Speaker:
Professor Jacques Barber, Professor of Psychology in Psychiatry, Centre for Psychotherapy Research, University of Pennsylvania, School of Medicine, USA

Professor Barbara Milrod, Associate Professor of Psychiatry, Weill Medical College of Cornell University, New York, USA

• Operationalising a modern, panic-focused dynamic treatment
• The design of our research studies
• What we have found so far, in terms of treatment outcomes and efficacy, and what we still want to find out
• Strengths and weaknesses of RCTs for studying psychotherapy efficacy

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Abstract

Some researchers and clinicians claim that dynamic therapy is not as efficacious as other forms of psychotherapy. This is especially thought to be the case when treating mood and anxiety disorders. In my portion of the talk, I will first evaluate this claim and discuss methodological issues having a potential bearing on this conclusion. I will then briefly review relevant literatures comparing the use of brief forms of dynamic therapy to other modalities that target these specific disorders. This will be followed by Professor Barbara Milrod’s presentation. Finally, I will review some of the strengths and limitations of RCTs as they pertain to psychotherapy research.

Session report by Jan McGregor Hepburn, BPC

The closing session, often the ‘graveyard’ slot, was very interesting ideed. PROFESSORS JACQUES BARBER & BARBARA MILROD spoke on the title ‘advances in evidence-based psychotherapies in the USA.’ Jacques Barber told us that he wished to examine the claims that psychodynamic therapies are not as efficacious as other forms of therapy, especially in the treatment of mood and anxiety disorders. This he did, and showed that indeed there is evidence that this treatment is at least as efficacious as other forms of therapy. He also pointed out that RCTs have many limitations.

He then handed over to Barbara Milrod, who spoke extremely well and showed evidence of a 12 week study on ‘operationalising a modern, panic-focused dynamic treatment’ She is a psychoanalyst, who drew up this programme, consulted with 12 other analysts, agreed the treatment was how they would think about and work with patients presenting with symptoms of panic, and got going. The method is focussed on the symptom and the work is largely transference based. Patients attend twice weekly, and the last third of the sessions has to focus on the ending process. She has proof, on a chart, that this works, just as well if not better, than the CBT equivalent, and I was thrilled! I was also struck, however, with the amount of training and expertise she has to be able to do this; it didn’t seem to me that this could be manualised.