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Psychodynamic Therapy: A Guide to Evidence-Based Practice
Firmly grounded in contemporary clinical practice and research, this pragmatic guide for professionals and students is now in a revised and expanded second edition. The book explains the theory underlying psychodynamic approaches and lays out a model for understanding psychopathology. Vivid case examples demonstrate how to tailor psychodynamic therapy effectively for individual patients. The authors provide a framework for diagnosing the patient’s core psychodynamic problem and engaging the most useful mechanisms of change, using an integrative approach. Special topics include remote and hybrid treatment, combining therapy with psychopharmacology, and working with couples and families.
New to This Edition
*Incorporates cutting-edge research on psychotherapy process and mechanisms of change.
*Chapter on telepsychotherapy, including clear recommendations for practice.
*More attention to the social determinants of health--the psychic effects of adversity and various forms of oppression.
*New and revised case examples, with diversity in age, gender, race, culture, and sexual identity.
See also Practicing Psychodynamic A Casebook, edited by Summers and Barber, which features 12 in-depth cases that explicitly illustrate the approach in this book.
New to This Edition
*Incorporates cutting-edge research on psychotherapy process and mechanisms of change.
*Chapter on telepsychotherapy, including clear recommendations for practice.
*More attention to the social determinants of health--the psychic effects of adversity and various forms of oppression.
*New and revised case examples, with diversity in age, gender, race, culture, and sexual identity.
See also Practicing Psychodynamic A Casebook, edited by Summers and Barber, which features 12 in-depth cases that explicitly illustrate the approach in this book.
424 pages, Kindle Edition
First published November 12, 2009
87 people are currently reading
330 people want to read
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Displaying 1 - 6 of 6 reviews
February 4, 2018
A clear and well written model of psychodynamic therapy. Great for those interested in learning about the theory and the underlying beliefs it has.
January 5, 2025
The problem with psychotherapy manuals, especially psychodynamic psychotherapy manuals, is that they are often too subjective and free-formed for someone interested in learning and conducting a specific modality. Manuals such as Gabbard’s are filled with proverbial and general prescriptions, making them feel more like self-help books. This is why I was particularly drawn to schema therapy, which is highly structured without being overly rigid or constraining. What I need are tangible formats and prescribed techniques to ensure I, as the therapist, understand the direction of the sessions. Schema therapy offers the Young Schema Questionnaire, which aids in diagnosing underlying psychodynamic issues. It clearly outlines the therapist’s stances—limited reparenting and empathic confrontation—and organizes therapy into well-defined cognitive, behavioral, and experiential components.
However, with more experience over the past year, I’ve observed that some clients respond poorly—or even quite negatively—to schema therapy. This led me to consider that different clients have varying levels of ego strength. Some simply lack the robust ego strength needed to engage effectively with the structure of schema therapy. For instance, a patient with suspected borderline personality disorder was admitted to the ward with a plushie due to intense suicidal ideation. Her voluntary admission and the presence of the plushie suggested to me that she might be at a transitional level of object relations. During a session, I offered an interpretation that the plushie represented a dissociated part of herself. The patient responded with an intense, cathartic, and even hysterical reaction.
The next day, she asked me a puzzling question: "Where is the child inside the plushie?" It became clear that the patient did not see the plushie as a transitional parental representation but as a locus for her splitting. In her perception, the world was a dangerous place, and the “child” she believed resided in the plushie absorbed all the calamities, allowing her to maintain a stable internal ideal self. In reality, she was operating at a paranoid-schizoid level of object relations. The "child" in the plushie functioned as an essential crutch to project her anxiety onto and interpret her emotional states. My schema-based interpretation inadvertently disrupted this mechanism, leaving her without a coping tool, and the result was an overwhelming storm of affect.
Learning from this incident, I began developing a scale to assess a client’s stage of object relations before initiating any psychodynamic therapy. Why psychodynamic psychotherapy instead of, say, cognitive therapy? Cognitive therapy requires a formal, regular setting—something clinicians like me often lack. In acute inpatient settings, we must address pressing issues before discharge to prevent recurrent, severe admissions. The limited daily sessions with inpatients must at least redirect the patient toward some germination of inner insight, a goal well-suited to psychodynamic psychotherapy.
In relation to my proposed scale of object-relation, there would be a corresponding set of psychodynamic psychotherapy modalities for each of the stages. The archetypal psychodynamic psychotherapy, as presented in this book, represents a good choice for a client with a more mature paranoid-schizoid stage, or a client in a transitional stage.
Psychodynamic psychotherapy, as the name suggests, emphasizes analyzing the inner dynamics and motives contributing to a person’s psychological and behavioral responses. In this manual, I was pleasantly surprised to find that psychodynamic psychotherapy doesn’t have to be as subjective as Gabbard portrays it. This manual is grounded in updated, evidence-based prescriptions, covering everything from the overall effectiveness of psychodynamic psychotherapy to the specific mechanisms of change driving the therapy.
