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Comparison of Cognitive-behaviour Therapy with Psychoanalytic and Psychodynamic Therapy for Depressed Patients

Z Psychosom Med Psychother. 2012;58(3):299-316

Authors: Huber D, Zimmermann J, Henrich G, Klug G

Empirical Studies of the Efficacy of Psychoanalytic Psychotherapy

Primary Studies

Bateman, A., & Fonagy, P. (1999). Effectiveness of partial hospitalization in the treatment of borderline personality disorder – a randomised control trial. American Journal of Psychiatry, 156(10), 1563-1569.

Blatt, S. J. (1992). The differential effect of psychotherapy and psychoanalysis with anaclitic and introjective patients: The Menninger Psychotherapy Research Project revisited. Journal of the American Psychoanalytic Association, 40, 691-724.

Borckardt JJ. (2002) Case study examining the efficacy of a multi-modal psychotherapeutic intervention for hypertension, International Journal of Clinical and Experimental Hypnosis, 50(2), 189-201.

Bressi C, Porcellana M, Marinaccio PM, Nocito EP, Magri L. (2010) Short-term psychodynamic psychotherapy versus treatment as usual for depressive and anxiety disorders: a randomized clinical trial of efficacy. Journal of Nervous and Mental Disease, 198(9), 647-52.

Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2004). The Personality Disorders Institute / Borderline Personality Disorder Research Foundation randomized control trial for borderline personality disorder: Rationale, methods, and patient characteristics. Journal of Personality Disorders. 18 (1): 52-72.

Creed, F., Fernandes, L., Guthrie, E., Palmer, S., Ratcliffe, J., Read, N., et al. (2003). The cost-effectiveness of psychotherapy and paroxetine for severe irritable bowel syndrome. Gastroenterology, 124(2), 303-317.

Dekker JJ, Koelen JA, Van HL, Schoevers RA, Peen J, Hendriksen M, Kool S, Van Aalst G, De Jonghe F. (2008) Speed of action: the relative efficacy of short psychodynamic supportive psychotherapy and pharmacotherapy in the first 8 weeks of a treatment algorithm for depression. Journal of Affective Disorders, 109(1-2), 183-8.

Driessen E, Van HL, Schoevers RA, Cuijpers P, van Aalst G, Don FJ, Hendriksen M, Kool S, Molenaar PJ, Peen J, Dekker JJ. (2007) Cognitive Behavioral Therapy versus Short Psychodynamic Supportive Psychotherapy in the outpatient treatment of depression: a randomized controlled trial. BMC Psychiatry, 26;7, 58.

Fonagy, P., & Moran, G. S. (1991). Studies of the efficacy of child psychoanalysis. Journal of Consulting and Clinical Psychology, 58, 684-695.

Franz M, Janssen P, Lensche H, Schmidtke V, Tetzlaff M, Martin K, Wöller W, Hartkamp N, Schneider G, Heuft G. (2000) On the effects of psychoanalytic oriented psychotherapy – an inpatient multicenter study. Zeitschrift fur Psychosomatische Medizin und Psychotherapie, 46(3), 242-258.

Hilsenroth, M. J. (2007). A programmatic study of short-term psychodynamic psychotherapy: assessment, process, outcome, and training. Psychotherapy Research, 17(1): 31-45

Horn H, Geiser-Elze A, Reck C, Hartmann M, Stefini A, Victor D, Winkelmann K, Kronmüller KT. (2005) Efficacy of psychodynamic short-term psychotherapy for children and adolescents with depression. Praxis der Kinderpsychologie Kinderpsychiatrie, 54(7), 578-97.

Kantrowitz, J., Katz, A. & Paolitto, F. (1990) Follow-up of psychoanalysis five to ten years after termination: III. The relation between the resolution of the transference and the patient-analyst match. Journal of the American Psychoanalytic Association, 38, 655-678.

