Evaluative Research on Psychodynamic Therapy: Foundations and Recent Advances

Psychodynamic therapy (PDT), a technical adaptation of psychoanalysis, is one of the most widely practiced forms of psychotherapy, making evaluative research on it essential. Although research on PDT has been ongoing for several decades, theoretical and practical challenges initially hindered the adoption of evidence-based medicine standards in such research, a shift that has largely taken place over the past 20 years. This article reviews the evolution of evaluative research on PDT for mental disorders in adults, with a focus on those with complex conditions. Since the first prospective evaluative studies in the 1950s, an accumulating body of knowledge-including cohort studies, randomized controlled trials, and meta-analyses-has established PDT as an evidence-based treatment for common mental disorders such as depression, anxiety, somatic symptoms and related disorders, and personality disorders, as well as complex mental disorders involving combinations of these conditions. There is also evidence supporting PDT's usefulness in treating anorexia nervosa and opioid dependence, along with some findings suggesting its potential use for schizophrenia spectrum disorders, bulimia nervosa, and posttraumatic stress disorder. Recent studies indicate that PDT can serve as a personalized treatment, promoting deep and lasting psychopathological changes in patients with severe, complex, and chronic mental disorders, involving specific technical features and mechanisms of change. These findings support the inclusion of PDT in mental health care policies and training, while ongoing research continues to explore its optimal treatment parameters.