| 1. |
- Mechler, Jakob, et al.
(author)
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Therapist-guided internet-based psychodynamic therapy versus cognitive behavioural therapy for adolescent depression in Sweden : a randomised, clinical, non-inferiority trial
- 2022
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In: The Lancet Digital Health. - : Elsevier. - 2589-7500. ; 4:8, s. E594-E603
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Journal article (peer-reviewed)abstract
- Background Adolescent major depressive disorder (MDD) is highly prevalent and associated with lifelong adversity. Evidence-based treatments exist, but accessible treatment alternatives are needed. We aimed to compare internet-based psychodynamic therapy (IPDT) with an established evidence-based treatment (internet-based cognitive behavioural therapy [ICBT]) for the treatment of adolescents with depression. Methods In this randomised, clinical trial, we tested whether IPDT was non-inferior to ICBT in the treatment of adolescent MDD. Eligible participants were 15-19 years old, presenting with a primary diagnosis of MDD according to DSM-5. Participants were recruited nationwide in Sweden through advertisements on social media, as well as contacts with junior and senior high schools, youth associations, social workers, and health-care providers. Adolescents who scored 9 or higher on the Quick Inventory of Depressive Symptomatology for Adolescents (QIDS-A17-SR) in an initial online screening were contacted by telephone for a diagnostic assessment using the Mini International Neuropsychiatric Interview. Participants were randomly assigned to ICBT or IPDT. Both interventions comprised eight self-help modules delivered over 10 weeks on a secure online platform. The primary outcome was change in depression severity measured weekly by the QIDS-A17-SR. Primary analyses were based on an intention -to-treat sample including all participants randomly assigned. A non-inferiority margin of Cohen's d=0.30 was predefined. The study is registered at ISRCTN, ISRCTN12552584. Findings Between Aug 19, 2019, and Oct 7, 2020, 996 young people completed screening; 516 (52%) were contacted for a diagnostic interview. 272 participants were eligible and randomly assigned to ICBT (n=136) or IPDT (n=136). In the ICBT group, 51 (38%) of 136 participants were classified as remitted, and 54 (40%) of 136 participants were classified as remitted in the IPDT group. Within-group effects were large (ICBT: within-group d=1.75, 95% CI 1.49 to 2.01; IPDT: within-group d=1.93, 1.67 to 2.20; both p<0.0001). No statistically significant treatment difference was found in the intention-to-treat analysis. Non-inferiority for IPDT was shown for the estimated change in depression during treatment (d=-0.18, 90% CI -0.49 to 0.13; p=0.34). All secondary outcomes showed non-significant between-group differences. Interpretation IPDT was non-inferior to ICBT in terms of change in depression for the treatment of adolescents with MDD. This finding increases the range of accessible and effective treatment alternatives for adolescents with depression. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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| 2. |
- Aafjes-van Doorn, Katie, et al.
(author)
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Patients’ Affective Processes Within Initial Experiential Dynamic Therapy Sessions
- 2017
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In: Psychotherapy. - : American Psychological Association (APA). - 0033-3204 .- 1939-1536. ; 54:2, s. 175-183
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Journal article (peer-reviewed)abstract
- Research has indicated that patients’ in-session experience of previously avoided affects may be important for effective psychotherapy. The aim of this study was to investigate patients’ in-session levels of affect experiencing in relation to their corresponding levels of insight, motivation, and inhibitory affects in initial Experiential Dynamic Therapy (EDT) sessions. Four hundred sixty-six 10-min video segments from 31 initial sessions were rated using the Achievement of Therapeutic Objectives Scale. A series of multilevel growth models, controlling for between-therapist variability, were estimated to predict patients’ adaptive affect experiencing (Activating Affects) across session segments. In line with our expectations, higher within-person levels of Insight and Motivation related to higher levels of Activating Affects per segment. Contrary to expectations, however, lower levels of Inhibition were not associated with higher levels of Activating Affects. Further, using a time-lagged model, we did not find that the levels of Insight, Motivation, or Inhibition during one session segment predicted Activating Affects in the next, possibly indicating that 10-min segments may be suboptimal for testing temporal relationships in affective processes. Our results suggest that, to intensify patients’ immediate affect experiencing in initial EDT sessions, therapists should focus on increasing insight into defensive patterns and, in particular, motivation to give them up. Future research should examine the impact of specific inhibitory affects more closely, as well as between-therapist variability in patients’ in-session adaptive affect experiencing.