Kellett S, Beail N. (1997) The treatment of chronic post-traumatic nightmares using psychodynamic-interpersonal psychotherapy: a single-case study. British Journal of Medical Psychology, 70, 35-49.

Knekt, P., & Lindfors, O. (2004). A randomized trial of the effect of four forms of psychotherapy on depressive and anxiety disorders. Helsinki: Kela.

Knijnik DZ, Blanco C, Salum GA, Moraes CU, Mombach C, Almeida E, Pereira M, Strapasson A, Manfro GG, Eizirik CL. (2008) A pilot study of clonazepam versus psychodynamic group therapy plus clonazepam in the treatment of generalized social anxiety disorder. European Psychiatry, 23(8), 567-74.

Lampe A, Mitmansgruber H, Gast U, Schüssler G, Reddemann L. (2008) Treatment outcome of psychodynamic trauma therapy in an inpatient setting. Neuropsychiatrie, 22(3), 189-97.

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

Leuzinger-Bohleber, M., Stuhr, U., Ruger, B., Beutel, M. (2003) How to study the quality of psychoanalytic treatments and their long-term effects on patients’ well-being: a representative, multi-perspective follow-up study. International Journal of Psychoanalysis 84, 263-290.

Levy, K. N., Meehan, K. B., Kelly, K. M., Reynoso, J. S., Weber, M., Clarkin, J. F., Kernberg, O. F. (in press) Change in attachment patterns and reflective function in a randomized controlled trial of Transference Focused Psychotherapy for borderline personality disorder. Journal of Consulting and Clinical Psychology.

Lingiardi, V., Shedler, J. & Gazzillo, F. (2006) Assessing Personality Change in Borderline Personality Disorder using the SWAP-200. Journal of Personality Assessment (86)1, 23-32.

Meyer AE, Stuhr U, Wirth U, Rüster P. (1988) 12-year follow-up study of the Hamburg short psychotherapy experiment: an overview. Psychotherapy Psychosomatics, 50 (4), 192-200.

Milrod, B., Leon, A. C., Busch, F., Rudden, M., Schwalberg, M., Clarkin, J., et al. (in press). The efficacy of psychoanalytic psychotherapy for panic disorder. American Journal of Psychiatry.

Muratori F, Picchi L, Casella C, Tancredi R, Milone A, Patarnello MG. (2002) Efficacy of brief dynamic psychotherapy for children with emotional disorders.Psychotherapy and Psychosomatics. 71(1), 28-38.

Paley G, Cahill J, Barkham M, Shapiro D, Jones J, Patrick S, Reid E. (2008) The effectiveness of psychodynamic-interpersonal therapy (PIT) in routine clinical practice: a benchmarking comparison. Psychology and Psychotherapy, 81(Pt 2), 157-75.

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.

Target, M., & Fonagy, P. (1994). The efficacy of psychoanalysis for children with emotional disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 361-371.

Vinnars, B., Barber, J. P., Norén, K., Gallop, R., & Weinryb, R. M. (2005). Manualized supportive-expressive psychotherapy versus nonmanualized community-delivered psychodynamic therapy for patients with personality disorders: Bridging efficacy and effectiveness. American Journal of Psychiatry, 162(10), 1933-1940.

Wallerstein, R.S. (1989) The Psychotherapy Research Project of the Menninger Foundation: an overview. Journal of Consulting and Clinical Psychology, 57 (2), 195-205.

Winkelmann K, Stefini A, Hartmann M, Geiser-Elze A, Kronmüller A, Schenkenbach C, Hildegard H, Kronmüller KT. (2005) Efficacy of psychodynamic short-term psychotherapy for children and adolescents with behavioral disorders. Praxis der Kinderpsychologie Kinderpsychiatrie, 54(7), 598-614.



Reviews & Meta-Analyses

Abbass AA, Henderson J, Kisely S., Hancock JT. (2006). Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database Syst Rev. Oct 8;(4):CD004687

Alberdi F, Rosenbaum B. (2010) Evidence to support psychodynamic psychotherapy. Ugeskr Laeger, 172(42), 2882-7.

