The Effectiveness of Psychoanalytic Psychotherapy Scale: A Psychometric Study

Abstract

The purpose of the present study was to develop a psychometrically robust measure to evaluate the effectiveness of psychoanalytic psychotherapy and psychoanalysis, entitled as the "Effectiveness of Psychoanalytic Psychotherapy Scale [EPPS]". This scale was designed to assess the changes experienced by patients/analysands who undergo psychoanalytic psychotherapy or psychoanalysis. A sample of 216 individuals above the age of 18 who had been continuing their own psychoanalytic psychotherapy or psychoanalysis for at least three months participated in the study. The participants were given EPPS along with the other measures such as the Reassurance-Seeking Scale, The Satisfaction with Life Scale, and The Positive and Negative Affect Schedule. Factor structure of the EPPS and its reliability and validity coefficients were examined. Several analyses including reliability analysis, exploratory factor analysis, hierarchical regression analyses and MANOVA were conducted to confirm EPPS's factor structure and psychometric strength. Obtained results suggested that EPPS is a psychometrically sound measure to evaluate the effectiveness of psychoanalytic work.

Keywords

• effectiveness of psychotherapy
• psychoanalytic psychotherapy
• psychoanalysis
• scale development

Psikanalitik Psikoterapinin Etkililiği Ölçeği: Psikometrik Bir Çalışma

Abstract

Psikanalitik psikoterapi, Sigmund Freud'un keşfettiği ve bilinçdışını çalışmayı merkeze aldığı bir yöntem olan psikanalizden temel alır. Freud bilinçdışı motivasyonların kişilerin gündelik eylemlerinde temel bir yeri olduğunu söylemiş ve psikanalizde bilinçdışının çalışılmasına büyük önem vermiştir. Psikanalitik psikoterapi ruh sağlığı sorunları için daha derinlemesine ve uzun vadeli çözümler sunmaktadır. Bu çalışmada, psikanalitik psikoterapi ve psikanalizin etkililiğini incelemek için geliştirilen Psikanalitik Psikoterapinin Etkililiği Ölçeği’nin [PPEÖ] psikometrik özellikleri sunulmaktadır. Bu ölçek, psikanalitik psikoterapiye veya psikanalize devam eden kişilerdeki değişiklikleri değerlendirmeyi amaçlamaktadır. Çalışmaya en az üç aydır kendi psikanalitik psikoterapi sürecini veya psikanalizini sürdürmekte olan 18 yaş üstü 216 kişi katılmıştır. Katılımcılara, Güvence Arayışı, Yaşam Doyumu, Pozitif ve Negatif Duygu ölçekleri ile birlikte PPEÖ verilmiştir. PPEÖ'nün faktör yapısı incelenmiş, güvenilirlik ve geçerlilik çalışmaları yapılmıştır. PPEÖ'nün faktör yapısını ve psikometrik gücünü doğrulamak için güvenilirlik analizi, açımlayıcı faktör analizi, hiyerarşik regresyon analizleri ve çok değişkenli varyans analizlerini içeren çeşitli analizler yapılmıştır. Sonuçlar, PPEÖ’nün psikanalitik çalışmanın etkililiğini değerlendirmek için psikometrik olarak güçlü bir ölçek olduğunu göstermektedir.

Keywords

• psikoterapinin etkililiği
• psikanalitik psikoterapi
• psikanaliz
• ölçek geliştirme

References

1. Abbass, A., Kisely, S. & Kroenke, K (2009). Short-term psychodynamic psychotherapy for somatic disorders: systematic review and meta-analysis of clinical trials. Psychotherapy and Psychosomatics, 78, 265- 274.
2. Brandon, T. H., Vidrine, J. I., & Litvin, E. B. (2007). Relapse and relapse prevention. Annual Review of Clinical Psychology, 3(1), 257–284. https://doi.org/10.1146/annurev.clinpsy.3.022806.091455
3. Coyne, J. C. (1976) Toward an interactional description of depression. Psychiatry, 39, 28-40.
4. De Maat, S., De Jonghe, F., De Kraker, R., Leichsenring, F., Abbass, A., Luyten, P., Barber, J. P., Van, R., & Dekker, J. (2013). The current state of the empirical evidence for psychoanalysis. Harvard Review of Psychiatry, 21(3), 107–137. https://doi.org/10.1097/hrp.0b013e318294f5fd
5. Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75.
6. Dulsster, D., Vanheule, S., Cauwe, J., Ingouf, J., & Truijens, F. (2019). Lacanian talking therapy considered closely: A qualitative study. Psychoanalytic Psychology, 36(1), 19–28. https://doi.org/10.1037/pap0000187
7. Durak, M., Şenol-Durak, E., & Gençöz, T. (2010). Psychometric properties of the satisfaction with life scale among Turkish university students, correctional officers, and elderly adults. Social Indicators Research, 99(3), 413-429.
8. Eysenck, H. J. (1952). The effects of psychotherapy: an evaluation. Journal of Consulting Psychology, 16(5), 319–324. https://doi.org/10.1037/h0063633