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| 3. |
- Abbass, Allan, et al.
(author)
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On Paolo Migione's "What Does Brief Mean?"
- 2014
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In: Journal of the American Psychoanalytic Association. - : SAGE Publications. - 0003-0651 .- 1941-2460. ; 62:5, s. NP18-NP22
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Journal article (other academic/artistic)
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| 4. |
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| 5. |
- Andersson, Christina, et al.
(author)
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Benevolence - Associations With Stress, Mental Health, and Self-Compassion at the Workplace
- 2021
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In: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 12
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Journal article (peer-reviewed)abstract
- Objective: Benevolence is an emerging concept in motivation theory and research as well as in on pro-social behavior, which has stimulated increasing interest in studying factors that impair or facilitate benevolence and effects thereof. This exploratory study examines the associations between benevolence, stress, mental health, self-compassion, and satisfaction with life in two workplace samples.Methods: In the first study n = 522 (38% = female, median age = 42) participants answered questionnaires regarding self-reported stress symptoms (i.e., emotional exhaustion), depressive symptoms and benevolence. In the second study n = 49 (female = 96%) participants answered questionnaires regarding perceived stress, self-compassion, anxiety, depression symptoms, and benevolence.Results: In study 1, measures of emotional exhaustion (r = −0.295) and depression (r = −0.190) were significantly negatively correlated with benevolence. In study 2, benevolence was significantly negatively correlated with stress (r = −0.392) and depression (r = −0.310), whereas self-compassion (0.401) was significantly positively correlated with benevolence. While correlations were in expected directions, benevolence was not significantly associated with Satisfaction with Life (r = 0.148) or anxiety (r = −0.199) in study 2.Conclusion: Self-assessed benevolence is associated with levels of perceived stress, exhaustion, depression, and self-compassion. Future studies are warranted on how benevolence is related to stress and mental ill health such as depression and anxiety, and if benevolence can be trained in order to decrease stress and mental ill health such as depression and anxiety in workplace settings.
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| 6. |
- Andersson, Christina, et al.
(author)
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Cultivating Compassion and Reducing Stress and Mental Ill-Health in Employees : A Randomized Controlled Study
- 2022
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In: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 12
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Journal article (peer-reviewed)abstract
- Stress and mental ill-health carry considerable costs for both individuals and organizations. Although interventions targeting compassion and self-compassion have been shown to reduce stress and benefit mental health, related research in organizational settings is limited. We investigated the effects of a 6-week psychological intervention utilizing compassion training on stress, mental health, and self-compassion. Forty-nine employees of two organizations were randomly assigned to either the intervention (n = 25) or a physical exercise control condition (n = 24). Multilevel growth models showed that stress (p = 0.04) and mental ill-health (p = 0.02) decreased over 3 months in both groups (pre-intervention to follow-up: Cohen’s d = −0.46 and d = 0.33, respectively), while self-compassion only increased in the intervention group (p = 0.03, between group d = 0.53). There were no significant effects on life satisfaction in any of the groups (p > 0.53). The findings show promising results regarding the ability of compassion training within organizations to decrease stress and mental ill-health and increase self-compassion.
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| 7. |
- Andersson, Christina, et al.