Anderson, E., & Lambert, M. (1995). Short-Term Dynamically Oriented Psychotherapy: A Review and Meta-Analysis. Clinical Psychology Review, 15, 503-514.

Bond M. (2006) Psychodynamic psychotherapy in the treatment of mood disorders. Current Opinion in Psychiatry, 19(1), 40-3.

Clemens NA. (2010) Evidence base for psychotherapy: two perspectives. Journal of Psychiatric Practice, 16(3), 183-6.

Cuijpers P, van Straten A, Andersson G, van Oppen P. (2008) Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. Journal Consulting and Clinical Psychology, 76(6), 909-22.

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

Driessen E, Cuijpers P, de Maat SC, Abbass AA, de Jonghe F, Dekker JJ. (2010) The efficacy of short-term psychodynamic psychotherapy for depression: a meta-analysis. Clinical Psychology Review, 30(1), 25-36.

Fonagy, P., Jones, E. E., Kächele, H., Krause, R., Clarkin, J., Perron, R., Gerber, A., & Allison, E. (2001). An open door review of outcome studies in psychoanalysis (Second ed.). London: International Psychoanalytic Association. (download or order via

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

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

Gibbons MB, Crits-Christoph P, Hearon B. (2008) The empirical status of psychodynamic therapies. Annual Review of Clinical Psychology, 4, 93-108.

Gottdiener, W. H., & Haslam, N. (2002). The benefits of individual psychotherapy for people diagnosed with schizophrenia: A meta-analytic review. Ethical Human Sciences and Services, 4, 163-187.

Kapfhammer HP. (2008) Therapeutic possibilities after traumatic experiences. Psychiatria Danubina, 20(4), 532-45.

Kronmüller KT, Postelnicu I, Hartmann M, Stefini A, Geiser-Elze A, Gerhold M, Hildegard H, Winkelmann K. (2005) Efficacy of psychodynamic short-term psychotherapy for children and adolescents with anxiety disorders. Praxis der Kinderpsychologie Kinderpsychiatrie, 54(7), 559-77.

Leichsenring F, Rabung S. (2008) Effectiveness of long-term psychodynamic psychotherapy: a meta-analysis. JAMA, 300(13), 1551-65.

Leichsenring F. (2005) Are psychodynamic and psychoanalytic therapies effective?: A review of empirical data. International Journal of Psychoanalysis, 86(Pt 3), 841-68.

Leichsenring, F. & Leibing, E. (2003). The Effectiveness of Psychodynamic Therapy and Cognitive Behavior Therapy in the Treatment of Personality Disorders: A Meta-analysis. American Journal of Psychiatry, 160, 1223-1232.

Leichsenring, F. (2001) Comparative Effects of Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Depression: A Meta-analytic Approach. Clinical Psychology Review, 21, 401-419.

Leichsenring, F., Rabung, S., & Leibing, E. (2004). The efficacy of short-term psychodynamic psychotherapy in specific psychiatric disorders: a meta-analysis. Arch Gen Psychiatry, 61(12), 1208-1216.

Puschner B, Kordy H. (2010) Transparency and outcome orientation as means to improve psychotherapeutic services: a study to evaluate outpatient psychotherapy (TRANS-OP). Psychotherapy, Psychosomatic Medizinische Psychologie. 60(9-10), 350-7.

Ritvo RZ, Papilsky SB. (1999) Effectiveness of psychotherapy. Current Opinion in Pediatrics. (4):323-7.

Shedler J. (2010) The efficacy of psychodynamic psychotherapy. The American Psychologist, 65(2), 98-109.

Windaus E. (2005) Efficacy studies in the field of psychotherapy–psychoanalytical and psychodynamic psychology–for children and adolescents: a survey. Praxis der Kinderpsychologie

Kinderpsychiatrie, 54(7), 530-58. Chlebowski S, Gregory RJ. (2009) Is a psychodynamic perspective relevant to the clinical management of obsessive-compulsive disorder? American Journal of Psychotherapy, 63(3), 245-56.