The mechanisms of change in psychodynamic psychotherapy have historically been somewhat of a trade secret among psychoanalysts. I suspect this partly stems from their desire to maintain a kind of charismatic authority over their patients. However, as Jung and later pioneers of psychodynamic psychotherapy emphasized, therapy is a collaborative process between the analyst and the analysand. I am therefore pleased that this manual provides objective, well-elaborated explanations of how psychodynamic psychotherapy facilitates change.
I would recommend this textbook to postgraduate students over Gabbard’s.
However, with more experience over the past year, I’ve observed that some clients respond poorly—or even quite negatively—to schema therapy. This led me to consider that different clients have varying levels of ego strength. Some simply lack the robust ego strength needed to engage effectively with the structure of schema therapy. For instance, a patient with suspected borderline personality disorder was admitted to the ward with a plushie due to intense suicidal ideation. Her voluntary admission and the presence of the plushie suggested to me that she might be at a transitional level of object relations. During a session, I offered an interpretation that the plushie represented a dissociated part of herself. The patient responded with an intense, cathartic, and even hysterical reaction.
The next day, she asked me a puzzling question: "Where is the child inside the plushie?" It became clear that the patient did not see the plushie as a transitional parental representation but as a locus for her splitting. In her perception, the world was a dangerous place, and the “child” she believed resided in the plushie absorbed all the calamities, allowing her to maintain a stable internal ideal self. In reality, she was operating at a paranoid-schizoid level of object relations. The "child" in the plushie functioned as an essential crutch to project her anxiety onto and interpret her emotional states. My schema-based interpretation inadvertently disrupted this mechanism, leaving her without a coping tool, and the result was an overwhelming storm of affect.
Learning from this incident, I began developing a scale to assess a client’s stage of object relations before initiating any psychodynamic therapy. Why psychodynamic psychotherapy instead of, say, cognitive therapy? Cognitive therapy requires a formal, regular setting—something clinicians like me often lack. In acute inpatient settings, we must address pressing issues before discharge to prevent recurrent, severe admissions. The limited daily sessions with inpatients must at least redirect the patient toward some germination of inner insight, a goal well-suited to psychodynamic psychotherapy.
In relation to my proposed scale of object-relation, there would be a corresponding set of psychodynamic psychotherapy modalities for each of the stages. The archetypal psychodynamic psychotherapy, as presented in this book, represents a good choice for a client with a more mature paranoid-schizoid stage, or a client in a transitional stage.
Psychodynamic psychotherapy, as the name suggests, emphasizes analyzing the inner dynamics and motives contributing to a person’s psychological and behavioral responses. In this manual, I was pleasantly surprised to find that psychodynamic psychotherapy doesn’t have to be as subjective as Gabbard portrays it. This manual is grounded in updated, evidence-based prescriptions, covering everything from the overall effectiveness of psychodynamic psychotherapy to the specific mechanisms of change driving the therapy.
The mechanisms of change in psychodynamic psychotherapy have historically been somewhat of a trade secret among psychoanalysts. I suspect this partly stems from their desire to maintain a kind of charismatic authority over their patients. However, as Jung and later pioneers of psychodynamic psychotherapy emphasized, therapy is a collaborative process between the analyst and the analysand. I am therefore pleased that this manual provides objective, well-elaborated explanations of how psychodynamic psychotherapy facilitates change.
I would recommend this textbook to postgraduate students over Gabbard’s.
March 8, 2025
A psychodynamic book written for CBT clinicians. An excellent, thought provoking overview of pragmatic psychodynamic psychotherapy that provides a comfortable distance from its Freudian roots.
September 8, 2025
One thing this book offers is to explain in detail what psychodynamic therapy is and it goes in depth, I have not read any other that helped me understand it.
This book gives a detailed understanding of the therapy, I don’t see it as written for new therapists but also for patients with keen interest.
This book gives a detailed understanding of the therapy, I don’t see it as written for new therapists but also for patients with keen interest.
January 28, 2018
One of the clearest books on psychodynamic therapy, which draws on the CCRT method of therapy. Does away with all the overly dense psychological jargon in traditional psychoanalytical literature.
March 7, 2013
Though it is basic in many ways - geared toward students learning the ropes of psychotherapy - this book is quite sophisticated in it's presentation of what dynamic therapy can and should look like today. Summers & Barber are important figures in the field of psychotherapy research, and they summarize the evidence well, doing a fine job of pointing out the current gaps in knowledge (of which there are many). When they are speaking from an evidenced-based perspective they say so; when little or no evidence exists to support specific claims, they say that too. They call their approach "pragmatic psychodynamic psychotherapy," which to me is one of those terms that has a feeling of inevitability to it for me, a "why didn't I think of that?" quality. It is good, solid stuff.
Displaying 1 - 6 of 6 reviews