(author)
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The effectiveness of smartphone compassion training on stress among Swedish university students : A pilot randomized trial
- 2021
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In: Journal of Clinical Psychology. - : John Wiley & Sons. - 0021-9762 .- 1097-4679. ; 77:4, s. 927-945
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Journal article (peer-reviewed)abstract
- Objective: To investigate the effects of a 6-week smartphone compassion training intervention on mental health.Method: Fifty-seven Swedish university students (mean age = 25, SD = 5) reporting high levels of stress were randomized to compassion training (n = 23), mindfulness (n = 19), or waitlist (n = 15).Result: Multilevel models indicated that both compassion and mindfulness training increased self-compassion compared to the waitlist, while only compassion significantly reduced stress. Between-group effect sizes for compassion compared to waitlist were large for both self-compassion (d = 1.61) and stress (d = 0.94). Compassion and mindfulness did not differ significantly, but effect sizes were in favor of compassion. Secondary outcomes indicated positive effects on emotional awareness, while no effect was found for global psychological distress.Conclusions: Our results suggest that compassion training via a smartphone application can improve self-compassion and reduce stress among university students. Future studies in larger clinical samples are warranted.
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| 8. |
- Johansson, Robert, et al.
(author)
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Allt starkare forskningsstöd för Intensive Short-Term Dynamic Psychotherapy
- 2015
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In: Psykologtidningen. - 0280-9702. ; :6, s. 28-31
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Research review (other academic/artistic)abstract
- Intensive Short-term Dynamic Psychotherapy, ISTDP, har god effekt för en bred patientgrupp. Men det finns behov av fler RCT-studier av hög kvalitet och vid fler diagnoser. Här ger psykologerna och forskarna Robert Johansson och Peter Lilliengren en beskrivning av ISTDP och redovisar det nuvarande forskningsläget på området.
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| 9. |
- Lilliengren, Peter, 1972-
(author)
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A comprehensive overview of randomized controlled trials of psychodynamic psychotherapies
- 2023
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In: Psychoanalytic Psychotherapy. - : Taylor & Francis Group. - 0266-8734 .- 1474-9734. ; 37:2, s. 117-140
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Journal article (peer-reviewed)abstract
- Randomized Controlled Trials (RCTs) are currently considered ‘gold standard’ for evaluating psychosocial interventions, including psychodynamic psychotherapies (PDTs). The aim of this review is to summarize all available RCTs involving PDTs. A thorough search yielded 298 studies published between 1967 and 2022. The number of studies has increased over time with 123 (41.2%) published in the last 10 years. Most studies have been conducted in western countries, evaluating PDTs of brief duration (<40 sessions) for adults with mood (k = 67, 22.5%), psychosomatic (k = 38, 12.8%), anxiety (k = 35, 11.7%), or personality disorders (k = 29, 9.7%). The studies have utilized comparative (k = 233, 78.2%), additive (k = 33, 11.1%), parametric (k = 30, 10.1%) and dismantling designs (k = 2, 0.7%) and includes a total of 374 comparisons. Categorization of outcomes suggests that PDTs typically outperforms inactive controls, while comparisons with active treatments, inclugding Cognitive-Behavior Therapy (CBT), typically indicate no statistical difference. While the evidence-base for PDTs is growing, there are still major limitations and many research questions yet to be addressed. There is a pressing need for disseminating the existing research for PDTs to policy makers and the general public, as well as integrating findings in psychodynamic training curriculums.
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| 10. |
- Lilliengren, Peter, 1972-, et al.
(author)
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Clinical- and cost-effectiveness of intensive short-term dynamic psychotherapy for chronic pain in a tertiary psychotherapy service
- 2020
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In: Australasian Psychiatry. - : SAGE Publications. - 1039-8562 .- 1440-1665. ; 28:4, s. 414-417
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The objective of this study is to assess the clinical- and cost-effectiveness of intensive short-term dynamic psychotherapy (ISTDP) for patients with chronic pain.METHOD: A sample of 228 pain patients was drawn from a larger naturalistic study of ISTDP. They received an average of 6.1 sessions delivered by 31 therapists. Psychiatric symptoms and interpersonal problems were assessed at three time points. Healthcare data from baseline year and three years following treatment came from independent governmental databases.RESULTS: Multilevel models indicated significant reductions in symptoms and interpersonal problems during treatment, including a moderate to large pre-post effect size (d = 0.76) for somatization. Further, the sample had successive reductions in yearly healthcare costs, reaching the normal population mean two years post-treatment.CONCLUSION: Within the limitations of the uncontrolled design, our study suggests that ISTDP may be both clinically effective and cost-effective for patients with chronic pain.
