Psychodynamic therapists have long thought that a moderate, as opposed to high, use of psychodynamic techniques might be optimal in therapy. McCarthy, Keefe and Barber (2014) found evidence for this idea in a sample of patients who were receiving supportive-expressive psychodynamic therapy for depression. In their study, trained observers watched tapes from early therapy sessions of 33 patients and rated the extent to which therapists used techniques from different types of therapy including supportive-expressive, process-experiential, and behavioral therapies. In this sample there was no evidence that getting more, or less of any therapeutic techniques was related to how patients fared in treatment. However, as the authors hypothesized, moderate, as opposed to high or low, levels of psychodynamic interventions predicted improvement. In a similar way, a moderate use of process-experiential techniques predicted better outcomes. Specific interventions that when used moderately predicted outcomes included exploring the function of symptoms of depression, discussing relationship patterns, and exploring avoided affect. The authors hypothesized that low levels of psychodynamic techniques might not be enough to enact change in patients. By contrast, using too many dynamic interventions may overwhelm patients. Like Goldilocks in the fairy tale trying to find what felt “just right,” effective dynamic and experiential therapists need to balance intervening too much or too little.
Society for Psychotherapy Research (SPR)
Marna S. Barrett, Ph.D.
Mood & Anxiety Disorders Treatment Research Unit
University of Pennsylvania Perelman School of Medicine
3535 Market St., Suite 670
Philadelphia, PA 19104