Skip to main content
SpringerLink
Log in

Psychoanalyse en psychoanalytische psychotherapie

Effectgroottes en klinische significantie

  • Artikelen
  • Published:
Tijdschrift voor Psychotherapie

Samenvatting

In dit artikel worden de resultaten gepubliceerd van onderzoek naar de effectiviteit van psychoanalyse (PA) en psychoanalytische psychotherapie (PP). Patiënten in verschillende fasen van behandeling (voor, na, follow-up) werden met elkaar vergeleken op symptomen en persoonlijkheidsfunctioneren (SCL-90-R, BDI-II, ZBV, IIP-64, MMPI-2). Daarnaast hebben we hun scores vergeleken met die van klinische en niet-klinische normgroepen. Zowel PA als PP bleek effectief in het verminderen van symptomen en persoonlijkheidsproblemen. Een groot deel van de patiënten bleek na behandeling op de meeste instrumenten in het niet-klinische bereik te functioneren.

Abstract

Psychoanalysis and psychoanalytic psychotherapy: effect sizes and clinical significance

In this article the effectiveness of psychoanalysis and psychoanalytic psychotherapy is examined. We compared symptoms and personality functioning (SCL-90-R, BDI-II, STAI, IIP-64, MMPI-2) of three groups of patients (before, after and at follow-up) and compared their scores with clinical and non-clinical reference groups. Both psychoanalysis and psychoanalytic psychotherapy were found to be effective in reducing symptoms and personality problems. After treatment a large proportion of the patients appeared to be functioning within the non-clinical range on most of the instruments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Notes

  1. De Vlaamse IIP is niet geheel identiek aan de Nederlandse vertaling.

Literatuur

  • Alden, L.E., Wiggins, J.S., & Pincus, A.L. (1990). Construction of circumplex scales for the Inventory of Interpersonal Problems. Journal of Personality Assessment, 55, 521-536.

    Google Scholar 

  • Arrindell, W.A., & Ettema, J.H.M. (2003). Symptom Checklist: Handleiding bij een multidimensionele psychopathologie-indicator. Lisse: Swets Test Publisher.

  • Atkins, D.C., Bedics, J.D., McGlinchey, J.B., & Beauchaine, T.P. (2005). Assessing clinical significance: Does it matter which method we use? Journal of Consulting and Clinical Psychology, 73, 982-989.

    Google Scholar 

  • Bauer, S., Lambert, M.J., & Nielsen, S.L. (2004). Clinical significance methods: A comparison of statistical techniques. Journal of Personality Assessment, 82, 60-70.

    Google Scholar 

  • Berghout, C.C., & Zevalkink, J. (2008). Identifying clinical cases among patients assigned to psychoanalytic treatment. Bulletin of the Menninger Clinic, 72, 163-178.

    Google Scholar 

  • Bickman, L., & Rog, D.J. (1998). Handbook of applied social research methods. Thousand Oaks: Sage Publications.

  • Blatt, S.J., & Auerbach, J. S. (2003). Psychodynamic measures of therapeutic change. Psychoanalytic Inquiry, 23, 268-307.

    Google Scholar 

  • Blatt, S.J., & Shahar, G. (2004). Psychoanalysis — With whom, for what, and how? Comparisons with psychotherapy. Journal of the American Psychoanalytic Association, 52, 393-448.

    Google Scholar 

  • Blomberg, J., Lazar, A., & Sandell, R. (2001). Long-term outcome of long-term psychoanalytically oriented therapies: First findings of the Stockholm Outcome of Psychotherapy and Psychoanalysis study. Psychotherapy Research, 11, 361-382.

    Google Scholar 

  • Cogan, R., & Porcerelli, J.H. (2005). Clinician reports of personality pathology of patients beginning and patients ending psychoanalysis. Psychology and Psychotherapy: Theory, Research and Practice, 78, 235-248.

    Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.

  • Connely Gibbons, M. B., Crits-Christoph, P., Barber, J. P., Stirman, S. W., Gallop, R., Goldstein, L. A., en anderen (2009). Unique and common mechanisms of change across cognitive and dynamic psychotherapies. Journal of Consulting and Clinical Psychology, 77, 801-813.

