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  • 1.
    Aafjes-van Doorn, Katie
    et al.
    Adelphi University, USA.
    Lilliengren, Peter
    Stockholm University.
    Cooper, Angela
    Dalhousie University, Canada.
    Macdonald, James
    Headington Psychotherapy, England.
    Falkenström, Fredrik
    Uppsala University.
    Patients Affective Processes Within Initial Experiential Dynamic Therapy Sessions2017In: Psychotherapy, ISSN 0033-3204, E-ISSN 1939-1536, Vol. 54, no 2, p. 175-183Article in journal (Refereed)
    Abstract [en]

    Research has indicated that patients in-session experience of previously avoided affects may be important for effective psychotherapy. The aim of this study was to investigate patients in-session levels of affect experiencing in relation to their corresponding levels of insight, motivation, and inhibitory affects in initial Experiential Dynamic Therapy (EDT) sessions. Four hundred sixty-six 10-min video segments from 31 initial sessions were rated using the Achievement of Therapeutic Objectives Scale. A series of multilevel growth models, controlling for between-therapist variability, were estimated to predict patients adaptive affect experiencing (Activating Affects) across session segments. In line with our expectations, higher within-person levels of Insight and Motivation related to higher levels of Activating Affects per segment. Contrary to expectations, however, lower levels of Inhibition were not associated with higher levels of Activating Affects. Further, using a time-lagged model, we did not find that the levels of Insight, Motivation, or Inhibition during one session segment predicted Activating Affects in the next, possibly indicating that 10-min segments may be suboptimal for testing temporal relationships in affective processes. Our results suggest that, to intensify patients immediate affect experiencing in initial EDT sessions, therapists should focus on increasing insight into defensive patterns and, in particular, motivation to give them up. Future research should examine the impact of specific inhibitory affects more closely, as well as between-therapist variability in patients in-session adaptive affect experiencing.

  • 2.
    Abbass, Allan
    et al.
    Dalhousie University, Canada.
    Lilliengren, Peter
    Stockholms universitet.
    Town, Joel
    Dalhousie University, Canada.
    On Paolo Migone's "What Does Brief Mean?"2014In: Journal of the American Psychoanalytic Association, ISSN 0003-0651, E-ISSN 1941-2460, Vol. 62, no 5, p. NP18-NP22Article in journal (Refereed)
  • 3.
    Abbass, Allan
    et al.
    Dalhousie University, Canada.
    Town, Joel
    Dalhousie University, Canada.
    Ogrodniczuk, John
    University of British Columbia, Canada.
    Joffres, Michel
    Simon Fraser University, Canada.
    Lilliengren, Peter
    Stockholms universitet.
    Intensive Short-Term Dynamic Psychotherapy Trial Therapy: Effectiveness and Role of Unlocking the Unconscious2017In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 205, no 6, p. 453-457Article in journal (Refereed)
    Abstract [en]

    This study examined the effects of trial therapy interviews using intensive short-term dynamic psychotherapy with 500 mixed sample, tertiary center patients. Furthermore, we investigated whether the effect of trial therapy was larger for patients who had a major unlocking of the unconscious during the interview compared with those who did not. Outcome measures were the Brief Symptom Inventory (BSI) and the Inventory of Interpersonal Problems (IIP), measured at baseline and at 1-month follow-up. Significant outcome effects were observed for both the BSI and the IIP with small to moderate preeffect/posteffect sizes, Cohen's d = 0.52 and 0.23, respectively. Treatment effects were greater in patientswho had a major unlocking of the unconscious comparedwith thosewho did not. The trial therapy interview appears to be beneficial, and its effects may relate to certain therapeutic processes. Further controlled research is warranted.