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| 11. |
- Lilliengren, Peter, 1972-, et al.
(author)
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Efficacy of Experiential Dynamic Therapy for Psychiatric Conditions : a Meta-Analysis of Randomized Controlled Trials
- 2016
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In: Psychotherapy. - : American Psychological Association (APA). - 0033-3204 .- 1939-1536. ; 53:1, s. 90-104
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Journal article (peer-reviewed)abstract
- Experiential dynamic therapy (EDT) is a subgroup of short-term psychodynamic psychotherapy (STPP) that emphasizes patients’ in-session affective processing. To evaluate the efficacy of EDT for psychiatric conditions, we conducted a meta-analysis of randomized controlled trials. Twenty-eight studies published between 1978 and 2014 were included, encompassing 1,782 adult patients with mood, anxiety, personality, or mixed disorders. Across targeted outcome domains, medium-size between-groups effects (Cohen’s ds ranging from 0.39 to 0.65) favored EDT over inactive controls at posttreatment and in symptom measures at follow-up. We found no differences between EDT and active treatments (e.g., medication, cognitive–behavioral therapy, manualized supportive therapy) at posttreatment, but EDT outperformed supportive therapy at follow-up (d = 0.75). In terms of within-group effect sizes, EDT was associated with large improvements in general psychiatric symptoms (d = 1.11), depression (d = 1.33), and anxiety (d = 1.09) and with small to moderate gains in the areas of interpersonal problems (d = 0.55) and global functioning (d = 0.86). Small but significant effects suggested continued improvement between posttreatment and follow-up. Heterogeneity in pre–post effects was explored in subgroup analyses, which indicated that EDT might be most effective in depressive disorders and that individual EDT had larger effects compared with group treatment. In addition, EDT performed better in higher quality studies. We conclude that EDT is a promising treatment for psychiatric conditions in adults. Further high-quality studies evaluating contemporary versions of EDT in specific psychiatric conditions are warranted.
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| 12. |
- Lilliengren, Peter, 1972-
(author)
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Exploring therapeutic action in psychoanalytic psychotherapy : Attachment to therapist and change
- 2014
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis was to explore therapeutic action in psychoanalytic psychotherapy from different perspectives (patient, therapist, observer), using different methodological approaches (qualitative and quantitative). Study I explores patients’ views of therapeutic action with grounded theory methodology. The results indicated that talking openly in a safe therapeutic relationship led to new relational experiences and expanding self-awareness. Hindering factors included difficulties “opening up” and experiencing something missing in treatment. Study II investigates experienced therapists’ views of therapeutic action. The development of a close and trusting relationship was perceived as the core curative factor. Patients’ fear of closeness hindered treatment from the therapists’ perspective. Study III involves the development and psychometric examination of a new rating scale for patient-therapist attachment (Patient Attachment to Therapist Rating Scale; PAT-RS). Inter-rater reliability was good for three of the subscales (Security, Deactivation, Disorganization), but poor for one (Hyperactivation). Patterns of correlations with other measures suggest construct validity for the reliable subscales. Study IV examines the relationships between secure attachment to therapist, alliance, and outcome. Linear mixed-effects models, controlling for therapist effects, treatment length and patient-rated alliance, indicated that secure attachment to therapist relates to outcome. Further, the unique variance associated with secure attachment to therapist predicted continued gains in functioning during follow-up. The results of this thesis suggest that the development of a secure attachment to the therapist is a central mechanism of therapeutic change. The results are discussed in relation to established notions of therapeutic action in psychoanalytic psychotherapy. Two tentative process models that may be useful for clinical practice and future research are proposed.
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| 13. |
- Lilliengren, Peter, 1972-, et al.