    Google Scholar 

  • Derksen, J.J.L., Mey, H.R.A. de, Sloore, H., & Hellenbosch, G. (2006). MMPI-2: Handleiding voor afname, scoring en interpretatie. Nijmegen: Pen Psychodiagnostics.

  • Derogatis, L.R., & Lazarus, L. (1994). SCL-90-R, Brief Symptom Inventory, and matching clinical rating scales. In M.E. Maruish (Ed.), The use of psychological testing for treatment planning and outcome assessment (pp. 217-248). Hillsdale, NJ: Lawrence Erlbaum.

  • Does, A.J.W., van der (2002). BDI-II-NL: Handleiding Beck Depression Inventory-II, Nederlandse vertaling en bewerking. Lisse: Swets Test Publisher.

  • Doidge, N. (1997). Empirical evidence for the efficacy of psychoanalytic psychotherapies and psychoanalysis: An overview. Psychoanalytic Inquiry, 17S, 102-150.

  • Fonagy, P., Leigh, T., Steele, M., Steele, H., Kennedy, R., Mattoon, G., en anderen (1996). The Relation of Attachment Status, Psychiatric Classification, and Response to Psychotherapy. Journal of Consulting and Clinical Psychology, 64, 22-31.

    Google Scholar 

  • Fonagy, P., Roth, A., & Higgitt, A. (2005). Psychodynamic psychotherapies: Evidence-based practice and clinical wisdom. Bulletin of the Menninger Clinic, 69, 1-58.

    Google Scholar 

  • Foster, S.L., & Mash, E.J. (1999). Assessing social validity in clinical treatment research issues and procedures. Journal of Consulting and Clinical Psychology, 67, 308-319.

    Google Scholar 

  • Gabbard, G.O. (2005). Psychodynamic psychiatry in clinical practice. The DSM-IV edition (3rd ed.). Washington, DC: American Psychiatric Press.

  • Gabbard, G.O. (2009). Techniques of psychodynamic psychotherapy. In G.O. Gabbard (Ed.), Textbook of Psychotherapeutic Treatments (pp. 43-67). Washington, DC: American Psychiatric Publishing.

  • Gabbard, G.O., Gunderson, J.G., & Fonagy, P. (2002). The place of psychoanalytic treatments within psychiatry. Archives of General Psychiatry, 59, 505-510.

    Google Scholar 

  • Galatzer-Levy, R.M., Bachrach, H., Skolnikoff, A., & Waldron Jr., S. (2000). Does psychoanalysis work? New Haven & London: Yale University Press.

  • Gezondheidsraad (2001). Doelmatigheid van langdurige psychotherapie. Den Haag: Gezondheidsraad.

  • Gordon, R.M. (2001). MMPI/MMPI-2 Changes in long-term psychoanalytic psychotherapy. Issues in Psychoanalytic Psychotherapy, 23, 59-79.

    Google Scholar 

  • Grande, T., Dilg, R., Jakobsen, T., Keller, W., Krawietz, B., Langer, M., en anderen (2006). Differential effects of two forms of psychoanalytic therapy: Results of the Heidelberg-Berlin study. Psychotherapy Research, 16, 470-485.

  • Greenson, R. R. (1967). The technique and practice of psychoanalysis. New York: International Universities Press.

  • Hill, C.E., & Lambert, M.J. (2004). Methodological issues in studying psychotherapy processes and outcomes. In M.J. Lambert (Ed.), Bergin and Garfield’s Handbook of psychotherapy and behavior change (5th ed., pp. 84-135). New York: John Wiley & Sons.

  • Horowitz, L.M., Alden, L.E., Wiggins, J.S., & Pincus, A.L. (2000). Inventory of Interpersonal Problems: Manual. New York: The Psychological Corporation Harcourt.

  • Horowitz, L.M., Rosenberg, S.E., & Bartholomew, K. (1993). Interpersonal problems, attachment styles, and outcome in brief dynamic psychotherapy. Journal of Consulting and Clinical Psychology, 61, 549-560.