  • 4.
    Ankarberg, Peter
    et al.
    Capio Psykiatri Östergötland.
    Bergsten, Katja
    Uppsala universitet.
    Bohman, Gunnar
    Stockholms universitet.
    Bäck, Malin
    Psykiatriska kliniken i Värnamo; Linköpings universitet.
    Falkenström, Fredrik
    Karolinska institutet; Stockholms läns landsting.
    Klingström, Anders
    Lilliengren, Peter
    Philips, Björn
    Stockholms universitet.
    Werbart, Andrzej
    Stockholms universitet.
    Socialstyrelsens riktlinjer är partiska och ovetenskapliga!2017In: Psykoterapi : Psykoterapicentrums tidskrift, ISSN 2001-5836, Vol. 26, no 2, p. 30-34Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Denna artikel är ett remissvar med synpunkter på de nationella riktlinjerna för ångest och depression, som vi publicerar i sin helhet i tidsskriften. Vi gör det på grund av den ingående kunskap om processerna i riktlinjearbetet som några av författarna har kunnat få genom egen medverkan och närvaro i det arbetet.

  • 5.
    Johansson, Robert
    et al.
    Stcokholms universitet, Linköpings universitet.
    Hesslow, Thomas
    Stockholms universitet.
    Ljótsson, Brjánn
    Karolinska institutet.
    Jansson, Angelica
    Linköpings universitet.
    Jonsson, Lina
    Linköpings universitet.
    Färdig, Smilla
    Linköpings universitet.
    Karlsson, Josefine
    Linköpings universitet.
    Hesser, Hugo
    Linköpings universitet.
    Frederick, Ronald J
    USA.
    Lilliengren, Peter
    Stockholms universitet.
    Carlbring, Per
    Stockholms universitet.
    Andersson, Gerhard
    Linköpings universitet, Karolinska institutet.
    Internet-based affect-focused psychodynamic therapy for social anxiety disorder: A randomized controlled trial with 2-year follow-up.2017In: Psychotherapy, ISSN 0033-3204, E-ISSN 1939-1536, Vol. 54, no 4, p. 351-360Article in journal (Refereed)
    Abstract [en]

    Social anxiety disorder (SAD) is associated with considerable individual suffering and societal costs. Although there is ample evidence for the efficacy of cognitive behavior therapy, recent studies suggest psychodynamic therapy may also be effective in treating SAD. Furthermore, Internet-based psychodynamic therapy (IPDT) has shown promising results for addressing mixed depression and anxiety disorders. However, no study has yet investigated the effects of IPDT specifically for SAD. This paper describes a randomized controlled trial testing the efficacy of a 10-week, affect-focused IPDT protocol for SAD, compared with a wait-list control group. Long-term effects were also estimated by collecting follow-up data, 6, 12, and 24 months after the end of therapy. A total of 72 individuals meeting diagnostic criteria for DSM-IV social anxiety disorder were included. The primary outcome was the self-report version of Liebowitz Social Anxiety Scale. Mixed model analyses using the full intention-to-treat sample revealed a significant interaction effect of group and time, suggesting a larger effect in the treatment group than in the wait-list control. A between-group effect size Cohen's d = 1.05 (95% [CI]: [0.62, 1.53]) was observed at termination. Treatment gains were maintained at the 2-year follow-up, as symptom levels in the treated group continued to decrease significantly. The findings suggest that Internet-based affect-focused psychodynamic therapy is a promising treatment for social anxiety disorder. (PsycINFO Database Record

  • 6.
    Johansson, Robert
    et al.
    Linköpings Universitet, Karolinska Institutet.
    Lilliengren, Peter
    Stockholms universitet.
    Starkt forskningsstöd för Intensive Short-Term Dynamic Psychotherapy2015In: Psykologtidningen, ISSN 0280-9702, no 6, p. 28-31Article, review/survey (Other academic)
    Abstract [sv]

    Intensive Short-term Dynamic Psychotherapy, ISTDP, har god effekt för en bred patientgrupp. Men det finns behov av fler RCT-studier av hög kvalitet och vid fler diagnoser. Här ger psykologerna och forskarna Robert Johansson och Peter Lilliengren en beskrivning av ISTD P och redovisar det nuvarande forskningsläget på området.