Methodological Issues

Gabbard, G. O., Gunderson, J. G., & Fonagy, P. (2002). The place of psychoanalytic treatments within psychiatry. Archives of General Psychiatry, 59 (6), 505-510 + commentaries.

Glick RA, Roose SP. (2009) Empirical research, psychoanalytic training, and psychoanalytic attitudes. Journal of The American Psychoanalytic Association, Jun 57(3), 657-61.

Grant DC, Harari E. (2005) Psychoanalysis, science and the seductive theory of Karl Popper. The Australian and New Zealand Journal of Psychiatry, Jun 39(6), 446-52.

Joyce AS, Wolfaardt U, Sribney C, Aylwin AS. (2006) Psychotherapy research at the start of the 21st century: the persistence of the art versus science controversy.Canadian Journal of Psychiatry, 51(13), 797-809.

Kramer U, Ambresin G, de Roten Y, Fassassi S, Hedjal A, Herrera F, Kolly S, Pomini V, Preisig M, Despland JN. (2010) What place is there for psychotherapy in public psychiatry? Revue Medicale Suisse, 6(263), 1760-2, 1764.

Krystal H. (1992) Psychoanalysis as a “normal” science. Journal of the American Academic of Psychoanalysis. Fall 20(3), 395-412.

Kurthen M, Linke DB, Reuter BM. (1991) Psychoanalysis and science-theoretical critique–new aspects of an old controversy. Psychotherapie, Psychosomatik, medizinische Psychologie, Mar-Apr 41(3-4), 147-53.

Mechelli A. (2010) Psychoanalysis on the couch: can neuroscience provide the answers? Medical Hypotheses, Dec 75(6), 594-9.

Oatley K. (1982) Refutation and the appropriation of truth in psychoanalysis. British Journal of Medicinal Psychology, Mar 55(Pt 1), 1-11.

Ouss-Ryngaert L, Golse B. (2010) Linking neuroscience and psychoanalysis from a developmental perspective: why and how? Journal of Physiology, Paris, Dec 104(6), 303-8.

Philips B. (2009) Comparing apples and oranges: how do patient characteristics and treatment goals vary between different forms of psychotherapy? Psychology Psychotherapy, 82(3), 323-36.

Rief W, Hofmann SG. (2009) Saving psychoanalysis. At any cost? Der Nervenarzt, 80(5), 593-7.

Wallerstein RS. (1988) Psychoanalysis, psychoanalytic science, and psychoanalytic research–1986. Journal of American Psychoanalytic Association, 36(1), 3-30.

Wallerstein RS. (2009) What kind of research in psychoanalytic science? International Journal of Psychoanalysis, Feb 90(1), 109-33.

Westen and Weinberger (2004). When clinical description becomes statistical prediction. American Psychologist 59(7):595-613.

Westen, D., Novotny, C. M., & Thompson-Brenner, H. (2004) The empirical status of empirically supported psychotherapies: Assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin. 130 (4): 631-663.

Zepf S. (2010) Psychoanalysis–on its way down a dead-end street? A concerned commentary. The Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, Fall 38(3), 459-81.



Empirical Studies of Psychoanalytic Process

Primary Studies

Ablon, S. and Jones, E.E. (1998) How expert clinicians’ prototypes of an ideal treatment correlate with outcome in psychodynamic and cognitive-behavioral therapy. Psychotherapy Research, 8:(71-83).

Ablon J, S, Jones EE: On Analytic Process. Journal of the American Psychoanalytic Association 2005; 53(2):541-568

Barber, J., et al., (2000). Alliance Predicts Patients’ Outcome Beyond In-Treatment Change Symptoms. Journal of Consulting and Clinical Psychology, 68, 1027-1032.

Blatt, S. J., & Shahar, G. (2004). Psychoanalysis – with whom, for what, and how? Comparisons with psychotherapy. Journal of the American Psychoanalytic Association, 52(2), 393-447.