    Google Scholar 

  • Horowitz, L.M., Strauss, B., & Kordy, H. (1994). Inventar zur Erfassung interpersonaler Probleme. Deutsche Version. Weinheim: Beltz Testverlag.

  • Jacobsen, N.S., Follette, W.C., & Revenstorf, D. (1984). Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance. Behavior Therapy, 15, 336-352.

    Google Scholar 

  • Jacobsen, N.S., Roberts, L.J., Berns, S.B., & McGlinchey, J.B. (1999). Methods of defining and determining the clinical significance of treatment effects. Description, application, and alternatives. Journal of Consulting and Clinical Psychology, 67, 300-307.

    Google Scholar 

  • Jacobsen, N.S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19.

    Google Scholar 

  • Kantrowitz, J.L., Katz, A.L., Paolitto, F., Sashin, J., & Solomon, L. (1987). Changes in the level and quality of object relations in psychoanalysis: Followup of a longitudinal, prospective study. Journal of the American Psychoanalytic Association, 35, 23-46.

    Google Scholar 

  • Kazdin, A.E. (1999). The meanings and measurement of clinical significance. Journal of Consulting and Clinical Psychology, 67, 332-339.

    Google Scholar 

  • Kendall, P.C., & Grove, W.M. (1988). Normative comparisons in therapy outcome. Behavioral Assessment, 10, 147-158.

    Google Scholar 

  • Kendall, P.C., Marrs-Garcia, A., Nath, S.R., & Sheldrick, R. C. (1999). Normative comparisons for the evaluation of clinical significance. Journal of Consulting and Clinical Psychology, 67, 285-299.

    Google Scholar 

  • Kendall, P.C., & Norton-Ford, J.D. (1982). Therapy outcome research methods. In P.C.K.J.N. Butcher (Ed.), Handbook of research methods in clinical psychology (pp. 429-460). New York: John Wiley & Sons.

  • Leichsenring, F., Biskup, J., Kreische, R., & Staats, H. (2005). The Göttingen study of psychoanalytic therapy: First results. International Journal of Psychoanalysis, 86, 433-455.

    Google Scholar 

  • Leichsenring, F., & Rabung, S. (2008). Effectiveness of long-term psychodynamic psychotherapy. A meta-analysis. Journal of the American Medical Association, 300, 1551-1565.

    Google Scholar 

  • Maat, S. de, Dekker, J., Schoevers, R., & Jonghe, F. de (2006). Relative efficacy of psychotherapy and pharmacotherapy in the treatment of depression: A meta-analysis. Psychotherapy Research, 16, 562-572.

    Google Scholar 

  • Maat, S. de, Jonghe, F. de, Schoevers, R., & Dekker, J. (2009). The effectiveness of long-term psychoanalytic therapy: A systematic review of empirical studies. Harvard Review of Psychiatry, 17, 1-23.

    Google Scholar 

  • Ogles, B. M., Lunnen, K. M., & Bonesteel, K. (2001). Clinical significance: History, application, and current practice. Clinical Psychology Review, 21, 421-446.

    Google Scholar 

  • Person, E.S., Cooper, A.M., & Gabbard, G.O. (Eds.) (2005). Textbook of psychoanalysis. Washington, DC: American Psychiatric Press.

  • Ploeg, H. M., van der (2000). Handleiding bij de ZelfBeoordelingsVragenlijst: Een Nederlandstalige bewerking van de Spielberger State-Trait Anxiety Inventory. Lisse: Swets Test Publisher.

  • Puschner, B., Kraft, S., Kächele, H., & Kordy, H. (2007). Course of improvement over 2 years in psychoanalytic and psychodynamic outpatient psychotherapy. Psychology and Psychotherapy, 80, 51-68.

    Google Scholar 

  • Robinson, L.A., Berman, J. S., & Neimeyer, R.A. (1990). Psychotherapy for the treatment of depression: A comprehensive review of controlled outcome research. Psychological Bulletin, 108, 30-49.

    Google Scholar 

  • Roth, A., & Fonagy, P. (1996). What works for whom? A critical review of psychotherapy research. New York: The Guilford Press.