  • 7.
    Leichsenring, Falk
    et al.
    Tyskland.
    Liliengren, Peter
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Lindqvist, Karin
    Stockholms universitet.
    Mechler, Jakob
    Stockholms universitet.
    Falkenstöm, Fredrik
    Linköpings universitet.
    Philips, Björn
    Stockholms universitet.
    Steinert, Christiane
    Tyskland.
    Abbass, Allan
    Kanada.
    Inadequate Reporting of a Randomized Trial Comparing Cognitive-Behavioral Therapy and Psychodynamic Therapy for Depression.2019In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 207, no 6, p. 421-422Article in journal (Refereed)
  • 8.
    Lilliengren, Peter
    Stockholms universitet.
    Exploring therapeutic action in psychoanalytic psychotherapy: Attachment to therapist and change2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to explore therapeutic action in psychoanalytic psychotherapy from different perspectives (patient, therapist, observer), using different methodological approaches (qualitative and quantitative). Study I explores patients’ views of therapeutic action with grounded theory methodology. The results indicated that talking openly in a safe therapeutic relationship led to new relational experiences and expanding self-awareness. Hindering factors included difficulties “opening up” and experiencing something missing in treatment. Study II investigates experienced therapists’ views of therapeutic action. The development of a close and trusting relationship was perceived as the core curative factor. Patients’ fear of closeness hindered treatment from the therapists’ perspective. Study III involves the development and psychometric examination of a new rating scale for patient-therapist attachment (Patient Attachment to Therapist Rating Scale; PAT-RS). Inter-rater reliability was good for three of the subscales (Security, Deactivation, Disorganization), but poor for one (Hyperactivation). Patterns of correlations with other measures suggest construct validity for the reliable subscales. Study IV examines the relationships between secure attachment to therapist, alliance, and outcome. Linear mixed-effects models, controlling for therapist effects, treatment length and patient-rated alliance, indicated that secure attachment to therapist relates to outcome. Further, the unique variance associated with secure attachment to therapist predicted continued gains in functioning during follow-up. The results of this thesis suggest that the development of a secure attachment to the therapist is a central mechanism of therapeutic change. The results are discussed in relation to established notions of therapeutic action in psychoanalytic psychotherapy. Two tentative process models that may be useful for clinical practice and future research are proposed. 

  • 9.
    Lilliengren, Peter
    Stockholms universitet.
    Skräddarsydd behandling med ISTDP: referat från RPC:s höstkonferens och workshop med Jon Frederickson 18-19 november 20112012In: Insikten : Riksföreningen Psykoterapicentrums tidning, ISSN 1400-0938, no 1, p. 11-17Article in journal (Other academic)
  • 10.
    Lilliengren, Peter
    et al.
    Stockholms universitet.
    Falkenström, Fredrik
    Uppsala universitet.
    Sandell, Rolf
    Lunds universitet.
    Risholm Mothander, Pia
    Stockholms universitet.
    Werbart, Andrzej
    Stockholms universitet.
    Secure attachment to therapist, alliance, and outcome in psychoanalytic psychotherapy with young adults2015In: Journal of counseling psychology, ISSN 0022-0167, E-ISSN 1939-2168, Vol. 62, no 1, p. 1-13Article in journal (Refereed)
    Abstract [en]

    Using a novel approach to assess attachment to therapist from patient narratives (Patient Attachment to Therapist Rating Scale; PAT-RS), we investigated the relationships between secure attachment to therapist, patient-rated alliance, and outcome in a sample of 70 young adults treated with psychoanalytic psychotherapy. A series of linear mixed-effects models, controlling for length of therapy and therapist effects, indicated that secure attachment to therapist at termination was associated with improvement in symptoms, global functioning and interpersonal problems. After controlling for the alliance, these relationships were maintained in terms of symptoms and global functioning. Further, for the follow-up period, we found a suppression effect indicating that secure attachment to therapist predicted continued improvement in global functioning whereas the alliance predicted deterioration when both variables were modeled together. While limited by the correlational design, this study suggests that the development of a secure attachment to therapist is associated with treatment gains as well as predictive of post-treatment improvement in functioning. Future research should investigate the temporal development of attachment to therapist and its interaction with alliance and outcome more closely. To ensure differentiation from patient-rated alliance, observer-based measurement of attachment to therapist should be considered.

