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Psychiatr Clin North Am. 2018 Jun;41(2):193-205. doi: 10.1016/j.psc.2018.01.004. Epub 2018 Mar 20.

The Place for Psychodynamic Therapy and Obstacles to Its Provision.

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George Washington University School of Medicine, Washington, DC 20037, USA; Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Washington Psychoanalytic Institute, Washington, DC 20037, USA. Electronic address:


Psychodynamic treatment provides benefits for patients with personality disorders, chronic depressive and anxiety disorders, and chronic complex disorders, and its intensity and duration have independent positive effects. Obstacles to its provision include a bias privileging brief treatments, especially cognitive behavior therapy, seen as a gold standard of treatment, despite difficulties with the design of, and ability to generalize from, its supporting research and the diagnostic nosology of the illnesses studied. Another obstacle lies in insurance company protocols that violate the mandate for mental health parity and focus on conserving insurers' costs rather than the provision of optimum treatment to patients.


Anxiety disorders; Chronic complex disorders; Chronic depressive disorders; Insurance company protocols; Mental health parity; Personality disorders; Psychodynamic treatment

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