  • Sandell, R., Blomberg, J., Lazar, A., Carlsson, J., Broberg, J., & Schubert, J. (2000). Varieties of long-term outcome among patients in psychoanalysis and long-term psychotherapy. International Journal of Psychoanalysis, 81, 921-942.

    Google Scholar 

  • Terlidou, C., Moschonas, D., Kakitsis, P., Manthouli, M., Moschona, T., & Tsegos, I.K. (2004). Personality changes after completion of long-term group-analytic psychotherapy. Group Analysis, 37, 401-418.

    Google Scholar 

  • Vanheule, S., Desmet, M., & Rosseel, Y. (2006) The factorial structure of the Dutch translation of the Inventory of Interpersonal Problems: A test of the long and short versions. Psychological Assessment, 18, 112-117.

    Google Scholar 

  • Wallerstein, R.S. (1995). The talking cures: The psychoanalyses and the psychotherapies. New Haven, CT: Yale University Press.

  • Wise, E.A. (2004). Methods for analyzing psychotherapy outcomes: A review of clinical significance, reliable change, and recommendations for future directions. Journal of Personality Assessment, 82, 50-59.

    Google Scholar 

  • Wolf, M.H.M. de (2002). Inleiding in de psychoanalytische psychotherapie: Ontwikkeling, psychopathologie, diagnostiek en behandelvormen. Bussum: Coutinho.

  • Zevalkink, J., & Berghout, C.C. (2006). Expanding the evidence base for the cost-effectiveness of long-term psychoanalytic treatment. Journal of the American Psychoanalytic Association, 54, 1313-1319.

    Google Scholar 

  • Zevalkink, J., & Berghout, C.C. (2008a). Door de bank genomen. Hoe effectief zijn psychoanalytische behandelingen? Amsterdam: Nederlands Psychoanalytisch Instituut.

  • Zevalkink, J., & Berghout C.C. (2008b). Klinische besluitvorming ten aanzien van indicatie voor psychoanalyse en psychoanalytische psychotherapie: Een empirische invalshoek. Tijdschrift voor Psychotherapie, 34, 151-168.

    Google Scholar 

  • Zevalkink, J., & Berghout, C.C. (2008c). Mental health characteristics of patients assigned to long-term ambulatory psychoanalytic psychotherapy and psychoanalysis in the Netherlands. Psychotherapy Research, 18, 316-325.

    Google Scholar 

  • Zevalkink, J., Katzko, M.W., Berghout, C.C., & Riksen-Walraven, J.M.A. (in voorbereiding). Inventory of Interpersonal Problems in the Netherlands: Screening and interpreting relational distress in non-clinical and clinical samples.

Download references

Authors
  1. Caspar C. Berghout
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jolien Zevalkink
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thijs de Wolf
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

caspar c. berghout, gz-psycholoog in opleiding, is werkzaam op de afdeling Volwassenen van het Nederlands Psychoanalytisch Instituut en als promovendus verbonden aan de Vrije Universiteit, Amsterdam.jolien zevalkink, psycholoog en antropoloog, is werkzaam als hoofd op de afdeling Onderzoek & Kwaliteitszorg van het Nederlands Psychoanalytisch Instituut en als Universitair Docent Ontwikkelingspsychologie op de Radboud Universiteit, Nijmegen.thijs de wolf, klinisch psycholoog en psychoanalyticus, is lid van de Raad van Bestuur van het Nederlands Psychoanalytisch Instituut en opleider van de NVPA.

De auteurs zijn dank verschuldigd aan Z. Saltzherr en A. Beekhuyzen voor hun medewerking aan de dataverzameling tijdens de intakefase. Dit project werd gesponsord door de ZonMw-subsidie 945-04-414.

C.C. Berghout, Afdeling Onderzoek en Kwaliteitszorg, Nederlands Psychoanalytisch Instituut, Postbus 7031, 1007 JA Amsterdam.

About this article

Cite this article

Berghout, C.C., Zevalkink, J. & de Wolf, T. Psychoanalyse en psychoanalytische psychotherapie. TIJDSCHRIFT PSYCHOTHERAPIE 36, 22–39 (2010). https://doi.org/10.1007/BF03096115

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03096115

Search

Navigation