Goldilocks on the couch: Moderate levels of psychodynamic and process-experiential technique predict outcome in psychodynamic therapy.

OBJECTIVE

Greater symptom change is often assumed to follow greater technique use, a "more is better" approach. We tested whether psychodynamic techniques, as well as common factors and techniques from other orientations, had a curvilinear relation to outcome (i.e., whether moderate or "just right" intervention levels predict better outcome than lower or higher levels).

METHODS

For 33 patients receiving supportive-expressive psychodynamic psychotherapy for depression, interventions were assessed at Week 4 using the multitheoretical list of therapeutic interventions and symptoms were rated with the Hamilton Rating Scale for Depression.

RESULTS

Moderate psychodynamic and experiential techniques predicted greater symptom change compared to lower or higher levels.

CONCLUSIONS

This "Goldilocks effect" suggests a more complex relation of intervention use to outcome might exist.