  • 11.
    Lilliengren, Peter
    et al.
    Stockholms universitet.
    Johansson, Robert
    Linköpings universitet.
    Lindqvist, Karin
    Ericastiftelsen.
    Mechler, Jakob
    Norra Stockholms psykiatri.
    Andersson, Gerhard
    Linköpings universitet.
    Efficacy of Experiential Dynamic Therapy for Psychiatric Conditions: A Meta-Analysis of Randomized Controlled Trials2016In: Psychotherapy, ISSN 0033-3204, E-ISSN 1939-1536, Vol. 53, no 1, p. 90-104Article in journal (Refereed)
    Abstract [en]

    Experiential dynamic therapy (EDT) is a subgroup of short-term psychodynamic psychotherapy (STPP) that emphasizes patients in-session affective processing. To evaluate the efficacy of EDT for psychiatric conditions, we conducted a meta-analysis of randomized controlled trials. Twenty-eight studies published between 1978 and 2014 were included, encompassing 1,782 adult patients with mood, anxiety, personality, or mixed disorders. Across targeted outcome domains, medium-size between-groups effects (Cohens ds ranging from 0.39 to 0.65) favored EDT over inactive controls at posttreatment and in symptom measures at follow-up. We found no differences between EDT and active treatments (e.g., medication, cognitive-behavioral therapy, manualized supportive therapy) at posttreatment, but EDT outperformed supportive therapy at follow-up (d = 0.75). In terms of within-group effect sizes, EDT was associated with large improvements in general psychiatric symptoms (d = 1.11), depression (d = 1.33), and anxiety (d = 1.09) and with small to moderate gains in the areas of interpersonal problems (d = 0.55) and global functioning (d = 0.86). Small but significant effects suggested continued improvement between posttreatment and follow-up. Heterogeneity in pre-post effects was explored in subgroup analyses, which indicated that EDT might be most effective in depressive disorders and that individual EDT had larger effects compared with group treatment. In addition, EDT performed better in higher quality studies. We conclude that EDT is a promising treatment for psychiatric conditions in adults. Further high-quality studies evaluating contemporary versions of EDT in specific psychiatric conditions are warranted.

  • 12.
    Lilliengren, Peter
    et al.
    Stockholms universitet.
    Johansson, Robert
    Karolinska institutet.
    Town, Joel, M.
    Storbritannien; Kanada.
    Kisely, Steve
    Australien.
    Abbass, Allan
    Kanada.
    Intensive Short-Term Dynamic Psychotherapy for generalized anxiety disorder: A pilot effectiveness and process-outcome study.2017In: Clinical Psychology and Psychotherapy, ISSN 1063-3995, E-ISSN 1099-0879, Vol. 24, no 6, p. 1313-1321Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to evaluate the clinical- and cost-effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) for generalized anxiety disorder (GAD). We further aimed to examine if a key clinical process within the ISTDP framework, termed the level of mobilization of unprocessed complex emotions (MUCE), was related to outcome. The sample consisted of 215 adult patients (60.9% female) with GAD and comorbid conditions treated in a tertiary mental health outpatient setting. The patients were provided an average of 8.3 sessions of ISTDP delivered by 38 therapists. The level of MUCE in treatment was assessed from videotaped sessions by a rater blind to treatment outcome. Year-by-year healthcare costs were derived independently from government databases. Multilevel growth models indicated significant decreases in psychiatric symptoms and interpersonal problems during treatment. These gains were corroborated by reductions in healthcare costs that continued for 4 years post-treatment reaching normal population means. Further, we found that the in-treatment level of MUCE was associated with larger treatment effects, underlining the significance of emotional experiencing and processing in the treatment of GAD. We conclude that ISTDP appears to reduce symptoms and costs associated with GAD and that the ISTDP framework may be useful for understanding key therapeutic processes in this challenging clinical population. Controlled studies of ISTDP for GAD are warranted.

