Description

The rationale and practice of psychoanalytic therapy are outlined. Unlike cognitive behavioural therapy (CBT), this aims to modify personality structures which affect interpersonal relationships. Lengthy treatment and sophisticated outcome measures are needed. More easily-researched brief psychotherapies, whether analytic or cognitive, show modest efficacy. Randomised controlled trials (RCTs) are problematic for long complex treatments, and more naturalistic studies need examining alongside the recently-accumulating RCT evidence concerning clinical effectiveness. There are indications of important added value for psychoanalysis and psychoanalytic psychotherapy, as compared with the results of brief psychotherapies. In general, longer, more intensive and completed treatments appear superior. More research is needed, and this  ight usefully be focused on

distressed and high service-using personality-disordered patients.