What if the antidepressant or templated talking treatment doesn't work??
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Jonathan Shedler, PhD, author of "The Efficacy of Psychodynamic Psychotherapy"( Shedler J.
.Am Psychol. 2010 Feb-Mar;65(2):98-109) wrote:
"...With the caveats noted above, the available evidence indicates that effect sizes for psychodynamic psychotherapies
are as large as those reported for other treatments that have been actively promoted as “empirically supported”
and “evidence based.” It indicates that the (often unacknowledged) “active ingredients” of other therapies include techniques and processes that have long been core, centrally defining features of psychodynamic treatment."
"Finally, the evidence indicates that the benefits of psychodynamic treatment are lasting and not just transitory,
and appear to extend well beyond symptom remission. For many people, psychodynamic psychotherapy may foster inner resources and capacities that allow richer, freer, and more fulfilling lives."
In his 5/14/16 SDPC presentation, Dr. Shedler noted that randomized, controlled studies have demonstrated the significant efficacy of psychotherapy.
The findings below could be used with patients and colleagues who ask whether psychodynamic psychotherapy has been scientifically- proven to be effective, especially since many point to the "gold standard" of "evidence-based" CBT.
Studies show the following effect sizes: [Note on Effect Size: .8 = large (8/10 of a standard deviation unit), .5 = moderate (1/2 of a standard deviation), .2 = small (1/5 of a standard deviation)]
Active placebo .17, Antidepressant meds .31, CBT .62 and .68, Psychodynamic psychotherapy .97
What does an effect size of .97 mean in more tangible terms?
Height: male - grow 1/2 foot taller, Weight: male: lose 70 pounds. female - lose 77 pounds, SAT test performance: gain 100 points, IQ: increase 15 points, Income increase: $34,000
Dr. Shedler noted that for psychodynamic psychotherapy, treatment effects grow after termination. With other treatments, the effect size decays over time.
At 9 months post-termination, the effect size for psychodynamic psychotherapy increases from .97 to 1.5 (for general symptoms)
Dr. Shedler also stated that "it is a myth that CBT takes [only] 12 weeks." In surveying therapists of all types, it was found that the duration of "meaningful therapy" is about one year, regardless of whether treatment is CBT or psychodynamic.