  • 13.
    Lilliengren, Peter
    et al.
    Södermalms psykiatriska jour- och öppenvårdsmottagning, Södra Stockholms Psykiatri, Stockholms läns landsting.
    Lindert, Patrik
    Integrativ metod förbättrar behandling av affektfobier2006In: Psykologtidningen, ISSN 0280-9702, no 2, p. 18-20Article in journal (Other academic)
  • 14.
    Lilliengren, Peter
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Philips, Björn
    Stockholms universitet.
    Falkenström, Fredrik
    Linköpings universitet.
    Bergquist, Mia
    Region Västra Götaland.
    Ulvenes, Pål
    Research Institute, Modum Bad Psychiatric Center.
    Wampold, Bruce
    Research Institute, Modum Bad Psychiatric Center.
    Comparing the treatment process in successful and unsuccessful cases in two forms of psychotherapy for cluster C personality disorders.2019In: Psychotherapy, ISSN 0033-3204, E-ISSN 1939-1536, Vol. 56, no 2, p. 285-296Article in journal (Refereed)
    Abstract [en]

    Different forms of psychotherapy are effective for cluster C personality disorders, but we know less about what in-session processes promote change. Contrasting successful and unsuccessful cases may elucidate processes that facilitate or impede outcome and offer suggestions for clinical practice and future research. In this exploratory outcome-process study, 10 successful and 10 unsuccessful cases were selected from a randomized trial comparing cognitive therapy and short-term psychodynamic psychotherapy for cluster C personality disorders. Videotaped sessions were rated with the Psychotherapy Process Q-Set (PQS). The treatments were compared in terms of which PQS items differentiated successful and unsuccessful cases, as well as their resemblance with PQS prototypes of "ideal treatments." Therapists' behavior in early sessions was also explored. Results indicate that successful cases in our sample were characterized by a more active and engaged patient. In contrast, unsuccessful cases were characterized by a more directive or "controlling" therapist stance. Correlations with PQS prototypes were moderate to strong in both successful and unsuccessful cases, suggesting that optimal and suboptimal interpersonal processes may be independent of adherence to particular treatments. Exploration of therapist behaviors in early sessions indicated that therapists were more likely to adjust their way of working in the successful cases. Our result suggests that patient engagement and therapists' early efforts to improve the therapy relationship may be pivotal for successful outcome, whereas therapist controlling behavior may obstruct the treatment process, regardless of therapy model used. The impact of these in-session processes should be examined more closely in larger samples in future studies. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

  • 15.
    Lilliengren, Peter
    et al.
    Stockholms universitet.
    Werbart, Andrzej
    Stockholms universitet.
    Therapists' view of therapeutic action in psychoanalytic psychotherapy with young adults2010In: Psychotherapy, ISSN 0033-3204, E-ISSN 1939-1536, Vol. 47, no 4, p. 570-585Article in journal (Refereed)
    Abstract [en]

    Studying experienced therapists' implicit theorizing may contribute to our understanding of what is helpful and what hinders treatment with particular patient populations. In this study, 16 therapists' views of curative factors, hindering factors, and outcome were explored in 22 interviews conducted at termination of individual psychoanalytic psychotherapy with young adults. Grounded theory methodology was used to construct a tentative model of therapeutic action based on the therapists' implicit knowledge. The results indicated that developing a close, safe and trusting relationship was viewed as the core curative factor in interaction with the patient making positive experiences outside the therapy setting and the therapist challenging and developing the patient's thinking about the self. The therapeutic process was experienced as a joint activity resulting in the patient becoming a subject and acquiring an increasing capacity to think and process problems. The patient's fear about close relationships was seen as hindering treatment and leading to core problems remaining. The model is discussed in relation to major theories of therapeutic action in the psychoanalytic discourse and previous research focusing on young adults' view of curative and hindering factors in psychotherapy. Implications for practice and further research are suggested.

