The DPV Follow-Up Study
Leuzinger-Bohleber, M.; Rüger, B.; Stuhr, U.; Beutel, M. (2002): "Forschen und Heilen" in der Psychoanalyse. Ergebnisse und Berichte aus Forschung und Praxis. Stuttgart: Kohlhammer.
Leuzinger-Bohleber, M.; Stuhr, U.; Rüger, B.; Beutel, M. (2003): How to study the 'quality of psychoanalytic treatments' and their long-term effects on patient's well-being. A representative, multi-perspective follow-up study. The International Journal of Psychoanalysis 84: 263-290
In the so-called “DPV Katamnesestudie” [Outcome study of psychoanalyses and psychoanalytic psychotherapies of the German Psychoanalytic Association], we investigated a representative sample of all the patients who had terminated their psychoanalyses and psychoanalytic long-term psychotherapies with members of the DPV between 1990 and 1993 (n = 402 patients). We applied a large variety of different instruments, questionnaires, psychological tests, analyses of “objective data” from the health insurance companies, and intensive psychoanalytic follow-up interviews. The study led to important results: for example, around 80% of all the treatments showed—on average six years after termination—a good outcome according to the evaluations of the former patients, their analysts, independent analysts, and nonanalysts, as well as “objective information” concerning mental health data (significant reduction of costs by a significant reduction of days off work, days spent in hospitals, etc.; see Leuzinger-Bohleber, Rüger, Stuhr, & Beutel, 2002, 2003).
But the most important, often unexpected insights were gained through the 200 intensive, psychoanalytic follow-up interviews with the former patients and with their former psychoanalysts by independent psychoanalytic interviewers. The interviews were mostly tape-recorded or, if patient or analyst did not consent, carefully documented directly after the interview. This documentation proved to be a unique and rich source for psychoanalytic and non-psychoanalytic insights (particularly concerning the tragic findings of the 4% of the psychoanalyses with negative outcomes). The richness of the interview material confronted us with the methodological challenge of how to summarise and communicate the complexity of the conscious and unconscious discoveries of these interviews in a critical way that would be transparent, reliable, and acceptable by members of the psychoanalytic, as well as the non-psychoanalytic, community. In this context, we developed the so-called psychoanalytic expert validation, which proved to be a very helpful and convincing method to summarise the psychoanalytic findings of the follow-up interviews (see ODR: Psychoanalytical Expert Validation).
To mention just one of the unexpected findings: 62% of all the interviewed patients had been severely traumatized children of World War II. Treating children of the perpetrators and the „normal“ German population had been a taboo in Germany for a long time. The unexpected findings of the DPV Outcome Study evoked a broad discussion of this topic within and outside the psychoanalytical community (see e.g. publications by Hartmut Radebold and his team)
The DPV Outcome Study was the first study investigating the outcomes of psychoanalyses and psychoanalytical therapies by a whole, large psychoanalytical society. Therefore - at the time oft he conceptualization of the study -, only a retrospective design was accepted by the clinicans. Many of them feared that an empirical-prospective study could have negative influences on the psychoanalytical process. –
Because the study was discussed in each assembly of the membership (in all the annual conferences) it evoked interesting and challenging methodological and epistemological controversies in the DPV. This lead to the positive result that many of the analysts became very much interested in empirical research. This is one reason why many of them were now willing to engage in a prospective, randomized outcome study, the LAC Depression Study (starting in 2005). (see summary in the ODR)
Marianne Leuzinger-Bohleber: M.Leuzinger-Bohleber@gmx.de