No couch, and no therapist in the room. Dealing with depression needs little more than a computer and an internet connection.
“It sounds paradoxical – psychodynamic therapy without seeing a therapist. But the fact is, it works very well,” said Robert Johansson, who recently completed his doctorate in clinical psychology at Linköping University.
He conducted two treatment studies, where 192 depression patients either participated in ten weeks of internet-delivered psychodynamic therapy, or were part of an active control group. The results were clear: the anxiety and depression symptoms decreased noticeably in the group that underwent psychodynamic therapy.
“The treatments we tested were based on guided self-help. The patients learn to see and understand their life patterns. The therapies aim for both intellectual insight and emotional understanding of the problems they have got stuck in,” said Dr Johansson.
Previous studies from Linköping University and elsewhere have shown that internet delivery of CBT is effective against anxiety and depression.
“One approach doesn’t rule out the other. People are different, so different forms of therapy probably suit different patients to different degrees,” said Dr Johansson. Instead, he sees the possibilities of the new delivery mode.
“And today we have many more psychodynamic therapists than CBT-trained therapists.”
This means that many more people can have access to the treatment form. The treatment is very time effective for the therapist. In the study, the therapist devoted on average 10 to 15 minutes per patient per week.
“It might seem insufficient, but the research shows that it’s enough to yield good effects. In the treatment, the patient is emailed materials in text form, which he or she reads and reflects upon. These reflections are sent to the therapist who gives feedback, again by email.
“The patient and therapist never meet, which can be an advantage. Depression sufferers often avoid social contact, so they appreciate not having to see someone face to face.”
In his thesis, Robert Johansson investigated online delivery of CBT, psychodynamic therapy and affect-focused psychodynamic psychotherapy – without comparing the results between the various approaches. Each proved effective – although to various degrees, depending on the symptom.
Robert Johansson defended his doctoral thesis on 6 December. Title: Treating depression and its comorbidity: From individualized Internet-delivered cognitive behavior therapy to affect-focused psychodynamic psychotherapy
Sofia Ström Bernad 2013-12-18