  • 16.
    Lilliengren, Peter
    et al.
    Stockholms universitet.
    Werbart, Andrzej
    Stockholms universitet.
    Risholm Mothander, Pia
    Stockholms universitet.
    Ekström, August
    Stockholms universitet.
    Sjögren, Susanna
    Stockholms universitet.
    Ögren, Marie-Louise
    Stockholms universitet.
    Patient attachment to therapist rating scale: development and psychometric properties2014In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381, Vol. 24, no 2, p. 184-201Article in journal (Refereed)
    Abstract [en]

    Objective: To report on the development and initial psychometric properties of a new rating scale for patent-therapist attachment. Method: Seventy interviews from the Young Adult Psychotherapy Project (YAPP) were rated. Results: Excellent internal consistency (Cronbach's > .90) was observed for all four subscales (Security, Deactivation, Hyperactivation, and Disorganization). Three subscales showed good inter-rater reliability (ICC > .60), while one (Hyperactivation) had poor (ICC < .40). Correlations with measures of alliance, mental representations, and symptom distress support the construct validity of the reliable subscales. Exploratory factor analysis indicated three underlying factors explaining 82% of the variance. Conclusions: The Patient Attachment to Therapist Rating Scale is a promising approach for assessing the quality of attachment to therapist from patient narratives. Future development should focus on improving the discrimination of the insecure subscales.

  • 17.
    Lilliengren, Peter
    et al.
    Stockholms universitet.
    Werbart, Andzej
    Stockholms universitet.
    A model of therapeutic action grounded in the patients’ view of curative and hindering factors in psychoanalytic psychotherapy2005In: Psychotherapy, ISSN 0033-3204, E-ISSN 1939-1536, Vol. 42, no 3, p. 324-339Article in journal (Refereed)
  • 18.
    Maroti, Daniel
    et al.
    Karolinska institutet; Danderyds sjukhus.
    Lilliengren, Peter
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Bileviciute-Ljungar, Indre
    Karolinska institutet; Danderyds sjukhus.
    The Relationship Between Alexithymia and Emotional Awareness: A Meta-Analytic Review of the Correlation Between TAS-20 and LEAS2018In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 9, p. 1-10-, article id 453Article in journal (Refereed)
    Abstract [en]

    Background: Alexithymia and emotional awareness may be considered overlapping constructs and both have been shown to be related to psychological and emotional well-being. However, it is not clear how the constructs relate to each other empirically or if they may overlap more or less in different populations. The aim of this review was therefore to conduct a meta-analysis of correlations between the most commonly used measures of alexithymia (i.e., the self-report instrument Toronto Alexithymia Scale; TAS-20) and emotional awareness (i.e., the observer-rated instrument Level of Emotional Awareness Scale; LEAS) and to explore potential moderators of their relationship. 

    Methods: Electronic databases were searched for studies published until the end of February 2018. Study samples were coded as medical conditions, psychiatric disorders and/or healthy controls and sample mean age and gender distribution were extracted. Correlations between the TAS-20 and the LEAS were subjected to a random effect of meta-analysis and moderators were explored in subgroup analyses and meta-regressions. Publication bias was considered. 

    Results: 21 studies reporting on 28 independent samples on correlation analysis were included, encompassing a total of 2857 subjects (57% women). The aggregated correlation between TAS-20 and LEAS was r = −0.122 (95% CI [−0.180, −0.064]; Z = −4.092; p < 0.001), indicating a significant, but weak, negative relationship between the measures. Heterogeneity was moderate, but we found no indication of significant differences between patients with medical conditions, psychiatric disorders or healthy controls, nor that mean age or percentage of female subjects moderated the relationship. The overall estimate became somewhat weaker after adjusting for possible publication bias. 

    Conclusions: Our results indicate that TAS-20 and LEAS measure different aspects of emotional functioning. The small overlap suggests that alexithymia and emotional awareness are distinct constructs of emotional well-being. Clinicians need to assess both aspects when considering treatment options for individual patients. Moreover, from the clinical standpoint, an easy reliable and valid way of measuring emotional awareness is still needed. More research should be focus on the differences between alexithymia and emotional awareness in specific conditions, but also how to integrate self-report instrument and observed based measures in a clinical situation.

