The Melbourne Study of Psychoanalytic Psychotherapy II: Patients' and psychotherapists' perspectives on expectations, therapeutic experience and benefits

Abstract

The naturalistic, longitudinal Melbourne Study of Psychoanalytic Psychotherapy was conducted in a subsidized community clinic established by the Victorian Association of Psychoanalytic Psychotherapists as a demonstration project operating over 8 years. It offered lower SES adults twice-weekly psychoanalytic psychotherapy for 2 years. An independent research program used the RE-AIM planning and evaluation framework to investigate the Reach, Effectiveness, Adoption, Implementation and Maintenance of the service. Complementary quantitative and qualitative methodologies studied mental health and general-life functioning outcomes and underlying processes of treatment. Two papers present the qualitative arm of the research, exploring the lived experience of the psychotherapy, reported contemporaneously and retrospectively by patients and psychotherapists. This first paper details the qualitative design and methods employed. In-depth semi-structured narrative interviews during psychotherapy, upon completion at 2 years, and at an additional 8-month follow-up point for patients, were conducted. Analysis of the narrative transcripts of 143 participant interviews revealed themes regarding patient expectations of treatment and the perceptions of both patients and psychotherapists of the long-term psychoanalytic psychotherapy experience and its benefits. Narratives thus provided evidence of the Reach, Effectiveness, Adoption, Implementation and Maintenance of the service. The findings enrich understanding of the effective processes underlying the outcomes of the quantitative arm of the study reported separately. The second qualitative paper presents the findings concerning participants' experiences of facilitative and challenging aspects of the treatment, as well as the implications of the qualitative findings overall.