The first experimental study of transference work-in teenagers (FEST-IT): a multicentre, observer- and patient-blind, randomised controlled component study

Randi Ulberg, Benjamin Hummelen, Anne Grete Hersoug, Nick Midgley, Per Andreas Høglend, Hanne-Sofie Johnsen Dahl, Randi Ulberg, Benjamin Hummelen, Anne Grete Hersoug, Nick Midgley, Per Andreas Høglend, Hanne-Sofie Johnsen Dahl

Abstract

Background: Little is known about the influence on outcome of exploration of the patient-therapist relationship (that is, transference work) in psychoanalytic psychotherapy. We hypothesized that depressed adolescents would have better long-term effects from psychoanalytic psychotherapy with than without transference work.

Methods: Depressed adolescent (16 to 18 years) were recruited in health authority funded out-patient clinics in Oslo and Vestfold County, Norway. They were randomized to 28 weeks of treatment with psychoanalytic psychotherapy with or without transference work. Change was assessed using linear-mixed models. The primary outcome measure was the Psychodynamic Functioning Scale (pre- post-, and 1-year post-treatment). Level of depression was measured at the same time points and during therapy (week 12, and 20).

Results: 69 adolescents were treated with (N = 39) or without (N = 31) transference work. The mean number of sessions was 18.6 (SD = 8,6) in the transference work group and 18.0 (SD = 10.9) in the non-transference work group. Both groups showed large and significant improvement on Psychodynamic Functioning Scale during the whole study period. The difference between the two groups was not significant during the treatment period (95% CI -.79 to 1.2, p = .674, F = .18), or from post-treatment to one-year follow-up (95% CI -.13 to .96; p = .134; F = 2.3). For the secondary outcome measures the transference work group had significantly better outcomes from 12 weeks in treatment to one-year follow-up (Beck Depression Inventory, 95% CI - 1.7 to -.14, p = .022; Montgomery and Åsberg Depression Rating Scale, 95% CI - 1.6 to -.23, p = .009).

Conclusion: The findings suggest that exploration of the adolescents' relations to the therapist amplify the effects of short-term psychoanalytic psychotherapy on their depressive symptoms for adolescents with a Major Depressive Disorder.

Trial registration: ClinicalTrials.gov . Id: NCT01531101 . Registered 8 February 2012.

Keywords: Major Depressive Disorder; Psychoanalytic; Psychodynamic; Transference; Youth psychotherapy.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Trial profile. The primary hypothesis was analyzed in 69 patients. 16 patients had missing PFS at one occasion. 16 patients had missing BDI at one occasion. 11 patients had missing MADRS at one occasion. One patient in the non-transference group withdrew consent before starting treatment
Fig. 2
Fig. 2
Mean trajectories for Montgomery and Åsberg Depression Rating Scale (MADRS) over time for patients in psychotherapy with or without transference interventions. The level of MADRS over time. 0, pre-treatment; 1 and 2, measures during therapy; 20 weeks; 3, post-treatment; 4, post-treatment

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