  • 19. Mechler, Jakob
    et al.
    Lilliengren, Peter
    Stockholms universitet.
    Lindqvist, Karin
    Starkt stöd för psykodynamisk terapi vid depression2017In: Psykologtidningen, ISSN 0280-9702, no 2, p. 24-27Article in journal (Other academic)
    Abstract [sv]

    Olika psykologiska behandlingsmetoder tycks ha likvärdiga effekter vid depression men fortfarande är frågan om vilken metod som passar vem bäst, till stor del obesvarad. Det skriver psykologerna Peter Lilliengren, Jakob Mechler och Karin Lindqvist, som här redogör för aktuell forskning om psykodynamisk psykoterapi vid depression.

  • 20.
    Talia, Alessandro
    et al.
    Tyskland.
    Miller-Bottome, Madeleine
    USA.
    Wyner, Rachel
    USA.
    Lilliengren, Peter
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Bate, Jordan
    USA.
    Patients’ Adult Attachment Interview classification and their experience of the therapeutic relationship: are they associated?2019In: Research in Psychotherapy, ISSN 2499-7552, Vol. 22, no 2, p. 175-188Article in journal (Refereed)
    Abstract [en]

    In the last decade of his career, Jeremy Safran became increasingly interested in investigating the ways in which attachment representations influence the therapeutic relationship. In this paper, we test such influence in a sample of thirty outpatients who received Brief Relational Therapy by comparing their independently coded pre-treatment Adult Attachment Interview (AAI) with their narratives in a post-treatment interview about the relationship with the therapist (the Patient Relationship Interview at Termination, PRI-T). The PRI-T was coded with the following three measures: i) The Patient Attachment to Therapist Rating Scale (PAT-RS), which assesses the quality of the patient’s attachment relationship to the therapist; ii) the Coherence scale from the AAI, adapted for use on the PRI-T; and iii) the Patient Attachment Classification System (PACS), which measures generalized differences in how individuals convey their experiences and feelings. Results suggest that patients’ AAI predicts how they experience, represent, and communicate about the therapeutic relationship at the end of treatment, as shown by the PAT-RS, the Coherence scale adapted for use on the PRI-T, and the PACS applied to the PRI-T. These findings lend support to Safran and others’ hypothesis that patients’ AAI-status plays a role in patients’ representations of the relationship with the therapist.

  • 21.
    Werbart, Andrzej
    et al.
    Stockholms universitet.
    Missios, Peter
    Stockholms universitet.
    Waldenström, Fredrik
    Stockholms universitet.
    Lilliengren, Peter
    Stockholms universitet.
    "It was hard work every session": Therapists' view of successful psychoanalytic treatments2017In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381, p. 1-18Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore therapists' experiences of the therapeutic process in successful cases of psychoanalytic psychotherapy.

    METHOD: A two-stage, mixed-method design was used. Sixteen successful cases were drawn from a sample of 92 young adults in psychoanalytic psychotherapy according to Jacobson's criteria for reliable and clinically significant improvement. Therapist interviews at baseline and termination were analyzed applying Inductive Thematic Analysis.

    RESULTS: Three core themes emerged: Being Particularly Motivated to be This Patient's Therapist, Maintaining a Safe and Attentive Therapeutic Position, and Assiduous Work Every Session. The therapists experienced positive feelings towards the patient from the outset of treatment and described active, relational work that included paying attention to incongruities in the patient's self-presentation and being mindful of patient's avoidant behavior. The therapist's motivation and attentive position made it possible to balance support and challenge in the therapeutic relationship.

    CONCLUSIONS: Successful therapeutic work presupposes positive expectations, an active therapeutic stance and assiduous work session-by-session. Therapist expertise may involve the ability to mobilize and work effectively with patient-specific resources and obstacles from the beginning of treatment. In addition to identifying the characteristics and actions of effective therapists, research should also focus on processes emerging within effective therapeutic dyads. Clinical or methodological significance of this article: Our study indicates several factors that seem to characterize therapist expertise and can inform psychotherapy training. Successful therapeutic work presupposes positive expectations, an active therapeutic stance, courage to challenge the patient, and assiduous work session-by-session. Therapist expertise may involve the ability to mobilize and work effectively with patient-specific resources and obstacles from the beginning of treatment. In addition to identifying the characteristics and actions of effective therapists, research should also focus on processes emerging within effective therapeutic dyads.

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