9. Fink, B. (1997). A clinical introduction to Lacanian psychoanalysis: Theory and technique. Cambrigde & London: Harvard Unity Press.
10. Ferrari, J. R., Bristow, M., & Cowman, S. E. (2005). Looking good or being good? The role of social desirability tendencies in student perceptions of institutional mission and values. College Student Journal, 39(1), 7-14.
11. Freedman, N., Hoffenberg, J. D., Vorus, N., & Frosch, A. (1999). the effectiveness of psychoanalytic psychotherapy: the role of treatment duration, frequency of sessions, and the therapeutic relationship. Journal of the American Psychoanalytic Association, 47(3), 741–772. https://doi.org/10.1177/00030651990470031001
12. Freud, S. (2001). The interpretation of dreams. In J. Strachey (Ed. and Trans.) The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume IV. London: Hogarth Press (1900).
13. Freud, S. (1964). The unconscious. In J. Strachey (Ed. and Trans.) The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XIV. London: Hogarth Press (1915).
14. Freud, S. (1963). Introductory lectures on psycho-analysis. In J. Strachey (Ed. and Trans.) The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XVI. London: Hogarth Press (1915-1917).
15. Freud, S. (2001). Constructions in analysis. In J. Strachey (Ed. and Trans.), The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XXIII (1937-1939). Moses and Monotheism, An Outline of Psycho-Analysis and Other Works. London: Hogarth Press (2001).
16. Fridhandler, B. M. (1986). Outline of psychoanalytic theory of emotion (dissertation). Retrieved from https://scholarworks.umass.edu/dissertations_1/1403.
17. Gençöz, T. (2000). Positive and negative affect schedule: a study of validity and reliability. Türk Psikoloji Dergisi, 15(46), 19–28.
18. Gençöz, T., & Gençöz, F. (2005). Psychometric properties of the reassurance-seeking scale in a Turkish sample. Psychological Reports, 96(1), 47-50
19. Gençöz, T. (2019). Lacanyen psikanaliz. Türkiye Klinikleri Psikoloji - Özel Konular (1st ed.).Ankara: Türkiye Klinikleri. ISBN: 978-605-034-070-9
20. Green, A. (1999). The fabric of affect in the psychoanalytic discourse. Routledge.
21. Jones, E. E., & Ablon, J. S. (2005). On analytic process. Journal of the American Psychoanalytic Association, 53, 541–568. http://dx.doi.org/10 .1177/00030651050530020101
22. Kalita, L., & Chrzan-Dętkoś, M. (2017). Effectiveness of psychoanalytic psychotherapies. Psychoterapia, 4(183). 5-16.
23. Knekt, P., Lindfors, O., Laaksonen, M. A., Renlund, C., Haaramo, P., Härkänen, T., & Virtala, E. (2011). Quasi-experimental study on the effectiveness of psychoanalysis, long-term and short-term psychotherapy on psychiatric symptoms, work ability and functional capacity during a 5-year follow-up. Journal of Affective Disorders, 132, 37-47. doi: 10.1016/j.jad.2011.01.014
24. Lacan, J. (1998). The seminar of Jacques Lacan book XI: The four fundamental concepts of psychoanalysis. (J.-A. Miller, Ed.). W. W. Norton & Company.
25. Lacan, J. (2002). The seminar of Jacques Lacan book XV: The psychoanalytic act. C. Gallagher (Tr.). Unedited French manuscripts, 1967-1968.
26. Lacan, J. (2008). The seminar of Jacques Lacan book XVII: The other side of psychoanalysis. R. Grigg (Tr.). N.Y.: WW Norton & Company.
27. Lacan, J. (2015). The seminar of Jacques Lacan book VIII: Transference. J.A. Miller (Ed.), B. Fink (Tr.). Cambridge: Polity Press, 1960-1961.
28. Lacan, J. (2017). The seminar of Jacques Lacan book IV: The object relation. J.A. Miller (Ed.), R.V.A Roche (Tr.). Cambridge: Polity Press. (1956-1957).
29. Lacan, J. (2017). The seminar of Jacques Lacan book XXIII: Sinthome. J.A. Miller (Ed.), A. R. Price (Tr.). Cambridge: Polity Press. (1975-1976).
30. Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, Research, Practice, Training, 38(4), 357–361. doi.org/10.1037/0033-3204.38.4.357
