Fiorini Guilherme, Khoe Zane, Fonagy Peter, Midgley Nick
Division of Psychology and Language Sciences, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.
Anna Freud, London, United Kingdom.
Front Psychol. 2024 Sep 19;15:1389833. doi: 10.3389/fpsyg.2024.1389833. eCollection 2024.
Short-term psychoanalytic psychotherapy (STPP) is an evidence-based treatment for adolescents with depression, but like all treatment approaches, not all patients benefit from it. Previous investigations of the process of STPP have mostly focused on successful cases, and only a few studies have included the perspectives of young people, their parents, and therapists in the understanding of treatment non-response.
Semi-structured interviews were carried out with young people who were considered "non-responders" to STPP, as well as with their parents and therapists. These cases were analyzed using a descriptive-interpretative approach.
The data analysis revealed three themes: (1) Therapy as a safe space; (2) Can short-term psychotherapy ever be enough?; and (3) Therapists making links and connections that did not make sense to the young people.
This study's findings indicate that "poor outcome" psychotherapy does not necessarily equate to a "poor experience" of psychotherapy, with different stakeholders appreciating the treatment setting as a "safe space." However, they also suggest that some felt that a relatively short-term treatment could not lead to substantial change and that young people in STPP might have a more negative view of their outcomes compared to their parents and therapists. Finally, the findings indicate that some interventions made by clinicians in STPP feel wrong or do not make sense to young people, potentially affecting the therapy process.
短期精神分析心理治疗(STPP)是一种针对青少年抑郁症的循证治疗方法,但与所有治疗方法一样,并非所有患者都能从中受益。先前对STPP治疗过程的研究大多集中在成功案例上,只有少数研究在理解治疗无反应时纳入了年轻人、他们的父母和治疗师的观点。
对被认为对STPP“无反应”的年轻人及其父母和治疗师进行了半结构化访谈。采用描述性解释方法对这些案例进行分析。
数据分析揭示了三个主题:(1)作为安全空间的治疗;(2)短期心理治疗足够吗?;(3)治疗师建立的联系对年轻人来说毫无意义。
本研究结果表明,“疗效不佳”的心理治疗不一定等同于心理治疗的“体验不佳”,不同的利益相关者将治疗环境视为“安全空间”。然而,研究结果还表明,一些人认为相对短期的治疗无法带来实质性改变,与父母和治疗师相比,接受STPP治疗的年轻人可能对自己的治疗结果持更负面的看法。最后,研究结果表明,STPP中临床医生的一些干预措施让年轻人感觉不对或毫无意义,这可能会影响治疗过程。