach to analysis of change was based on assumption that change consists of series of quantum differences in functioning of individuals--looked at in terms of arbitrary measurement moments.

TechniqueDefinitionPsychoanalysisInvestigation method involving identification of subconscious significance of a person's words, actions, imaginary constraints . The method is based on the person's free associations, which guarantees the validity of the interpretation.Psychoanalytical therapyPsychotherapeutic method based on investigation involving identification of subconscious significance of a person's words, actions, or imaginary productions. Long-term psychotherapies can be distinguished from the brief or short-term psychotherapies . They may be centred on an event, or alternatively may be interpretative and centred on personality. The aim of treatment is to acquire insight or to obtain a change in personality, and the techniques used stress interpretation work and analysis of the transference. Focal psychotherapy identifies a central conflict present since childhood, reactivated during adult life and forming the origin of the problem.

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Market Cap is calculated by multiplying the number of shares outstanding by the stock's price. To calculate, start with total shares outstanding and subtract the number of restricted shares. Restricted stock typically is that issued to company insiders with limits on when it may be traded.Dividend YieldA company's dividend expressed as a percentage of its current stock price. Nevertheless, despite intensive interventions, the authors found a lack of progress in some children, whereas those who progressed most had the best cognitive competencies at the start. Studies that were dedicated to childhood autism, therefore, appear to confirm that autism does not represent a homogeneous group of diseases and/or handicaps and that there is a very wide range of responses between children and families to intensive therapeutic approaches.

  • These latter members must provide evidence of 4 years of training involving 200 hours per year and 4 years of family therapy practice.
  • Therapies for autism are based to a large extent on the operant behaviour and conditioning principle and on psychoeducational and behavioural approaches centred on cognitive and developmental acquisition of competencies .
  • Because these programmes usually include active participation of the parents, proof supporting the efficacy of CBT in these indications is reported in the context of family therapies.
  • In addition, the effects of psychotherapies are generally superior for CBT compared to non-CBT treatments and slightly superior for family or supportive therapies compared to psychodynamic treatments.
  • These therapies are offered to families facing the same problem (schizophrenia, eating disorders, mood disorders, etc.).

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Evaluation criteria for controlled therapeutic trials (from Foa and

The psychodynamic approach brings together practices ranging from traditional psychoanalysis to psychodynamic psychotherapies, both long and brief. The general underlying psychoanalytical theory to these psychotherapeutic practices is common to them all. Meta-analysis therefore involves combining the studies, coding the results, and calculating the amplitude or treatment effect size. For a given criterion that is being studied at the end of treatment, this represents the difference in mean values3 between the study group and its comparator group . The effect size therefore reflects the possible gain by the treatment group compared to the control group.


Two controlled trials on the treatment of anxiety disorders were found in the literature. Horowitz short psychodynamic psychotherapy (centred on resolution of intra-psyche conflicts as a result of a traumatic experience) was shown to be effective in patients with post-traumatic stress state compared to a control group. The effects were particularly large on traumatic, avoidance, and somatisation symptoms.

Description of the different types of therapies used in the family

The results demonstrated a considerable improvement in behavioural indicators, social adaptation, overall symptoms, and depression. No significant difference was found between group and individual psychodynamic therapies at the end best online stock brokers for all investors in 2021 of treatment and at 24 months of follow-up. For the personality disorders , the literature contains one meta-analysis conducted in 2003 that grouped 15 trials, two of which compared psychodynamic therapy to a control condition .

CBT has been used very widely in different anxiety disorders, and there are many results available from efficacy assessments of these therapies. For panic disorder and agoraphobia, 3 meta-analyses have demonstrated a significant decline in symptoms in response to CBT compared to control conditions. The most effective therapeutic combination appears to be a combination of in vivo exposure and antidepressants. 30% of the patients treated with interpersonal psychodynamic psychotherapy no longer had the DSM diagnostic criteria for personality disorder after 1 year, whereas the patients from the control group had not changed.

The aim of meta-analysis is essentially to solve the problem of discordant results by providing more detailed information about the magnitude of the effects. Starting from these points, the quality criteria for a meta-analysis can then be defined. Browse an unrivalled portfolio of real-time and historical market data and insights from worldwide sources and experts. Reuters, the news and media division of Thomson Reuters, is the world’s largest multimedia news provider, reaching billions of people worldwide every day. Reuters provides business, financial, national and international news to professionals via desktop terminals, the world's media organizations, industry events and directly to consumers. The Company is engaged in monitoring and analyzing the situation of the different areas of capital market.

In addition, one meta-analysis reported CBT to be superior after a follow-up period of 1 to 12 months, with no fall in the effect size that was obtained initially. Two meta-analyses that compared psychodynamic psychotherapy with CBT produced different results. One, which directly compared brief psychodynamic psychotherapy with CBT, found no significant difference, although CBT but not psychodynamic therapy leverage and margin was statistically different to no treatment. The other meta-analysis also found no significant difference between psychodynamic therapy and CBT, although both treatments were more effective than supportive therapy. For mild or moderate depressive disorders treated on an outpatient basis, cognitive therapies have been proven to be more effective than antidepressant treatments (2 meta-analyses).

However, the trials included in these meta-analyses were limited in number, mediocre in quality, and they used samples of patients recruited from the general population rather than those requesting care, and therefore people who were less severely affected. We can refer to the CBT as being of presumed efficacy in moderate depressive disorders in children and adolescents, although the CBT cannot currently be recommended as monotherapy in cases of severe depression in young people. Finally, one randomised controlled trial studied the results of brief psychodynamic interpersonal therapy at 6 months in adults after a self-poisoning suicide attempt. The results showed a reduction in depressive symptoms, suicidal ideation and relapse, and higher satisfaction.