Suitability for psychoanalytic psychotherapy: a review

Objective: To review empirical studies on outpatients' pretherapy suitability for psychoanalytic psychotherapy. Method: A literature search for studies in English was made in the databases MEDLINE, PsychInfo and EM-base. Forty-one studies spanning 20 years were selected for a thorough evaluation. Results: Seventy-five per cent of the studies concerned brief dynamic psychotherapy. In general, application of single measures of suitability had a modest predictive value with correlations in the range of 0.17-0.73. There was no consistent difference between various formats of therapies. Most promising variables with the highest correlations with good outcome were: 'good quality of object relations', 'psychological mindedness' and 'motivation for change'. Some clinical guidelines can be drawn from quantitative research to provide the therapist with best method and format. Conclusion: The importance of psychological variables known from the development of the brief dynamic therapies and earlier research was confirmed. Most correlations were modest and single factors could not be identified. Multivariate designs that combine different methods and formats with patient characteristics seem most promising in future predictor-outcome research.