The role of patient characteristics in the selection of patients for psychodynamic psychotherapy – A.L.J. de Jonge, H.L. Van, J. Peen –
background Although the effectiveness of psychodynamic psychotherapy has been demonstrated in patients suffering from DSM-defined disorders, it appears that in clinical practice other patient characteristics also play an important role in the selection of patients for psychodynamic therapy.
aim To review the patient characteristics that predict the outcome of psychodynamic psychotherapy and to define the role that clinical judgement plays in the selection of patients for psychodynamic therapy.
method We studied the literature using Medline, PsycINFO and Embase in order to retrieve articles relating to patient characteristics, predictive factors and clinical judgement regarding the outcome of psychodynamic therapy.
results Object-related functioning, motivation and ‘psychological mindedness’ appear to have a low-to-moderate influence on the outcome of psychodynamic therapy. In practice, however, suitability for treatment was actually determined on the basis of the clinical judgement of patient characteristics and on an assessment of whether the therapeutic process was likely to lead to a profitable patient-clinician relationship.
conclusion Determining whether a patient should receive psychodynamic psychotherapy is a differentiated process of clinical judgement. More research is needed into the process of clinical judgement. This could, for instance, compare the advantages of selection based on systematic clinical judgement over randomised selection.[tijdschrift voor psychiatrie 55(2013)1, 35-44]