> Dr. Mittelman and all,
>
> Hello again. Despite my multitudinous faults and wicked, wicked ways, I don't
>
> disappear as quickly
> as Dr. Mittelman
> described in his last message.
>
> I have a different recollection of our previous exchanges. I believe that
> they
> eventually became friendly backchannel messages within which we basically
> agreed
> that a non-medical model (or psychopathological model) of psychoanalytic
> practice
> obviated any further discussion about the need for empirical outcome
> research.
> Thus, our discussions ended on a note of agreement.
>
> With respect to the meta-analytic research on therapy outcome, I believe
> that I
> made the following points:
>
> 1. The research you referred to was with psychodynamic NOT PSYCHOANALYTIC
> treatment. At present, there is no reason to believe that the results of
> the
> former necessarily apply to the latter.
>
> 2. The psychodynamic approaches often used in current research are
> psychodynamic
> because their authors so label them. Luborsky's Core Conflict Relationship
> Theme
> therapy, called psychodynamic by Luborsky, which has been shown to be
> quite
> successful in rigorous empirical tests, does not involve interpretations
> of the
> unconscious and thus can just as easily be called cognitive psychotherapy.
> This
> form of psychotherapy is quite different from the psychodynamic therapy
> which is
> supposed to be a direct derivative of psychoanalysis.
>
> 3. A number of meta-analytic studies by Weitz and Weitz have shown that
> outcome
> studies carried out in actual service institutions (hospitals, clinics)
> get far
> lower effects sizes for behavioral change than studies done in academic
> institutions (Universities and medical schools) NO MATTER WHAT THE TYPE OF
> THERAPY. Weitz and Weitz have suggested that this may be because
> psychotherapists
> only adhere to the style of therapy they claim to be doing when they are
> monitored or follow a written manual (a control done at Universities but
> not in
> clinics). See 4 below
>
> 4, My own research (done as part of a team), publised decades ago, investigated the actual
> therapy
> sessions of  psychiatrists who were in training to be psychoanalysts (or
> were
> applicants, I don't remember for sure). They said they were doing
> psychodynamic
> therapy, which is what they had been instructed to do. We tape recorded
> the
> sessions, and our analyses of psychotherapist statements indicated that
> they
> mostly made supportive or Rogerian (reflecting feelings) statements rather
> than
> psychodynamic ones.
>
> Thus, I doubt if any definitive statements about psychodynamic therapy,
> much less
> psychoanalysis can yet be made. I also believe that this is substantially true
>
of all the "empirically supported" therapies. My quarrel with
psychoanalysis is that almost no research is done. Psychoanalysts with
rare exceptions, don't even try.

>
> In any case, how are you doing?
>
> Howard
>
>