https://doi.org/10.4081/rp.2023.793
Dalla montagna al topolino: commento a ‘Consensus conference sulle terapie psicologiche per ansia e depressione’
Pubblicato: 6 settembre 2023
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Autori
Il presente lavoro vuole costituire una lettura critica della Consensus conference sulle terapie psicologiche per ansia e depressione che è oggi un documento ufficialmente assunto dal Ministero della Salute e dunque fa da riferimento per gli operatori del settore. Questa autorevolezza formale rende opportuno che il documento venga conosciuto e valutato in modo approfondito. Vengono qui analizzati i principali ambiti trattati distinguendo fra la relazione per la giuria e le raccomandazioni assunte dalla giuria stessa. Come vedremo vi è grande distanza fra le due parti come i giudici stessi hanno colto. Ma altri aspetti riteniamo meritino attenzione: l’insufficiente approfondimento sull’infanzia e l’adolescenza, la prospettiva ristretta assunta rispetto al tipo di studi ritenuti utili, le raccomandazioni sulla formazione. Limiti che definiamo gravi e che rendono il documento, pur animato dalle migliori intenzioni, almeno in apparenza, un testo scarsamente convincente che necessita di ampie revisioni per raggiungere standard accettabili.
American Psychological Association (2012). Recognition of psychotherapy effectiveness. Psychotherapy, 2013;50:102-109. Disponibile da: www.apa.org/about/policy/resolutionpsychotherapy
DOI: https://doi.org/10.1037/a0030276
Asay, T.P., Lambert, M. (1999). The empirical case for the common factors in therapy: Quantitative findings. In M.A. Hubble, B.L. Duncan, S.D. Miller (Eds.), The heart and soul of change: What works in therapy. Washington, DC, American Psychological Association, pp. 33-56.
DOI: https://doi.org/10.1037/11132-001
Bandelow, B., Michaelis, S. Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience, 19:93-107.
DOI: https://doi.org/10.31887/DCNS.2017.19.2/bbandelow
Barkowski, S., Schwartze, D., Strauss, B., Burlingame, G.M., Rosendahl, J. (2020). Efficacy of group psychotherapy for anxiety disorders: A systematic review and meta-analysis. Psychotherapy Research, 30:1-18.
DOI: https://doi.org/10.1080/10503307.2020.1729440
Bergin, A.E. (1971). The evaluation of psychotherapeutic outcomes. In S.L. Garfield, A.E. Bergin (Eds.), Handbook of Psychotherapy and Behavior Change: An empirical analysis (2nd ed., pp. 139-190). New York: Wiley.
Chambless, D.L., Ollendick T.H. (2001). Empirically supported psychological interventions: controversies and evidence. Annual Review of Psychology, 52:685-716 (trad. it.: Gli interventi psicologici validati empiricamente: controversie ed evidenze empiriche. Psicoterapia e Scienze Umane, 2001;35:5-46).
DOI: https://doi.org/10.1146/annurev.psych.52.1.685
Clark, D.M. (2017). Il programma inglese Improving Access to Psychological Therapies (IAPT). Psicoterapia e Scienze Umane, 51:529-550.
DOI: https://doi.org/10.3280/PU2017-004002
Cuijpers, P., Cristea, I.A., Karyotaki, E., Reijnders, M., Huibers, M.J.H. (2016). How effective are cognitive behavior therapies for major depression and anxiety disorders? A metaanalytic update of the evidence. World Psychiatry, 15:245-258.
DOI: https://doi.org/10.1002/wps.20346
Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S.D., van Straten, A. (2014). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: A meta-analysis. Journal of Affective Disorders, 159:118-126.
DOI: https://doi.org/10.1016/j.jad.2014.02.026
Cuijpers, P., Karyotaki, E., de Wit, L., Ebert, D.D. (2020). The effects of fifteen evidencesupported therapies for adult depression. A meta-analytic review. Psychotherapy Research, 30:279-293.
DOI: https://doi.org/10.1080/10503307.2019.1649732
Deacon, B.J. Abramowitz, J.S. (2005). Patients’ perceptions of pharmacological and cognitive-behavioral treatments for anxiety disorders. Behavior Therapy, 36:139-145.
