POSTERS

RESEARCH METHODOLOGY IN PSYCHOTHERAPY: USES AND ABUSES OF META-ANALYSIS

Aims: The presence of conflicts of interest in psychotherapy, with the consequent errors and/or falsifications, has not been adequately considered in psychotherapy. In this work, a much cited study by Jonathan Shedler of mega-analyses of efficacy studies of various treatments in psychiatry, both psychotherapeutic and pharmacological, is taken into consideration for in-depth examination, in which two Authors declared conflicts of interest: General psychotherapy, CBT, Psychodynamic Psychotherapy (PP), Antidepressant Psychopharmacotherapy (PTAD).

Method: Examination of the method and results of the studies considered in J. Shedler’s mega-analysis in the light of statistical methodology. We then proceeded to examine: a) the method used for merging the results, b) the correctness of the calculations, c) the congruence between results and conclusions.
Results: Numerous meta-analyses included in this study do not have the sufficient number to consider reliable the calculation of the Effect Size (ES or Degree of Effect), one in the PTAD group, six in the PP group. Furthermore, meta-analysis studies are included together with some mega-analyses, and a meta-analysis study of PP does not have control groups, therefore it is not comparable to the others. Therefore, only one of the meta-analyses has characteristics that can lend themselves to verifying the efficacy of the PP, that of Abbas & coll. (2006), but many sub-analyses of this study do not have the sufficient number to consider the calculation of the ES reliable, therefore they should be excluded. Finally, the final result (ES = .77) is erroneously reported in the conclusions as ES = .97.

Discussion: In view of the above, the study presents numerous errors, which can sometimes be interpreted as manipulation or falsification of data, and represents a real example of abuse of the meta-analysis method.

CLINICAL CASE OF CORRADO

The case of a homosexual patient sent to a psychology service for depressive-anxious symptoms is described. The patient had adopted an avoidance coping and a passive-anassertive attitude towards his sexual orientation, especially due to the shame deriving from a self-stigma. He had a brother who was married with three children and died 3 years earlier. The trans-diagnostic framework of the clinical case leads to the identification of short, medium and long-term therapeutic objectives such as: immediate psychological support, and then, once the mood had improved, reduction self-stigma for HIV, internalized homophobia, and then the coping with social problems and avoidance behaviors. Recognizing that his avoidance behaviors have been learned in the family context, psychotherapy proceeded rapidly, especially since the patient has started making decisions in his favor and following his preference. Today he has moved to a new home where he lives happily, he also bought a new car and meets a man he has been dating for a few months.

Historical Archive

Vic Meyer, of Polish origin, was a British psychologist at the Middlesex Hospital Medical School of the University of London (now UCL Medical School) and is considered the “spiritual father” of clinical case formulation, an approach to understanding complex psychiatric problems using learning principles derived from experimental psychological research and idiographically adapted to the individual case to develop an effective intervention regimen.