The efficacy of psychodynamic psychotherapy
Also known as The Efficacy of Psychodynamic Psychotherapy, Shedler 2010
Jonathan Shedler's 2010 review: psychodynamic therapy works as well as evidence-based ones
At a glance
What it found
Effects as large as other therapies, Gains that grow, Shared techniques
See all 3Key ideas: seven distinctive features
1. Focus on emotion, 2. Exploring avoidance, 3. Recurring patterns …
See all 7Criticism and limits
Overstated evidence, Criticisms not addressed, Whose techniques?
See all 3Read next
Psychodynamic psychotherapy, The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses, The Great Psychotherapy Debate
See all 3Connections
Jonathan Shedler, Psychodynamic psychotherapy and 2 others
See all 4
Also on this page: Key facts · Links · Sources · Related pages
- Shedler reviews meta-analyses and finds psychodynamic therapy's effect sizes as large as those of therapies promoted as evidence based.
- Patients keep their gains and seem to keep improving after therapy ends.
- He lists seven features that distinguish psychodynamic technique, such as a focus on emotion and on recurring patterns.
- Other therapies may work partly because skilled therapists use these same techniques.
- He blames the belief that it lacks evidence on selective spreading of research findings.
Why it matters
- A widely read answer to the claim that psychodynamic therapy is unscientific.
- Read it with the published replies, which dispute how strong the evidence is.
Key facts
- Author
- Jonathan Shedler (University of Colorado Denver School of Medicine)1
- Published
- February 20101
- Journal
- American Psychologist, vol. 65, issue 2, pp. 98–1091
- DOI
- 10.1037/a00183781
- Design
- Narrative review of meta-analyses1
- Main result
- Cites a Cochrane meta-analysis (Abbass et al., 2006) of 23 trials and 1,431 patients: effect size .97 for general symptom improvement, 1.51 at follow-up over nine months2
- Comparison
- Antidepressants .31 (Turner et al., 2008); CBT for depression, panic and anxiety .68 (Haby et al., 2006)2
- Cited by
- 360 (Europe PMC count, October 2026)1
What it found
-
Effects as large as other therapies1
Effect sizes for psychodynamic therapy are as large as those reported for therapies promoted as "empirically supported".
-
Gains that grow1
Patients maintain their gains and appear to keep improving after treatment ends.
-
Shared techniques1
Non-psychodynamic therapies may work partly because skilled practitioners use psychodynamic techniques.
Key ideas: seven distinctive features
-
1. Focus on emotion2
Helping patients put words to the full range of their feelings, including contradictory or troubling ones.
-
2. Exploring avoidance2
Noticing and exploring the ways people avoid distressing thoughts and feelings.
-
3. Recurring patterns2
Identifying themes that repeat in thoughts, feelings, relationships and life experiences.
-
4. The past2
Discussing past experience to see how it shapes the present.
-
5. Relationships2
A heavy emphasis on the patient's relationships and interpersonal experience.
-
6. The therapy relationship2
Working with the client-therapist relationship, where interpersonal themes tend to reappear.
-
7. Wishes and fantasies2
Encouraging patients to speak freely, so desires, fears, fantasies and dreams come up.
Criticism and limits
-
Overstated evidence3
Anestis, Anestis and Lilienfeld (2011): Shedler glosses over methodological details, ignores contrary findings and overstates the evidence.
-
Criticisms not addressed4
Thombs, Jewett and Bassel (2011): he did not engage specific criticisms, separate short-term from long-term therapy, or weigh the quality of the meta-analyses.
-
Whose techniques?5
Tryon and Tryon (2011) argue that no therapy owns common factors such as the relationship.
Read next
-
The approach itself.
-
The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses
The matching review for CBT.
-
The Great Psychotherapy Debate
Why different therapies may produce similar results.
Connections
Links
Sources
- Shedler J. The efficacy of psychodynamic psychotherapy. Am Psychol 2010;65(2):98-109 (Europe PMC) (opens europepmc.org)
- Shedler J. The Efficacy of Psychodynamic Psychotherapy, pre-publication version revised 9 October 2009 (PDF) (opens briancollinson.ca)
- Anestis MD, Anestis JC, Lilienfeld SO. When it comes to evaluating psychodynamic therapy, the devil is in the details. Am Psychol 2011 (Europe PMC) (opens europepmc.org)
- Thombs BD, Jewett LR, Bassel M. Is there room for criticism of studies of psychodynamic psychotherapy? Am Psychol 2011 (Europe PMC) (opens europepmc.org)
- Tryon WW, Tryon GS. No ownership of common factors. Am Psychol 2011 (Europe PMC) (opens europepmc.org)
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