Milan study on facilitated psychoanalytic treatment for adults in collaboration with mental health services

Link: IPA Research Database: http://www.ipa.org.uk

Objectives

The Research project, granted by IPA, was planned by the Study Group for the Adult Facilitated Clinical Service of the Center of Psychoanalysis of Milan, composed of twenty analysts, where treatments are carried out in collaboration with Mental Health Services to favorable economic conditions, with the aim to investigate the subjective changes in patients and the transference-countertransference dynamics, which is recognized to be essential for successful treatment. A main objective is to see whether the economic variables and provenance from public services have an impact on the therapeutic relationship and to verify the potential of the psychoanalytic approach in treatment of severe psychological distress enhancing collaboration with Mental Health Services, taking into account the current socio-economic difficulties. Research questions are: 1. if and to what extent the variables 'money' and 'coming from public services' may influence the therapeutic relationship; 2. which variables are significant; 3. whether psychoanalytic approach can be a valuable instrument enabling severe patients in specific conditions to acquire more appropriate relational and representational capacity, and to improve emotional balance.  

Sample

We have planned to apply the survey on a sample of 20 subjects minimum, selected through contact with mental health services and treated in facilitated psychoanalytic care, comparing them with a control group of equal number of patients treated under the same therapeutic conditions, except for the economic ones. Frequency and setting are kept the same in both groups; the focus is on the evolution of the patient-analyst relationship. 

Instruments

Three tools were chosen for the survey: 1) a form aimed to collect information at the beginning of therapy on objective and subjective data relating to patient (a special tab to collect initial data and Core-OM); 2) administration of OPD (Operationalized Psychodynamic Diagnosis), SCL-90-R (Symptoms Check List- 90-Revised) and the Feeling Word Checklist – 58, to obtain psychodynamic and relational data from patient and analyst; 3) a form for the collection of dreams at beginning and during therapy, according to pre-established steps, to identify the representational ways of the subject.

Current state of research

The development of the study required a first step of preparation, in which have been analyzed in depth the objectives and research instruments, and addressed difficulties related to the carrying out of research in clinical psychoanalysis, achieving the homogeneity of the group; were established the procedures and instruments for conducting the survey, and for selection of patients. A dedicated team was set up in collaboration with the University of Milan, Bicocca, to deal with the research development and to monitor the implementation of the study, according to ethical and clinical issues. Therapists who endorsed the research have been trained in OPD applications and to other instruments' usage. Collection of cases and their monitoring are currently underway.

Evaluation

Since the research is still in progress, we can not produce at the time reliable evaluations on results; however, the preparation and launching of the project have raised interesting issues on conducting research in psychoanalytic without interfering with the natural course of care and the achievement of its objectives. During the research will try to answer these questions.

Contact

Licia Reatto*, Luisa Laghi*, Anna Daniela Linciano*, Pietro Roberto Goisis** 

*  Italian Psychoanalytic Society & IPA

** Italian Psychoanalytic Society & IPA - Coordinator of the clinical Study Group, Center of Psychoanalysis of Milan

Licia Reatto  E-mail: liciareatto@hotmail.com