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The talking cure in the cross fire of empiricism - The struggle for the hearts and minds of psychoanalytic clinicians - Commentary on papers by Lester Luborsky and Hans H. Strupp

Fonagy, P; (2001) The talking cure in the cross fire of empiricism - The struggle for the hearts and minds of psychoanalytic clinicians - Commentary on papers by Lester Luborsky and Hans H. Strupp. PSYCHOANAL DIALOGUES , 11 (4) 647 - 658.

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Abstract

I outline the arguments advanced by Lester Luborsky and Hans H. Strupp on the current controversy regarding empirically supported treatment (EST). I support Luborsky's criticisms of some current attempts to provide empirical support for psychoanalytic treatment, but, unable to endorse the conclusion that therapies are equally effective, I argue that substantial evidence does exist to guide clinicians, even if this evidence is not yet accessible through a mechanical process of review. I also suggest that Luborsky's "open verdict" on the length-of-treatment issue is too conservative. Longer psychoanalytic treatments have been repeatedly associated with superior outcomes across a range of measures. I agree with Strupp that the current emphasis on EST is probably motivated primarily by economic rather than ethical conditions. However, I criticize Strupp's largely negative treatment of the issue of treatment "manualization" and argue that, though manualization is a mixed blessing, only a clear, structured, and coherent framework that guides the therapeutic process can enable the therapist to withstand the interpersonal pressures inevitably generated in the consulting room. I conclude by arguing that there is a need for refinement of the concepts and methods by which outcomes are evaluated in order to help psychoanalysis and psychotherapy become a more specific family of treatments for particular conditions.

Type: Article
Title: The talking cure in the cross fire of empiricism - The struggle for the hearts and minds of psychoanalytic clinicians - Commentary on papers by Lester Luborsky and Hans H. Strupp
Keywords: CHILD-PSYCHOTHERAPY, TREATMENT EFFICACY, THERAPY, METAANALYSIS, ADOLESCENTS, MEDIATORS, GAP
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/133756
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