Effectiveness of Short-Term Psychodynamic Psychotherapy in Preadolescents and Adolescents Affected by Psychiatric Disorders

Combining action research theory with focus-solving short-term psychotherapy for psychological stress, adjustment, and rehabilitation in patients with postoperative acute myocardial infarction following percutaneous coronary intervention

OBJECTIVE

To evaluate the impact of combining action research theory with focus-solving short-term psychotherapy on the psychological stress, adjustment, and rehabilitation of patients with acute myocardial infarction (AMI) following percutaneous coronary intervention (PCI).

METHODS

Between January 2022 and January 2023, a prospective study was conducted involving 300 AMI patients at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Participants were divided into a control group and a study group, with 150 patients in each. The control group received standard treatment and rehabilitation guidance, while the study group also received interventions based on action research theory and focus-solving short-term psychotherapy. Outcomes measured included scores from the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Mental Health Inventory (MHI), National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Essential Skills for Caregivers Assessment (ESCA), and patient satisfaction. Prognostic factors were also analyzed.

RESULTS

Post-intervention, the study group demonstrated significantly lower scores in HAMA and HAMD and reported less psychological pain, alongside higher scores in psychological well-being, compared to the control group (all P < 0.05). Additionally, the study group showed improved neurological function (NIHSS scores) and motor skills (FMA scores) as well as enhanced self-care abilities (higher ESCA scores) (all P < 0.05). Patient satisfaction was also notably higher in the study group (P < 0.05). Key prognostic factors included history of diabetes, Killip classification, and door-to-balloon (DTB) time.

CONCLUSION

The integration of action research theory with focus-solving short-term psychotherapy significantly alleviated anxiety and depression in AMI patients post-PCI, enhanced their psychological adjustment, and facilitated the recovery of neurological and motor functions. This approach also improved self-care capabilities. Effective management of underlying conditions, vigilant monitoring of Killip classification, and minimization of DTB time are critical to reducing major adverse cardiac events and improving patient outcomes.

Interaction Structures in Psychodynamic Psychotherapy for Adolescents

Despite advances in psychotherapy research showing an evidence-base for psychodynamic psychotherapy (PDT) in adolescents, developmentally specific treatment characteristics are under-researched. We aimed to identify interaction structures (IS: reciprocal patterns of in-session interactions involving therapist interventions, patient behaviors, and the therapeutic relationship) and assess associations between IS and outcome. The study cohort comprised 43 adolescents (M_age = 13.02 years) with nonclinical, internalizing, and comorbid internalizing-externalizing problems in PDT. A total of 123 sessions from different treatment phases were rated based on the Adolescent Psychotherapy Q-Set (APQ). Outcome was assessed with the Brief Problem Monitor-Youth (BPM-Y) administered repeatedly over the treatment course. Principal component analysis of APQ items resulted in five IS, named "Negative Therapeutic Alliance", "Demanding Patient, Accommodating Therapist", "Emotionally Distant Resistant Patient", "Inexpressive Patient, Inviting Therapist", and "Exploratory Psychodynamic Technique" (EPT). Multilevel modeling analyses with Bayesian Markov chain Monte Carlo (MCMC) estimations indicated a two-way interaction effect between EPT and problem levels at baseline such that patients with lower problems at baseline showed good outcome in the context of EPT, whereas an inverse relationship was found for patients with higher problems. Findings provide empirical evidence for characteristic components of PDT for adolescents and preliminary answers about who benefits from psychodynamic techniques.