Research
PSYCHOANALYTIC PSYCHOTHERAPY IN
CONTEMPORARY MENTAL HEALTH
SERVICES: CURRENT EVIDENCE, FUTURE
ROLE AND CHALLENGES
KAYLEIGH M. BROWN and DEREK K. TRACY
Three interacting challenges are facing all aspects of health care in the
United Kingdom: financial restraint in the context of a global economic
downturn; a move to services being commissioned and decommissioned
by primary care Clinical Commissioning Groups; and a need to provide
evidence based practice through ‘payment by results’. Psychoanalytic
psychotherapy faces more difficulty than most services in mental health,
with long and frequent criticisms of it being expensive and under-
researched; and it is not as well understood by GPs as cognitive
behavioural therapy, with which it is frequently unfavourably compared.
This review provides an overview of the existing evidence for psychoana-
lytic psychotherapy, identifying strengths and areas that are under
KAYLEIGH M. BROWN BA (Oxon) MSc is an Assistant Psychologist within South
London and Maudsley NHS Foundation Trust, London. She works with adults with complex
needs and histories of complex trauma, using mentalization and psychodynamic approaches.
She has previously worked in forensic settings using CBT interventions, as a tutor for
children with autistic spectrum disorders and as an assistant psychologist, working with
adults with diagnoses of psychosis. Her research interests include homelessness and psy-
chopharmacology and she has published research in this field. Address for correspondence:
Cognition, Schizophrenia and Imaging Laboratory, Department of Psychosis Studies, the
Institute of Psychiatry, King’s College London, UK. [kayleigh.brown@slam.nhs.uk]
DEREK K. TRACY MB BCh BAO MSc MRCPsych is a Consultant Psychiatrist at Oxleas
NHS Foundation Trust, London. He runs a specialist MSc module in psychopharmacology
at the Institute of Psychiatry and has published research in this field. His other research
interests include fMRI in schizophrenia and grant-awarded work on repetitive Transcranial
Magnetic Stimulation in the treatment of auditory hallucinations. As well as publishing on
these topics, he has written chapters on neuroanatomy, neurophysiology and psychophar-
macology for a forthcoming Oxford University Press textbook for trainee psychiatrists, a
book chapter of neuropsychiatry, and is currently writing a commissioned book chapter on
treatment resistance in schizophrenia.
British Journal of Psychotherapy 30, 2 (2014) 229–242 doi: 10.1111/bjp.12074
© 2014 BPF and John Wiley & Sons Ltd