(author)
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Intensive Short-Term Dynamic Psychotherapy for generalized anxiety disorder : A pilot effectiveness and process-outcome study
- 2017
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In: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 24:6, s. 1313-1321
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Journal article (peer-reviewed)abstract
- The objective of this study was to evaluate the clinical- and cost-effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) for generalized anxiety disorder (GAD). We further aimed to examine if a key clinical process within the ISTDP framework, termed the level of mobilization of unprocessed complex emotions (MUCE), was related to outcome. The sample consisted of 215 adult patients (60.9% female) with GAD and comorbid conditions treated in a tertiary mental health outpatient setting. The patients were provided an average of 8.3 sessions of ISTDP delivered by 38 therapists. The level of MUCE in treatment was assessed from videotaped sessions by a rater blind to treatment outcome. Year-by-year healthcare costs were derived independently from government databases. Multilevel growth models indicated significant decreases in psychiatric symptoms and interpersonal problems during treatment. These gains were corroborated by reductions in healthcare costs that continued for 4years post-treatment reaching normal population means. Further, we found that the in-treatment level of MUCE was associated with larger treatment effects, underlining the significance of emotional experiencing and processing in the treatment of GAD. We conclude that ISTDP appears to reduce symptoms and costs associated with GAD and that the ISTDP framework may be useful for understanding key therapeutic processes in this challenging clinical population. Controlled studies of ISTDP for GAD are warranted.
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| 14. |
- Lindqvist, Karin, et al.
(author)
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Affect-Focused Psychodynamic Internet-Based Therapy for Adolescent Depression : Randomized Controlled Trial
- 2020
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In: Journal of Medical Internet Research. - Toronto, ON, Canada : JMIR Publications Inc.. - 1438-8871. ; 22:3
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Journal article (peer-reviewed)abstract
- Background: Adolescent depression is one of the largest health issues in the world and there is a pressing need for effective and accessible treatments.Objective: This trial examines whether affect-focused internet-based psychodynamic therapy (IPDT) with therapist support is more effective than an internet-based supportive control condition on reducing depression in adolescents.Methods: The trial included 76 adolescents (61/76, 80% female; mean age 16.6 years), self-referred via an open access website and fulfilling criteria for major depressive disorder. Adolescents were randomized to 8 weeks of IPDT (38/76, 50%) or supportive control (38/76, 50%). The primary outcome was self-reported depressive symptoms, measured with the Quick Inventory of Depressive Symptomatology for Adolescents (QIDS-A17-SR). Secondary outcomes were anxiety severity, emotion regulation, self-compassion, and an additional depression measure. Assessments were made at baseline, postassessment, and at 6 months follow-up, in addition to weekly assessments of the primary outcome measure as well as emotion regulation during treatment.Results: IPDT was significantly more effective than the control condition in reducing depression (d=0.82, P=.01), the result of which was corroborated by the second depression measure (d=0.80, P<.001). IPDT was also significantly more effective in reducing anxiety (d=0.78, P<.001) and increasing emotion regulation (d=0.97, P<.001) and self-compassion (d=0.65, P=.003). Significantly more patients in the IPDT group compared to the control group met criteria for response (56% vs 21%, respectively) and remission (35% vs 8%, respectively). Results on depression and anxiety symptoms were stable at 6 months follow-up. On average, participants completed 5.8 (SD 2.4) of the 8 modules.Conclusions: IPDT may be an effective intervention to reduce adolescent depression. Further research is needed, including comparisons with other treatments.Trial Registration: International Standard Randomised Controlled Trial Number (ISRCTN) 16206254; http://www.isrctn.com/ISRCTN16206254
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| 15. |
- Maroti, Daniel, et al.
