Despite psychodynamic psychotherapy's evidence base as a treatment for a heterogenous group of maladies, the psychodynamic psychotherapy written case (PWC) remains a controversial training assessment.
Objective
The purpose of this article is to re-evaluate the PWC in light of recent scientific and cultural developments.
Conclusion
The PWC is a robust preliminary basis for learning both basic psychodynamic competencies but also generalizable skills in sustaining a therapeutic alliance, as well as wider clinical, systemic, and self-care applications, overlapping with the values of the recovery movement, trauma-informed, and person-centred care. It may also represent an aspect of psychiatric practice made more valuable because not replicated by AI.
McWilliamsN. Psychoanalytic psychotherapy: a practitioners guide. The Guilford Press, 2005. Chapter 2.
4.
State of Victoria, Royal Commission into Victoria’s Mental Health System, Final Report, Summary and recommendations, Parl Paper No. 202, Session 2018–2.
5.
LeichsenringFAbbassAHeimN, et al.The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders - an umbrella review based on updated criteria. World Psychiatry2023; 22(2): 286–304.
6.
WeerasekeraPManringJLynnDJ. Psychotherapy training for residents: reconciling requirements with evidence-based, competency-focused practice. Acad Psychiatry2010; 34(1): 5–12.
7.
KayLRKayTLawsonA, et al.Psychotherapy patients of psychiatry residents: a descriptive study. Am J Psychother2020; 73(2): 63–66.
8.
BalintE. The possibilities of patient-centered medicine. J R Coll Gen Pract1969; 17(82): 269–276.
9.
People-Centred Health Care: A Policy Framework. WHO western Pacific region. 2007.
10.
HorvathAODel ReACFlückigerC, et al.Alliance in individual psychotherapy. Psychotherapy2011; 48(1): 9–16.
11.
BaierALKlineACFeenyNC. Therapeutic alliance as a mediator of change: a systematic review and evaluation of research. Clin Psychol Rev2020; 82: 101921.
12.
FoulkesP. Trainee perceptions of teaching of different psychotherapies. Australas Psychiatry2003; 11(2): 209–214. DOI: 10.1046/j.1039-8562.2003.00551.x.
13.
ChazanL. “Teaching” the therapeutic alliance: on peeling a banana with a knife and fork. Australas Psychiatry2014; 22(6): 536–538.
14.
SchoreA. Right brain-to-right brain psychotherapy: recent scientific and clinical advances. Ann Gen Psychiatry2022; 21: 46.
15.
RubinMArnonHHuppertJD, et al.Considering the role of human empathy in AI-driven therapy. JMIR Ment Health2024; 11: e56529. DOI: 10.2196/56529.
16.
PlakunEM. Psychodynamic psychiatry, the biopsychosocial model, and the difficult patient. Psychiatr Clin North Am2018; 41(2): 237–248.
17.
McFarlandDCHlubockyFRibaM. Update on addressing mental health and Burnout in physicians: what is the role for psychiatry?Curr Psychiatry Rep2019; 21(11): 108.
18.
PitanupongJAnantapongKAunjitsakulW. Depression among psychiatrists and psychiatry trainees and its associated factors regarding work, social support, and loneliness. BMC Psychiatry2024; 24: 97.
19.
KatzmanJCoughlinP. The role of therapist activity in psychodynamic psychotherapy. Psychodyn Psychiatry2013; 41: 75–89. DOI: 10.1521/pdps.2013.41.1.75.
VenessBGTibbleHGrenyerBF, et al.Complaint risk among mental health practitioners compared with physical health practitioners: a retrospective cohort study of complaints to health regulators in Australia. BMJ Open2019; 9(12): e030525. DOI: 10.1136/bmjopen-2019-030525.
22.
RosenbergLM. Chapter: ‘Remaining relevant’, the applications of psychodynamic principles to the mental health workforce. Progress in Psychoanalysis. Routledge, 2018.
23.
National Health and Medical Research Council (NHMRC). Clinical practice guideline for the management of borderline personality disorder. Melbourne: National Health and Medical Research Council, 2012. Available at: https://www.nhmrc.gov.au/guidelines/publications/mh25
24.
BroadbearJHRotellaJALorenzeD, et al.Emergency department utilisation by patients with a diagnosis of borderline personality disorder: an acute response to a chronic disorder. Emerg Med Australas2022; 34(5): 731–737.
25.
Gonzalez-TorresMA. Psychodynamic psychotherapies for borderline personality disorders. Current developments and challenges ahead. BJPsych Int2018; 15(1): 12–14.
26.
GrenyerBFNgFYTownsendML, et al.Personality disorder: a mental health priority area. Aust N Z J Psychiatry2017; 51(9): 872–875.
27.
Australian BPD Foundation 2022-23: Pre-budget submission the National BPD Awareness, Training and Professional Development Strategy Raising awareness and upskilling and engaging clinicians working with people borderline personality disorder and their families.
