Jack Malone Introduction to psychology--PSY 101 HC Peer Review #1 Psychotherapy 2012, Vol. 49, No. 3, 276-290 Joel M.

Town, Allan Abbass, Ellen Driessen, Mark J. Diener, Falk Leichsenring, Sven Rabung Section I: Description Introduction: This article, published by the one of the APAs scholarly journals, Psychotherapy, is entitled A Meta-Analysis of Psychodynamic Psychotherapy Outcomes: Evaluating the Effects of Research-Specific Procedures. As the articles title suggests, its authors examine the impact of research-specific procedures (i.e. audio/video recording, treatment manuals, and fidelity checks) on the outcomes of psychodynamic psychotherapy. The article begins by introducing the three research-specific procedures it intends to investigate and some of the controversy surrounding their use in evaluating the effectiveness of psychodynamic psychotherapy. Thus, the overall purpose of the study is to demonstrate empirically the extent to which use of research-specific procedures in psychodynamic psychotherapy effect outcomes First, audio/video recording of therapy sessions is identified as a common research procedure used in the training of therapists. Though, as the article notes, some fear that it may undermine the therapeutic process by diminishing the level of trust between patient and therapist. Second, the article discusses the use of treatment manuals in research and explains that while, the empirical literature indicates that treatment manuals do not ensure effective delivery of therapy the studies are less clear on whether they have a negative effect on treatment and certain studies, note their limitations but overall support their clinical and training utility as a source of 'conceptual support' for defining patient problems and guiding the content of interventions... Finally, the article considers the impact of treatment fidelity or the extent to which therapy is delivered as intended. The two components of treatment fidelity are adherence (whether the core components or techniques, typically described in a treatment manual, are implemented) and treatment competence (the skill or accuracy with which these interventions are delivered.)

Sample: The sample included 46 independent psychodynamic psychotherapy treatment samples totaling 1,615 patients who took part in the study. Methods: The study detailed in the article included data from previously published studies. In all, 46 of the 71 separate samples were taken included based on the following: the treatments were (a)... described by the authors as psychodynamic or psychoanalytic in nature, (b) was provided in an individual or group format (e.g., not Internet delivered or self-help), and (c) applied verbal techniques (e.g., treatments using art as a form of expression were excluded). All participants in the studies were over the age of 18 and were reported to be experiencing common mental disorders like depression or anxiety. The effects of the use of the three research-specific methods were examined on the samples. Analysis: After examining the studies that found the effectiveness of psychodynamic treatments, the researchers further examined the possible effects that audio/video recording, the use of treatment manuals, and treatment fidelity on the results. Using various statistical methods the researchers compared the outcomes of treatments that utilized the procedures and those that did not. Discussion: The study further confirmed what the previous studies cited in the article found. That is, mounting evidence shows the effectiveness of psychodynamic therapy. However, the study explains that, the precise mechanisms of psychotherapeutic change remain unclear. Yet, the study seems to suggest that examining how the research-specific procedures can reveal what is actually delivered in psychotherapy. In other words, by further studying why the researchspecific procedures seem to create better outcomes we may shed light on what happens in the minds of those who experience therapeutic change. Conclusion: The article concludes by explaining that research-specific procedures are not shown to have a negative impact on therapy. Furthermore, these procedures outweigh the supposed limitations on outcomes by showing that, significant treatment gains occurring after therapy appear more likely

when these research-specific procedures are used. Section II: Application I believe that articles like the one detailed above represent a positive trend in the field of psychotherapy. Because there are a number of approaches to therapy, mental health clinicians' perspectives have often been at odds. Some emphasize biology and brain chemistry. Others, like Freudians and neo-Freudians emphasized childhood developmentwhich gave rise to the psychodynamic approach. Perhaps as a pushback to the conservatism and rigidity that developed within these approaches, and bolstered by scientific and empirical rigor, the cognitive approach to the treatment of mental illness became very influential in the later half of the twentieth century. The findings of this study, in my view, helps move toward a synthesis of all three approaches. In other words, it improves the prospects of a systems approach to treatment. By demonstrating the empirical validity of psychodynamic treatments and research procedures that improve their effectiveness, clinicians that may be skeptical of the effectiveness psychodynamic psychotherapy may be led to embrace psychodynamic techniques in their practice. Similarly, as science confirms the effectiveness of certain psychodynamic techniques, clinicians who are more psychodynamically-oriented might more seriously consider the wealth of scientific evidence associated with cognitive therapies. In all, I view the trend toward more eclecticism to be positive. I believe that the more therapists come to a collective understanding on what therapeutic techniques work for their clients and why, the better the outcomes will be for clients. The article and the study it details is a step in the right direction in terms of training therapists, investigating how therapeutic change occurs, and understanding how to improve effective therapies.