(author)
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Internet-Administered Emotional Awareness and Expression Therapy for Somatic Symptom Disorder With Centralized Symptoms : A Preliminary Efficacy Trial
- 2021
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In: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 12
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Journal article (peer-reviewed)abstract
- Background: There is growing evidence that trauma, psychosocial conflict, and difficulties with emotional processing contribute to centralized somatic symptoms. Emotional Awareness and Expression Therapy (EAET) was developed to address these factors and reduce symptoms, and EAET has shown efficacy in face-to-face formats. No trial of an internet-delivered EAET (I-EAET) exists, however, so we developed such an intervention and conducted an uncontrolled feasibility and potential efficacy trial of I-EAET for patients with Somatic Symptom Disorder (SSD) with centralized symptoms (SSD-CS).Method: After screening potential participants, a sample of 52 patients (50 women, two men; age M = 49.6, SD = 11.9) diagnosed with SSD-CS initiated treatment. I-EAET consisted of nine weekly modules focused on psychoeducation, emotional awareness and exposure, and anxiety regulation with self-compassion. Therapists communicated with each patient by email for about 20 min per week during treatment, answering questions and giving feedback on homework assignments. Patients completed measures of somatic symptoms, depression, anxiety, trauma-related symptoms, and functional disability before treatment and again at post-treatment and 4-month follow-up.Results: A large reduction in somatic symptoms (PHQ-15) occurred pre-to post-treatment (d = 1.13; 95% CI: 0.84-1.47) which was fully maintained at 4-month follow-up (d = 1.19; 95% CI: 0.88-1.56). Twenty-three percent of the patients at post-treatment and 27% at follow-up achieved a 50% or greater reduction in somatic symptoms, and about 70% achieved a minimally important clinical difference. In addition, at post-treatment, there were small to medium reductions (d's from 0.33 to 0.72) in anxiety (GAD-7), depression (PHQ-9), trauma-related symptoms (PCL-5), and functional disability (Sheehan Disability Scale). For all of these secondary outcomes, improvements were slightly to substantially larger at follow-up than at post-treatment (d's from 0.46 to 0.80).Conclusion: I-EAET appears to be a feasible treatment for adults with SSD and centralized symptoms, resulting in substantial and durable improvement not only in somatic symptoms but in other psychiatric symptoms and functioning. Controlled trials are needed determine the effects of I-EAET specifically and how this approach compares to face-to-face EAET and to other internet-delivered treatments, such as cognitive-behavioral interventions. Research should also identify treatment responders and mechanisms of change in EAET.
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| 16. |
- Maroti, Daniel, et al.
(author)
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Internet-based emotional awareness and expression therapy for somatic symptom disorder : A randomized controlled trial
- 2022
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In: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 163
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Journal article (peer-reviewed)abstract
- Objective: Somatic symptom disorder (SSD) is commonly encountered in health care settings. Cognitive-behavioural treatments have been most extensively studied, but they tend to have small effects of temporary duration. Emotional awareness and expression therapy (EAET) is a newly developed treatment for SSD, targeting emotional processing of trauma and conflict as a mechanism of symptom change. In an earlier uncontrolled study of self-guided, internet-administrated EAET (I-EAET), we found substantial reductions in somatic symptoms, prompting the need for a randomized controlled trial of I-EAET.Methods: We conducted a 2-arm RCT, comparing 10-week I-EAET (n = 37) to a waitlist control (WL; n = 37). Primary outcomes were reductions of somatic symptoms (PHQ-15) and pain intensity (BPI-4) at post-treatment, with a 4-month evaluation of effect duration. We also analysed emotional processing (EPS-25) and depression (PHQ-9) as possible mediators of I-EAET's effects.Results: Compared to controls, I-EAET significantly reduced somatic symptoms at both post-treatment and follow-up. I-EAET also reduced pain, depression, insomnia, and anxiety at post-treatment, but these effects were not retained at follow-up. As hypothesized, a facet of emotional processing partially mediated the treatment effect on somatic symptoms, even when controlling for depression.Conclusions: Although treatment effects were smaller than in the previous uncontrolled trial, I-EAET is a promising treatment for SSD, with a minority of patients (around 20%) experiencing substantial clinical improvement. The benefits of I-EAET are partially mediated by improved emotional processing. Future research should identify and target patients who respond best to I-EAET and develop tailored treatment to enhance treatment effects.
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| 17. |
- Mechler, Jakob, et al.