Bucci, W. (1997). Psychoanalysis and Cognitive Science: A Multiple Code Theory. New York: Guilford Press.

Dahl, H., & Teller, V. (1994). The characteristics, identification, and applications of FRAMES. Psychotherapy Research, 4(3&4), 253-276.

Freedman, N., Hoffenberg, J.D., Vorus, N. & Frosch, A. (1999) The effectiveness of psychoanalytic psychotherapy: The role of treatment duration, frequency of sessions, and the therapeutic relationship. Journal of the American Psychoanalytic Association 47, 741-772.

Gibbons MB, Crits-Christoph P, Barber JP, Wiltsey Stirman S, Gallop R, Goldstein LA, Temes CM, Ring-Kurtz S. (2009) Unique and common mechanisms of change across cognitive and dynamic psychotherapies. Journal of Consulting and Clinical Psychology, 77(5), 801-13.

Høglend, P., Amlo, S., Marble, A., Bogwald, K. P., Sorbye, O., Sjaastad, M. C., et al. (2006). Analysis of the patient-therapist relationship in dynamic psychotherapy: an experimental study of transference interpretations. Am J Psychiatry, 163(10), 1739-1746.

Josephs, L., Andrews, E., Bernard, A., Fatzer, K., & Streich, S. (2004). Assessing change in analysis terminable. Journal of the American Psychoanalytic Association, 52, 1185-1214.

Kaufman E. (1990-1991) Critical aspects of the psychodynamics of substance abuse and the evaluation of their application to a psychotherapeutic approach.International Journal of the Addictions, 25(2A), 97-114; discussion 115-6.

Lable I, Kelley JM, Ackerman J, Levy R, Waldron S Jr, Ablon JS. (2010) The role of the couch in psychoanalysis: proposed research designs and some preliminary data.Journal of American Psychoanalytic Association, Oct 58(5), 861-87.

Luborsky, L., & Crits-Christoph, P. (1998). Understanding Transference: The Core Conflictual Relationship Theme Method (Second ed.). Washington DC: American Psychological Association.

Shevrin, H., Bond, J. A., Brakel, L. A. W., Hertel, R. K., & Williams, W. J. (1996). Conscious and Unconscious Processes: Psychodynamic, Cognitive, and Neurophysiological Convergences. New York: Guilford Press.

Watzke B, Rueddel H, Koch U, Rudolph M, Schulz H. (2008) Comparison of therapeutic action, style and content in cognitive-behavioural and psychodynamic group therapy under clinically representative conditions. Clinical Psychology Psychotherapy, 15(6), 404-17.



Reviews & Meta-Analyses

Ackerman, S.J. & Hilsenroth, M.J. (2003) A review of therapist characteristics and techniques positively impacting the therapeutic alliance. Clinical Psychology Review 23, 1-33.

Bush M, Meehan W. (2011) Should supportive measures and relational variables be considered a part of psychoanalytic technique? Some empirical considerations.International Journal of Psychoanalysis, Apr 92(2), 377-99.

Martin, D.J., Garske, J.P. & Davis, M.K. (2000) Relation of the therapeutic alliance with outcome and other variables: a meta analytic review. Journal of Consulting and Clinical Psychology 68(3): 438-450.



Empirical Studies of Psychoanalytic Concepts

Primary Studies

Andersen, S. M., & Baum, A. (1994). Transference in interpersonal relations: inferences and affect based on significant-other representations. J Pers, 62(4), 459-497.

Betan, E., Heim, A. K., Zittel Conklin, C., & Westen, D. (2005). Countertransference phenomena and personality pathology in clinical practice: an empirical investigation. Am J Psychiatry, 162(5), 890-898.

