The effectiveness of psychodynamic therapy in an NHS psychotherapy service: outcomes for service-users with complex presentations

Rachel Hirschfeld, Scott Steen, Emily Dunn, Ayshah Hanif, Latoya Clarke

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Abstract

Complex and enduring mental health problems require greater treatment resources, usually in the form of multidisciplinary support, including providing psychological therapies. This paper reports on an NHS, tertiary-level specialist psychotherapy service offering Psychodynamic therapies with longer-term, exploratory transdiagnostic approaches to support complexity and sustained personality functioning. This paper adopts a naturalistic study design evaluating the effectiveness of Psychodynamic therapy using pre- and post-outcomes across a 10-year period. A total of n = 474 participants self-report pre- and post-outcome measures were used as the marker of effectiveness along with therapist assessments during intake and engagement. The findings showed that Psychodynamic therapy was effective in reducing psychological distress based on service-user self-report and therapist assessments. While intake scores varied by socio-demographic factors, the rate of change across most groups was similar. There were several limitations relating to data quality and completeness which reflect the naturalistic design. Despite the limits of a naturalistic design, this study provides evidence of support for the place of Psychodynamic therapies within NHS mental health care, catering to those with complex and enduring mental health problems.
Original languageEnglish
Article number2295437
Pages (from-to)1-21
Number of pages21
JournalPsychoanalytic Psychotherapy
DOIs
Publication statusPublished - 19 Feb 2024

Keywords

  • clinical practice
  • complex mental health problems
  • naturalistic study design
  • practice-based evidence
  • psychodynamic therapy

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