(author)
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Internet-based psychodynamic versus cognitive behaviour therapy for adolescents with depression : study protocol for a non-inferiority randomized controlled trial (the ERiCA study)
- 2020
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In: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 21:1
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Journal article (peer-reviewed)abstract
- Background: Adolescent depression is a common mental health problem and there is an urgent need for effective and accessible treatments. Internet-based interventions solve many obstacles for seeking and receiving treatment, thus increasing access to effective treatments. Internet-based cognitive behavioural therapy (ICBT) for adolescent depression has demonstrated efficacy in previous trials. In order to broaden the range of evidence-based treatments for young people, we evaluated a newly developed affect-focused Internet-based psychodynamic treatment (IPDT) in a previous study with promising results. The purpose of the planned study is to evaluate the efficacy of IPDT for adolescent depression in a non-inferiority trial, comparing it to ICBT.Methods: The study will employ a parallel randomized non-inferiority design (ratio 1:1; n = 270). Eligible participants are adolescents 15–19 years suffering from depression. The primary hypothesis is that IPDT will be non-inferior to ICBT in reducing depressive symptoms from pre-treatment to end of treatment. Secondary research questions include comparing outcomes of IPDT and ICBT regarding anxiety symptoms, emotion regulation and self-compassion. Additional data will be collected to evaluate cost-effectiveness as well as investigating predictors, moderators and mediators of outcome. In addition, we will examine long-term outcome up to 1 year after end of treatment. Diagnostic interviews with MINI 7.0 will be used to establish primary diagnosis of depression as well as ruling out any exclusion criteria. Both treatments consist of eight modules over 10 weeks, complemented with therapist support through text messages and weekly chat sessions. Primary outcome measure is the Quick Inventory of Depressive Symptomatology in Adolescents Self-Rated (QIDS-A17-SR). Primary outcome will be analysed using data from all participants entering the study using a multilevel growth curve strategy based on the weekly measurements of QIDS-A17-SR. The non-inferiority margin is defined as d = 0.30.Discussion: This trial will demonstrate whether IPDT is non-inferior to ICBT in the treatment of adolescent depression. The study might therefore broaden the range of evidence-based treatment alternatives for young people struggling with depression. Further analyses of data from this trial may increase our knowledge about “what works for whom” and the pathways of change for two distinct types of interventions.Trial registration: ISRCTN12552584, Registered on 13 August 2019.
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| 18. |
- Mechler, Jakob, et al.
(author)
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Internet-Delivered Affect-Focused Psychodynamic Therapy for Adolescent Depression : Treatment Principles and Clinical Application in the ERiCA Project
- 2024
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In: Journal of Infant, Child, and Adolescent Psychotherapy. - : Taylor & Francis Group. - 1528-9168 .- 1940-9214. ; , s. 1-19
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Journal article (peer-reviewed)abstract
- Internet-delivered, therapist-guided, self-help programs are novel ways to deliver psychotherapeutic interventions adapted from established therapy models. Such programs can be easily accessed online and may offer an important treatment option for patients who struggle with barriers to seeking out and engaging in face-to-face psychotherapy, including depressed adolescents. While there are evidence-based Internet-delivered self-help programs based on cognitive-behavioral therapies (i.e. ICBT) for adolescent depression, a program based on psychodynamic principles (i.e. IPDT) has so far been lacking. In this article we describe the IPDT program developed within the ERiCA project, which has so far been evaluated in two randomized controlled trials (RCTs). We further provide a case example from one of the trials to illustrate the treatment process and therapeutic interaction in detail. Given the novelty of the approach, we will particularly highlight and discuss how a psychodynamic understanding of adolescent development and depressive dynamics as well as affect-focused treatment principles inform the treatment, including the therapist’s role, tasks, and choice of interventions. The potential implications and utility of IPDT for regular clinical practice are elaborated as well as potential research directions for the future.
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| 19. |
- Philips, Björn, 1964-, et al.
(author)
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Psykodynamisk psykoterapi bör starkt rekommenderas
- 2023
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 120, s. 48-49
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Journal article (other academic/artistic)abstract
- En ny paraplyöversikt visar att psykodynamisk psykoterapi (PDT) är effektiv behandling vid depression, ångestsyndrom, personlighetssyndrom och funktionella somatiska tillstånd.Vid sidan av ökad forskning har en betydande metodutveckling skett inom PDT under senaste decennierna.PDT bör få en utökad plats inom både första linjens psykiatri och specialistpsykiatrin.
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