When reality doesn't fit the blueprint: Doing research on psychoanalysis and long-term psychotherapy in a public health service program

Author(s): Blomberg, J., Lazar, A.

Journal/Book: Psychother Res. 1997; 7: 72 Spring Street, New York, NY 10012. Guilford Publications Inc. 333-344.

Abstract: A public health service program in Sweden, involving the funding of psychoanalysis and long-term psychotherapy, seemed to offer an opportunity to conduct a large-scale natural experiment on long-term psychotherapy and psychoanalysis. This paper describes our experiences with this project, focusing on the methodological and practical difficulties we encountered in implementing our plans, primarily because of the complexities of patients' treatment histories and the consequent lack of control over the treatment variable. Thus, when confronted with the conditions of reality, our experimental design had to be transformed into a quasi-experimental one. Despite the various problems, valuable data has been secured on such issues as psychometrics, health outcomes, and comparative outcome processes. We conclude that health service projects may provide rare opportunities for conducting long-term psychotherapy outcome research, at the same time creating conflicts between external and internal validity.

Note: Article Sandell R, Karolinska Inst, Dept Psychotherapy, Bjorngardsgatan 25, S-11852 Stockholm, SWEDEN

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