31. Leichsenring, F., Klein, S., & Salzer, S., (2014). The efficacy of psychodynamic psychotherapy in specific mental disorders: A 2013 update of empirical evidence, Contemporary Psychoanalysis, 50(1-2), 89-130. doi.org/10.1080/00107530.2014.880310
32. Leichsenring, F., Rabung, S., & Leibing, E. (2004). The efficacy of short-term psychodynamic psychotherapy in specific psychiatric disorders. Archives of General Psychiatry, 61(12), 1208. doi.org/10.1001/archpsyc.61.12.1208
33. Levy, K. N., Ehrenthal, J. C., Yeomans, F. E., & Caligor, E. (2014). The efficacy of psychotherapy: focus on psychodynamic psychotherapy as an example. Psychodynamic Psychiatry, 42(3), 377–421. doi.org/10.1521/pdps.2014.42.3.377
34. Liddon, L., Kingerlee, R., & Barry, J. A. (2018). Gender differences in preferences for psychological treatment, coping strategies, and triggers to help‐seeking. British Journal of Clinical Psychology, 57(1), 42-58.
35. Mohr, D. C. (1995). Negative outcome in psychotherapy: A critical review. Clinical Psychology: Science and Practice, 2(1), 1–27. doi.org/10.1111/j.1468-2850.1995.tb00022.x
36. Nathan, P. E., Stuart, S. P., & Dolan, S. L. (2000). Research on psychotherapy efficacy and effectiveness: Between Scylla and Charybdis? Psychological Bulletin, 126(6), 964–981. doi.org/10.1037/0033-2909.126.6.964
37. Podsakoff, P. M., MacKenzie, S. B., Lee, J.-Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879–903. doi.org/10.1037/0021-9010.88.5.879
38. Roth, A., & Fonagy, P. (2005). What works for whom: A critical review of psychotherapy research (2nd ed.). Guilford Publications.
39. Rössler-Schülein, H., & Löffler-Stastka, H. (2013). Methoden Psychoanalyse und Psychoanalytische Psychotherapie–Unterschiede und Gemeinsamkeiten. Neuropsychiatrie, 27(4), 180–187. doi.org/10.1007/s40211- 013-0077-3
40. Saunders, S. M., Howard, K. I., & Orlinsky, D. E. (1989). The Therapeutic Bond Scales: Psychometric characteristics and relationship to treatment effectiveness. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 1(4), 323–330. doi.org/10.1037/1040-3590.1.4.323
41. Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98–109. doi.org/10.1037/a0018378
42. Shepherd, C., & Beail, N. (2017). A systematic review of the effectiveness of psychoanalysis, psychoanalytic and psychodynamic psychotherapy with adults with intellectual and developmental disabilities: Progress and challenges. Psychoanalytic Psychotherapy, 31(1), 94–117. doi.org/10.1080/02668734.2017.1286610
43. Slavin, J. H. (1994). On making rules: Toward a reformation of the dynamics of transference in psychoanalytic treatment. Psychoanalytic Dialogues, 4(2), 253–274. doi.org/10.1080/10481889409539017
44. Soler, C. (2015). Lacanian affects: The function of affect in Lacan’s work. Routledge.
45. Stringer, J. V., Levitt, H. M., Berman, J. S., & Mathews, S.S. (2010) A study of silent disengagement and distressing emotion in psychotherapy, Psychotherapy Research, 20(5), 495-510. doi: 10.1080/10503301003754515
46. Taber, K. S. (2017). The use of cronbach's alpha when developing and reporting research instruments in science education. Research in Science Education, 48(6), 1273–1296. doi.org/10.1007/s11165-016-9602-2
47. Tompkins, K. A., & Swift, J. K. (2015). Psychotherapy process and outcome research. The Encyclopedia of Clinical Psychology, 1-7. doi.org/10.1002/9781118625392.wbecp335
48. Tummala-Narra, P. (2015). Cultural competence as a core emphasis of psychoanalytic psychotherapy. Psychoanalytic Psychology, 32(2), 275–292. doi.org/10.1037/a0034041
49. Tyson, P. (2009). Research in child psychoanalysis: Twenty-five-year follow-up of a severely disturbed child. Journal of the American Psychoanalytic Association, 57(4), 919–945. doi.org/10.1177/0003065109342881
50. Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063.
51. Weinshel, E. M. (1992). Therapeutic technique in psychoanalysis and psychoanalytic psychotherapy. Journal of the American Psychoanalytic Association, 40(2), 327–347. doi.org/10.1177/000306519204000202