Slavin-Mulford Jenelle, Hilsenroth Mark, Weinberger Joel, Gold Jerold
The Psychological Evaluation and Research Laboratory, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts 02114, USA.
J Nerv Ment Dis. 2011 Apr;199(4):214-21. doi: 10.1097/NMD.0b013e3182125d60.
This is the first study with acceptable inter-rater reliability to examine specific therapeutic techniques related to change in anxiety disorder patients during short-term psychodynamic psychotherapy. The study first examined the effectiveness of short-term psychodynamic psychotherapy and results showed significant and positive pre-/post-treatment changes on both patient and independent clinical ratings for anxiety, global symptomatology, relational, social, and occupational functioning. Likewise, the majority of patients (76%) reported anxiety symptoms within a normal distribution at termination. Importantly, psychodynamic interventions rated early in treatment (third/fourth session) were positively related to changes in anxiety symptoms. Further, results showed that several individual psychodynamic techniques were meaningfully related to outcome including (1) focusing on wishes, fantasies, dreams, and early memories; (2) linking current feelings or perceptions to the past; (3) highlighting patients' typical relational patterns; and (4) helping patients to understand their experiences in new ways. Clinical applications are discussed.
这是第一项具有可接受的评分者间信度的研究，旨在考察短期精神动力心理治疗期间与焦虑症患者变化相关的特定治疗技术。该研究首先检验了短期精神动力心理治疗的有效性，结果显示，在患者自评和独立临床评定中，治疗前/后在焦虑、总体症状、人际关系、社交和职业功能方面均有显著的正向变化。同样，大多数患者（76%）在治疗结束时报告焦虑症状处于正常分布范围内。重要的是，在治疗早期（第三/四节）评定的精神动力干预与焦虑症状的变化呈正相关。此外，结果表明，几种个体精神动力技术与治疗结果有显著关联，包括：（1）关注愿望、幻想、梦境和早期记忆；（2）将当前的感受或认知与过去相联系；（3）突出患者典型的关系模式；（4）帮助患者以新的方式理解自身经历。文中还讨论了临床应用。