DOI: https://doi.org/10.1016/S0005-7894(05)80062-0
Eysenck, H.J. (1952). The effects of psychotherapy: An evaluation. Journal of Consulting Psychology, 16:319-324.
DOI: https://doi.org/10.1037/h0063633
Eysenck, H.J. (1961). The effects of psychotherapy. In H.J. Eysenck (Ed.), Handbook of Abnormal Psychology (pp. 697-725). New York: Basic Books.
Eysenck, H.J. (1966). The effects of psychotherapy. New York: International Science Press.
DOI: https://doi.org/10.1016/B978-1-4832-0087-3.50019-X
Fava, E., Gruppo Zoe (2016). La competenza a curare. Il contributo della ricerca empirica. Milano: Mimesis.
Fava, G.A. (2002). Long-term treatment with antidepressant drugs: the spectacular achievements of propaganda. Psychotherapy and Psychosomatics, 71:127-132.
DOI: https://doi.org/10.1159/000056279
Flückiger, C., Del Re, A.C., Munder, T., Heer, S., Wampold, B.E. (2014). Enduring effects of evidence-based psychotherapies in acute depression and anxiety disorders versus treatment as usual at follow-up. A longitudinal meta-analysis. Clinical Psychology Review, 34:367-375.
DOI: https://doi.org/10.1016/j.cpr.2014.05.001
Furukawa, T.A., Shinohara, K., Sahker, E., Karyotaki, E., Miguel, C., Ciharova, M., Bockting, C.L.H., Breedvelt, J.J.F., Tajika, A., Imai, H., Ostinelli, E.G. Sakata, M., Toyomoto, R., Kishimoto, S., Ito, M., Furukawa, Y., Cipriani, A., Hollon, S.D., Cuijpers, P. (2021). Initial treatment choices to achieve sustained response in major depression: A systematic review and network meta-analysis. World Psychiatry, 20:387-396.
DOI: https://doi.org/10.1002/wps.20906
Furukawa, T.A., Weitz, E.S., Tanaka, S., Hollon, S.D., Hofmann, S.G., Andersson, G., Twisk, J., DeRubeis, R.J., Dimidjian, S. Hegerl, U., Mergl, E., Jarrett, R.B., Vittengl, J.R., Watanabe, N., Cuijpers, P. (2017). Initial severity of depression and efficacy of cognitive-behavioural therapy: individual-participant data meta-analysis of pill-placebocontrolled trials. British Journal of Psychiatry, 210:190-196.
DOI: https://doi.org/10.1192/bjp.bp.116.187773
Gerber, A.J., Kocsis, J.H., Milrod, B.L., Roose, S.P., Barber, J.P., Thase, M.E., Perkins, P., Leon, A.C. (2011). A quality-based review of randomized controlled trials of psychodynamic psychotherapy. American Journal of Psychiatry. 168:19-28.
DOI: https://doi.org/10.1176/appi.ajp.2010.08060843
Gruppo di lavoro “Consensus sulle terapie psicologiche per ansia e depressione”. Consensus Conference sulle terapie psicologiche per ansia e depressione. Roma: Istituto Superiore di Sanità; 2022 (Consensus ISS 1/2022). Available from: http://www.iss.it/documents/20126/0/Consensus_1_2022_IT.pdf
Guidi, J., Brakemeier, E., Bockting, C.L.H., Cosci, F., Cuijpers, P., Jarrett, R.B., Linden, M., Marks, I., Peretti, C.S., Rafanelli, C., Rief, W., Schneider, S., Schnyder, U., Sensky, T., Tomba, E., Vazquez, C., Vieta, E., Zipfel, S., Wright, J.H., Fava, G.A. (2018). Methodological recommendations for trials of psychological intervention. Psychotherapy and Psychosomatics, 87:276-284.
DOI: https://doi.org/10.1159/000490574
Henry, W.P., Strupp, H.H. (1994). The therapeutic alliance as interpersonal process, in A.O. Horvath, L.S. Greenberg (Eds.), The Working Alliance: Theory, Research and Practice, New York, Wiley, pp. 259-287.
