Leichsenring, Falk; Abbass, Allan; Fonagy, Peter; Levy, Kenneth; Lilliengren, Peter; Luyten, Patrick; Midgley, Nick; Leichsenring, Falk; Abbass, Allan; Fonagy, Peter; Levy, Kenneth; Lilliengren, Peter; Luyten, Patrick; Midgley, Nick; Milrod, Barbara; - view fewer (2025) Psychodynamic therapy can be adapted to and implemented in non-western cultures – a comment on the WHO treatment guideline for mental disorders. Zeitschrift für Psychosomatische Medizin und Psychotherapie (In press).

Text Fonagy_Response to WHO (8) .pdf Access restricted to UCL open access staff until 14 July 2025. Download (274kB)

Abstract

The WHO recently issued updated the guidelines for treating mental health conditions in low- and middle-income countries, emphasizing evidence-based manual-guided psychotherapeutic treatments. As a limitation, these recommendations predominantly endorse cognitive-behavior therapy for both adults and young people. In a comment, we emphasized that the WHO overlooked the significant evidence supporting other therapeutic approaches, including but not limited to psychodynamic therapy. The WHO responded to our comment in a reply by Carswell and colleagues. However, several statements made by the authors are debatable. In this short communication, we critically address these statements, showing that they are not tenable. As a conclusion we emphasize that is necessary to embrace a broader array of empirical supported therapeutic methods to elevate the overall quality and efficacy of global mental health care. High-quality psychotherapy research in low- and middle-income countries is required, focusing not only on the narrow area of symptoms, but transdiagnostically on general psychopathology and psychosocial functioning, which are areas addressed in psychodynamic therapy.

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