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Exploring Termination Setback in a Psychodynamic Therapy for Panic Disorder
Lund Univ, Sweden.
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linnaeus Univ, Sweden.
Lund Univ, Sweden.
Lund Univ, Sweden.
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2021 (English)In: Journal of Consulting and Clinical Psychology, ISSN 0022-006X, E-ISSN 1939-2117, Vol. 89, no 9, p. 762-772Article in journal (Refereed) Published
Abstract [en]

Objective: Termination in psychodynamic therapy (PDT) is a potentially conflictual and turbulent phase for patients, with a risk for increases in symptoms. However, few studies of PDT have assessed symptoms frequently enough during the treatment to determine whether such setbacks are in fact common in PDT. Method: In a doubly randomized clinical preference trial, 217 adults, female = 163; M-age = 34.8 (12.6), with panic disorder with or without agoraphobia were treated with panic-focused psychodynamic psychotherapy (PFPP) or panic control treatment (PCT), a form of cognitive behavioral therapy. Participants completed the Panic Disorder Severity Scale Self-Report (PDSS-SR) weekly during treatment (Weeks 1-12), and 6, 12, and 24 months after treatment. Using piecewise latent growth curve modeling, we tested the trajectories of change focusing on the termination phase in PFPP. Results: Week-to-week improvement on the PDSS-SR stopped (a termination setback [TS]) in PFPP during Weeks 10-12, whereas PCT participants continued to improve. Larger symptom reductions up to Week 10 in PFPP predicted a more severe TS. Less avoidant attachment and less severe interpersonal problems also predicted more severe TS. The TS s tended to last, as evidenced by inferior outcomes, up to the 12-month follow-up. Conclusions: This study provides evidence of a TS in PDT. Resurgence of symptoms as termination approached was more common in PFPP than in PCT. Studies involving weekly assessment of primary and comorbid symptoms, as well as qualitative analyses of the patient experiences of the therapeutic process during termination, in different forms of PDT, are warranted.

Place, publisher, year, edition, pages
AMER PSYCHOLOGICAL ASSOC , 2021. Vol. 89, no 9, p. 762-772
Keywords [en]
termination setback; resurgence of symptoms; psychodynamic therapy; cognitive behavioural therapy; panic disorder
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:liu:diva-180387DOI: 10.1037/ccp0000678ISI: 000703559300005PubMedID: 34591549OAI: oai:DiVA.org:liu-180387DiVA, id: diva2:1604064
Note

Funding Agencies|Swedish Research Council for Health, Working Life, and WelfareSwedish Research CouncilSwedish Research Council for Health Working Life & Welfare (Forte); Swedish Social Insurance Agency; Lindhaga Foundation; B. Gadelius Foundation; L.J. Boethius Foundation; Region Skane; Region Halland

Available from: 2021-10-18 Created: 2021-10-18 Last updated: 2021-10-18

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