Keefe, K.R., McCarthy, K.S., Dinger, U., Zilcha-Mano, S., Barber, J.P. (2014). A meta-analytic review of psychodynamic therapies for anxiety disorders. Clinical Psychology Review, 34:309-323.
DOI: https://doi.org/10.1016/j.cpr.2014.03.004
Lambert, M.J. (2013). The efficacy and effectiveness of psychotherapy. In M.J. Lambert (Ed.) ‘Bergin and Garfield’s handbook of psychotherapy and behavior change’, 6th ed., Hoboken, NJ, Wiley, 169-218.
Leichsenring, F. Steinert, C. (2017). La terapia comportamentale è veramente la più efficace? Psicoterapia e Scienze Umane, 51:551-558. Anche in Migone, P. (a cura di), La terapia psicodinamica è efficace? Il dibattito e le evidenze empiriche. Milano: Franco Angeli, 2021;3:74-82.
DOI: https://doi.org/10.3280/PU2017-004003
Luborsky, L., Singer, B. Luborsky, L. (1975). Comparative studies of psychotherapies: ‘Is it true that everyone has won and all must have a prize?’, Archives of General Psychiatry, 32:995-1008.
DOI: https://doi.org/10.1001/archpsyc.1975.01760260059004
Norcross, J.C. (2001). Purposes, Processes, and Products of the Task Force on Empirically Supported Therapy Relationships. Psychotherapy: Theory, Research, Practice, Training, 38:345-356.
DOI: https://doi.org/10.1037/0033-3204.38.4.345
Norcross, J.C. (a cura di) (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients, Oxford University Press, New York.
Norcross, J.C. (Ed.) (2011). Psychotherapy relationships that work: Evidence-based responsiveness (2nd ed.). Oxford University Press. Available from: https://doi.org/ 10.1093/acprof:oso/9780199737208.001.0001
DOI: https://doi.org/10.1093/acprof:oso/9780199737208.001.0001
Norcross, J.C., Lambert, M.J. (2019). Psychotherapy relationships that work. Volume 1: Evidence-based therapist contributions (3rd ed.). New York: Oxford University Press.
DOI: https://doi.org/10.1093/med-psych/9780190843953.003.0001
Norcross, J.C., Wampold, B.E. (2019). Psychotherapy relationships that work. Volume 2: Evidence-based responsiveness (3rd ed.). New York: Oxford University Press.
DOI: https://doi.org/10.1093/med-psych/9780190843960.001.0001
Paris, J. (2008). Clinical trials of treatment for personality disorders. The Psychiatric Clinics of North America, 31:517-viii.
DOI: https://doi.org/10.1016/j.psc.2008.03.013
Patterson, T.L., Leeuwenkamp, O.R. (2008). Adjunctive psychosocial therapies for the treatment of schizophrenia. Schizophrenia Research, 100:108-119.
DOI: https://doi.org/10.1016/j.schres.2007.12.468
Rachman, S. (1971). The effects of psychotherapy (Vol. 15). Oxford: Pergamon.
Rennie, D.L. (1994). Clients’ deference in psychotherapy. Journal of Counseling Psychology, 41:427-437.
DOI: https://doi.org/10.1037/0022-0167.41.4.427
Rhodes, R.H., Hill, C.E., Thompson, B.J., Elliott, R. (1994). Client retrospective recall of resolved and unresolved misunderstanding events. Journal of Counseling Psychology, 41:473-483.
DOI: https://doi.org/10.1037/0022-0167.41.4.473
Rosenzweig, S. (1954). A transvaluation of psychotherapy: a reply to Hans Eysenck. The Journal of Abnormal and Social Psychology, 49:298-304.
DOI: https://doi.org/10.1037/h0061172
Safran, J.D., Muran, J.C., Samstag, L.W., Stevens, C. (2001). Repairing alliance ruptures. Psychotherapy: Theory, Research, Practice, Training, 38:406-412.
DOI: https://doi.org/10.1037/0033-3204.38.4.406
Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. The American psychologist, 65:98-109.
