> Dr. Mittelman and all, > > Hello again. Despite my multitudinous faults and wicked, wicked ways, I don't > > disappear as quickly > as Dr. Mittelman > described in his last message. > > I have a different recollection of our previous exchanges. I believe that > they > eventually became friendly backchannel messages within which we basically > agreed > that a non-medical model (or psychopathological model) of psychoanalytic > practice > obviated any further discussion about the need for empirical outcome > research. > Thus, our discussions ended on a note of agreement. > > With respect to the meta-analytic research on therapy outcome, I believe > that I > made the following points: > > 1. The research you referred to was with psychodynamic NOT PSYCHOANALYTIC > treatment. At present, there is no reason to believe that the results of > the > former necessarily apply to the latter. > > 2. The psychodynamic approaches often used in current research are > psychodynamic > because their authors so label them. Luborsky's Core Conflict Relationship > Theme > therapy, called psychodynamic by Luborsky, which has been shown to be > quite > successful in rigorous empirical tests, does not involve interpretations > of the > unconscious and thus can just as easily be called cognitive psychotherapy. > This > form of psychotherapy is quite different from the psychodynamic therapy > which is > supposed to be a direct derivative of psychoanalysis. > > 3. A number of meta-analytic studies by Weitz and Weitz have shown that > outcome > studies carried out in actual service institutions (hospitals, clinics) > get far > lower effects sizes for behavioral change than studies done in academic > institutions (Universities and medical schools) NO MATTER WHAT THE TYPE OF > THERAPY. Weitz and Weitz have suggested that this may be because > psychotherapists > only adhere to the style of therapy they claim to be doing when they are > monitored or follow a written manual (a control done at Universities but > not in > clinics). See 4 below > > 4, My own research (done as part of a team), publised decades ago, investigated the actual > therapy > sessions of psychiatrists who were in training to be psychoanalysts (or > were > applicants, I don't remember for sure). They said they were doing > psychodynamic > therapy, which is what they had been instructed to do. We tape recorded > the > sessions, and our analyses of psychotherapist statements indicated that > they > mostly made supportive or Rogerian (reflecting feelings) statements rather > than > psychodynamic ones. > > Thus, I doubt if any definitive statements about psychodynamic therapy, > much less > psychoanalysis can yet be made. I also believe that this is substantially true > of all the "empirically supported" therapies. My quarrel with psychoanalysis is that almost no research is done. Psychoanalysts with rare exceptions, don't even try. > > In any case, how are you doing? > > Howard > >