In 2010, Clinical Psychologist Jonathan Shedler published a paper in American Psychologist, the flagship journal of the American Psychological Association. He gave it a deliberately plain title: “The Efficacy of Psychodynamic Psychotherapy.” The plainness was the point. For decades, psychoanalytic treatment had been dismissed as unscientific, a relic of an earlier era. Shedler put a simple question to the research: does it work?

He gathered the existing meta-analyses and found that it does. The effect sizes for psychodynamic therapy were as large as those reported for treatments more often marketed as “evidence-based,” including cognitive-behavioral therapy and antidepressant medication.

The most striking finding, though, was about time. In one major review Shedler examined, patients’ improvement in overall symptoms carried an effect size of 0.97 at the end of treatment. When patients were assessed again nine months or more later, it had risen to 1.51. The gains did not fade once sessions ended; they grew. What took shape over the course of treatment sparked a process that outlasted it. Patients were able to take up what had happened in sessions and carry it forward on their own, in a continuing work of psychic development. 

Shedler also pointed to something less often discussed. When researchers studied what happens in sessions of other therapies, the moments that predicted good outcomes tended to be psychodynamic ones: exploring emotionally charged fantasies, attending to the therapeutic relationship, and noticing patterns that repeat across a life.

In other words, the efficacy of psychodynamic psychotherapy is not only a matter of relieving distress. It is a matter of setting into motion a kind of psychological evolution that continues after treatment sessions conclude. 

Citation

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98–109. https://doi.org/10.1037/a0018378