Therapist's private theories on curative and hindering factors in long-term psychoanalytic psychotherapy for treatment-resistant depression

Aim: The Tavistock Adult Depression Study (TADS, Fonagy et al. , 2015) has provided important evidence that long-term psychoanalytic psychotherapy (LTPP) is more effective than treatment-as-usual in reducing depressive symptoms for patients suffering from treatment-resistant depression. Overall, 40% of patients who received LTPP significantly improved. Despite this remarkable achievement, a considerable number of patients did not benefit. In pendant to our study that focused on the patients' experience presented previously, the aim of this study is to elucidate the findings by focusing on the therapists' private theories of curative and hindering factors that influenced the therapeutic process and therefore treatment outcome. Methods: Thematic analysis was used to analyse the Private Theories Interviews (PTI, Werbart et al 2006) of 25 therapists whose patients completed the treatment. Of particular interest was thereby to compare and contrast the emerging themes among therapists whose patients benefitted from the treatment (N=14) and those who did not (N=11) based on the Hamilton Depression Rating Scale. Therapists were blind to their patients' quantitative outcome. Results and Discussion: Qualitative methodology that stresses the subjective meaning-making bridges the gap that exists between primary clinical data and quantitative outcome data within a RCT design. The data analysis is currently under way and will be completed in time for the conference. Results so far point to interesting emerging themes of specific helpful as well as hindering factors from the treaters perspective, which may further our understanding in terms of the need to adapt psychoanalytic treatment for this particularly complex patient group