Psychodynamic psychotherapy, also known as psychoanalytic psychotherapy, is a modern form of talk therapy that has its roots in psychoanalysis, the technique first developed by Sigmund Freud and other pioneering doctors. Mental health professionals use psychodynamic psychotherapy in adult populations to address the effects of a number of disorders, including major depression, anorexia, borderline personality disorder and several types of anxiety disorders. According to the results of a new study review published in August 2013 in the Journal of the American Academy of Child & Adolescent Psychiatry, teenagers and younger children also appear to be well-served by the psychodynamic approach.
Psychodynamic Psychotherapy Basics
Psychodynamic psychotherapy has been part of the repertoire of many U.S. psychiatrists since the 1950s. Unlike classic psychoanalysis, the therapy typically takes place over a relatively short period of time (commonly less than half a year) and only involves one or two weekly sessions. Basic tenets of psychodynamic psychotherapy include a belief that unconscious activity plays a vital role in a person’s mental life, a belief that a person’s behaviors have underlying symbolic importance, a belief that people have ongoing conflicts within their mental processes, a belief that a person’s mental health symptoms have specific meanings within the context of his or her unconscious conflicts, and a belief that people commonly unconsciously act out their internal conflicts with others in everyday life. Psychodynamic psychotherapy addresses these issues in several ways. First, a patient undergoing the therapy is asked to explore his or her emotional life as fully as possible and identify potential areas of conflict. Next the therapist and patient look at the ways in which the patient habitually avoids dealing with emotional conflicts or unpleasant emotional states. From these initial steps, the therapist and patient pinpoint any ongoing emotional or behavioral patterns that limit or degrade the patient’s sense of mental well-being. This process takes into account experiences that took place in the patient’s past, emphasizes the importance of the patient’s relationships with others and gives the patient the freedom to explore his or her fantasy life in an open-ended manner. Psychodynamic psychotherapy also seeks to account for patients’ tendencies to unconsciously recreate their internal conflicts while working with their therapists.
In the study review published in the Journal of the American Academy of Child & Adolescent Psychiatry, a multinational research team used an assessment of 11 previous studies to examine the usefulness of a common form of psychodynamic psychotherapy—called short-term psychodynamic psychotherapy—in dealing with mental health problems in teenagers and younger children. The team undertook this assessment because no researchers had previously attempted to create a large-scale overview of the effectiveness of psychodynamic treatment for people in these age groups. All told, the 11 studies included 655 teens and children diagnosed with anorexia, depression, anxiety disorders or any one of a number of other significant conditions. After completing their analysis, the study review’s authors concluded that short-term psychodynamic psychotherapy generally works well for the targeted age groups and provides a level of treatment benefit that roughly equals the benefits of other popular psychotherapeutic approaches such as interpersonal therapy or cognitive behavioral therapy. They also concluded that, after undergoing psychodynamic treatment, teens and children appear to experience increasing improvement in their mental health symptoms over time. However, as a caution, the authors of the review note that the outcomes of the therapy vary substantially between specific illnesses. This means that doctors can’t expect blanket improvements in all of their patients and must carefully choose when to employ psychodynamic psychotherapy. Considerations In a report published in 2008 in the journal Psychiatry, researchers from Cincinnati Children’s Hospital Medical Center outlined some of the factors that make a teenager or younger child a good candidate for psychodynamic treatment. Examples of these factors include the presence of age-appropriate communication and social interaction skills, an awareness of the need for treatment, a generally stable mood (relative to the effects of the illness in question), an ability to think in abstract terms and a clear interest in academic or leisure activities. Parents’ attitudes can also have a major impact on the success or failure of psychodynamic psychotherapy. Parental attributes that contribute to successful use of the therapy include generally strong support for the treatment process, the ability to work collaboratively with the therapist administering treatment, and the maintenance of a strong relationship with a teen or younger child outside of the therapeutic process.