DOI: https://doi.org/10.1037/a0018378
Shedler, J. (2018). Where Is the Evidence for ‘Evidence-Based’ Therapy? The Psychiatric Clinics of North America, 41:319-329.
DOI: https://doi.org/10.1016/j.psc.2018.02.001
Solomon, D.A., Keitner, G.I., Ryan, C.E., Kelley, J. Miller, I.W. (2008). Preventing recurrence of bipolar I mood episodes and hospitalizations: Family psychotherapy plus pharmacotherapy versus pharmacotherapy alone. Bipolar Disorders, 10:798-805.
DOI: https://doi.org/10.1111/j.1399-5618.2008.00624.x
Steinert, C. Leichsenring, F. (2017). No psychotherapy monoculture for anxiety disorders. Lancet, 389:1882-1883.
DOI: https://doi.org/10.1016/S0140-6736(17)31206-0
Steinert, C., Munder, T., Rabung, S., Hoyer, J., Leichsenring, F. (2017). Psychodynamic Therapy: As Efficacious as Other Empirically Supported Treatments? A Meta-Analysis Testing Equivalence of Outcomes. The American journal of psychiatry, 174:943-953.
DOI: https://doi.org/10.1176/appi.ajp.2017.17010057
Thoma, N.C., McKay, D., Gerber, A.J., Milrod, B.L., Edwards, A.R. Kocsis, J.H. (2012). A quality-based review of randomized controlled trials of cognitive-behavioral therapy for depression: An assessment and metaregression. American Journal of Psychiatry, 169:22-30.
DOI: https://doi.org/10.1176/appi.ajp.2011.11030433
Thornton, J. (2018). Depression in adults: campaigners and doctors demand full revision of NICE guidance. British Medical Journal (BMJ), 361:k2681.
DOI: https://doi.org/10.1136/bmj.k2681
Tolin, D.F. (2015). Corrigendum to ‘Beating a dead dodo bird: Looking at signal vs. noise in cognitive-behavioral therapy for anxiety disorders’. Clinical Psychology: Science and Practice, 22:315-316.
DOI: https://doi.org/10.1037/h0101727
Tolin, D.F., McKay, D., Forman, E.M., Klonsky, E.D., Thombs, B.D. (2015). Empirically supported treatment: Recommendations for a new model. Clinical Psychology: Science and Practice, 22:317-338.
DOI: https://doi.org/10.1037/h0101729
Vocks, S., Tuschen-Caffier, B., Pietrowsky, R., Rustenbach, S.J., Kersting, A. & Hertpertz, S. (2010). Meta-analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorder. International Journal of Eating Disorders, 43:205-217.
DOI: https://doi.org/10.1002/eat.20696
Wachtel, P.L. (2010). Beyond ‘ESTs’. Problematic assumptions in the pursuit of evidence-based practice. Psychoanalytic Psychology, 27:251-272. (Trad. It. Al di là degli ‘EST’. Problemi di una pratica psicoterapeutica basata sulle evidenze. Psicoterapia e Scienze Umane, 2011, 45:153-180).
DOI: https://doi.org/10.1037/a0020532
Wampold, B.E. (2001). The great psychotherapy debate: Models, methods, and findings. Lawrence Erlbaum Associates Publishers.
Wampold, B.E., Imel, Z.E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). Routledge/Taylor & Francis Group (Trad. It. Il Grande dibattito in psicoterapia: L’evidenza della ricerca scientifica avanzata applicata alla clinica, Sovera editore, Roma, 2017).
DOI: https://doi.org/10.4324/9780203582015
Westen, D., Morrison Novotny, K., Thompson-Brenner, H. (2004). The empirical status of empirically supported psychotherapies: Assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin, 130:631-663.
DOI: https://doi.org/10.1037/0033-2909.130.4.631
Come citare
Papini, S. P., & Vanni, F. (2023). Dalla montagna al topolino: commento a ‘Consensus conference sulle terapie psicologiche per ansia e depressione’. Ricerca Psicoanalitica, 34(2). https://doi.org/10.4081/rp.2023.793
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