Lilliengren Peter, Mechler Jakob, Lindqvist Karin, Maroti Daniel, Johansson Robert
Department of Psychology, Stockholm University, Stockholm, Sweden.
Department of Psychology, Uppsala University, Uppsala, Sweden.
Clin Psychol Psychother. 2025 May-Jun;32(3):e70086. doi: 10.1002/cpp.70086.
There is a growing interest in clinical interventions targeting emotion regulation difficulties across mental health conditions. Experiential dynamic therapies (EDTs) are transdiagnostic, affect-focused, short-term psychodynamic therapy models that emphasize in-session emotional processing. This review provides a 10-year update on the efficacy of EDTs for mood, anxiety, personality and somatic symptom disorders in adults and children/adolescents. A comprehensive search identified 57 randomized controlled trials (n = 4330) conducted in Western (k = 38; n = 3178) and non-Western countries (k = 19; n = 1152) between 1978 and 2024. Random-effects meta-analyses on primary outcomes indicated large, significant effects for EDTs compared to inactive controls at post-treatment (Hedge's g = -0.96; k = 41) and follow-up (g = -1.11; k = 20). Compared to active controls, effects were small and non-significant post-treatment (g = -0.17; k = 27) but became significant at follow-up (g = -0.40; k = 19), suggesting a potential modest long-term advantage of EDTs. Despite substantial heterogeneity (I > 75%), results remained robust in sensitivity analyses. Moderator analyses revealed few significant findings, indicating relative consistency across diagnostic groups, treatment formats and active comparators. Non-Western and lower quality studies reported larger effects compared to inactive, but not active, controls. While cautious interpretation is warranted due to unexplained heterogeneity, findings support EDTs as efficacious transdiagnostic interventions for emotional disorders, with sustained benefits over time. Future research should prioritize large-scale, methodologically rigorous trials that explore mechanisms of change, optimize treatment delivery and identify moderators of long-term outcomes.
针对心理健康状况下情绪调节困难的临床干预措施越来越受到关注。体验式动力疗法(EDTs)是一种跨诊断、以情感为重点的短期心理动力治疗模式,强调治疗过程中的情感处理。本综述提供了关于EDTs对成人及儿童/青少年的情绪、焦虑、人格和躯体症状障碍疗效的10年更新情况。全面检索确定了1978年至2024年间在西方(k = 38;n = 3178)和非西方国家(k = 19;n = 1152)进行的57项随机对照试验(n = 4330)。对主要结局的随机效应荟萃分析表明,与无活性对照相比,EDTs在治疗后(Hedge's g = -0.96;k = 41)和随访时(g = -1.11;k = 20)有较大且显著的效果。与活性对照相比,治疗后效果较小且不显著(g = -0.17;k = 27),但在随访时变得显著(g = -0.40;k = 19),这表明EDTs可能有适度的长期优势。尽管存在显著异质性(I>75%),但敏感性分析结果仍然稳健。调节因素分析显示显著结果较少,表明各诊断组、治疗形式和活性对照之间相对一致。与无活性对照相比,非西方和质量较低的研究报告了更大的效果,但与活性对照相比则不然。由于存在无法解释的异质性,虽然需要谨慎解释,但研究结果支持EDTs作为情绪障碍的有效跨诊断干预措施,且随着时间推移有持续益处。未来的研究应优先进行大规模、方法严谨的试验,以探索变化机制、优化治疗实施并确定长期结局的调节因素。