A constructive replication of client change during psychodynamic treatment in an outpatient setting

Abstract

We responded to the need for replication in psychotherapy research by extending a prior naturalistic study documenting the effectiveness of long-term psychodynamic treatment. We employed three novel analytic strategies and evaluated their influence on substantive interpretations offered in the prior study. The sample consisted of clients (N = 387; M_age = 31.61; SD = 11.13; 58.9% female; 79.1% Caucasian/White) receiving outpatient treatment at a psychodynamic training clinic. Results replicated the original two-class solutions for social functioning, depression and life satisfaction. Novel to the replication analyses, each trajectory for social functioning and depression exhibited nonlinear change and results advanced research on a theorised mechanism of effective psychodynamic treatment. Results showed that change in experiential avoidance was a possible mechanism between early-treatment change in social functioning and later-treatment changes in depression symptoms and life satisfaction. Clinical implications focus on the influence that initial levels of symptoms and well-being may have on early and later phases of treatment, monitoring progress throughout treatment, and how to promote symptom and well-being improvement.