Bornstein, Robert F. (1999) Source Amnesia, Misattribution, and the Power of Unconscious Perceptions and Memories. Psychoanalytic Psychology. 16(2):155-178

Brakel LAW, Shevrin H: Anxiety, attributional thinking, and the primary process (2005). International Journal of Psychoanalysis; 86(6):1679-1693

Fonagy, P., Leigh, T., Steele, M., Steele, H., Kennedy, R., Mattoon, G., Target, M., & Gerber, A. (1996). The relation of attachment status, psychiatric classification, and response to psychotherapy. Journal of Consulting and Clinical Psychology, 64, 22-31.

Shedler J (2002). A new language for psychoanalytic diagnosis. Journal of the American Psychoanalytic Association; 50(2):429-456

Shedler, J., & Westen, D. (2004). Refining DSM-IV Personality Disorder Diagnosis: Integrating science and practice. American Journal of Psychiatry, 161, 1350-1365.

Shevrin, H., & Dickman, S. (1980). The psychological unconscious: A necessary assumption for all psychological theory? American Psychologist, 35, 421-434.

Siefert, Caleb J., Hilsenroth, Mark J., Weinberger, Joel, Blagys, Matthew D., Ackerman, Steven J. (2006) The relationship of patient defensive functioning and alliance with therapist technique during short-term psychodynamic psychotherapy. Clinical Psychology and Psychotherapy. 13, 20–33.

Silverman, L. H., & Weinberger, J. (1985). Mommy and I are one. Implications for psychotherapy. Am Psychol, 40(12), 1296-1308.

Solms M. (1995) New findings on the neurological organization of dreaming: implications for psychoanalysis. The Psychoanalytic Quarterly, Jan 64(1), 43-67.

Wong, Philip S. (1999). Anxiety, signal anxiety, and unconscious anticipation: Neuroscientific evidence for an unconscious signal function in humans. Journal of the American Psychoanalytic Association 47(3).



Reviews & Meta-Analyses

Bornstein, R.F. & Masling, J.M. Series on Empirical Studies of Psychoanalytical Theories. (1993, 1994, 1996, 1998)

Fisher, S., & Greenberg, R. P. (1977). The Scientific Credibility of Freud’s Theories and Therapy. New York: Basic Books.

Fisher, S., & Greenberg, R. P. (1996). Freud Scientifically Reappraised: Testing the Theories and Therapy. New York: John Wiley & Sons, Inc.

Grunbaum, A. (1984). The foundations of psychoanalysis. Berkeley, CA: University of CA Press.

Hardaway RA (1990). Subliminally activated symbiotic fantasies: facts and artifacts. Psychol Bull; 107(2):177-95

Kline, P. (1972). Fact and fantasy in Freudian theory. London: Methuen & Co.
Barron, J. W., Eagle, M. N., Wolitzky, D. L. (Eds.). (1992). Interface of psychoanalysis and psychology. Washington, DC: American Psychological Association.

Shevrin H (1995). Is psychoanalysis one science, two sciences, or no science at all? A discourse among friendly antagonists. Journal of the American Psychoanalytic Association; 43:963-986

Stern, D. N. (1998). The process of therapeutic change involving implicit knowledge: Some implications of developmental observations for adult psychotherapy. Infant Mental Health Journal, 19(3), 300-308.

Weinberger, J., & Hardaway, R.A. (1990). Separating science from myth in subliminal psychodynamic activation. Clinical Psychology Review. 10(6), 1990, 727-756.

Westen, D. (1998). The scientific legacy of Sigmund Freud: Toward a psychodynamically informed psychological science. Psychological Bulletin, 124, 333-371.

Westen, D., & Gabbard, G. O. (2002). Developments in cognitive neuroscience: I. Conflict, compromise, and connectionism. J Am Psychoanal Assoc, 50(1), 53-98.

Westen, D., & Gabbard, G. O. (2002). Developments in cognitive neuroscience: II. Implications for theories of transference. J Am Psychoanal Assoc, 50(1), 99-134.


While many of the references above have been independently sourced and collated, the SAPC recognises that many have been collected from the website of the American Psychoanalytic Association to whom we are very grateful.