Löffler-Stastka H, Narath U. Professional interventions affect outcome in depressed patients. World J Psychiatry 2026; 16(4): 114215 [DOI: 10.5498/wjp.v16.i4.114215]
Corresponding Author of This Article
Henriette Löffler-Stastka, MD, PhD, Dean, Director, Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria. henriette.loeffler-stastka@meduniwien.ac.at
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Psychology, Psychoanalysis
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Retrospective Study
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Apr 19, 2026 (publication date) through Mar 30, 2026
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World Journal of Psychiatry
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2220-3206
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Löffler-Stastka H, Narath U. Professional interventions affect outcome in depressed patients. World J Psychiatry 2026; 16(4): 114215 [DOI: 10.5498/wjp.v16.i4.114215]
World J Psychiatry. Apr 19, 2026; 16(4): 114215 Published online Apr 19, 2026. doi: 10.5498/wjp.v16.i4.114215
Professional interventions affect outcome in depressed patients
Henriette Löffler-Stastka, Ursula Narath
Henriette Löffler-Stastka, Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna 1090, Austria
Ursula Narath, University Program of Psychotherapy Research, Medical University Vienna, Vienna 1090, Austria
Author contributions: Löffler-Stastka H and Narath U participated in the conception and design of the study and were involved in the acquisition, analysis, or interpretation of data, wrote the manuscript, accessed and verified the study data; all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Medical University Vienna, approval No. 1561/2023.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Data sharing statement: Additional data are available on request from the corresponding author.
Corresponding author: Henriette Löffler-Stastka, MD, PhD, Dean, Director, Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria. henriette.loeffler-stastka@meduniwien.ac.at
Received: September 15, 2025 Revised: October 27, 2025 Accepted: December 10, 2025 Published online: April 19, 2026 Processing time: 197 Days and 20.1 Hours
Abstract
BACKGROUND
Psychotherapy research has long investigated the factors that influence the success of treatment. While the focus of psychotherapy research was initially primarily on disorder-specific methods, the focus has now increasingly shifted to common factors and techniques that are effective in different therapeutic schools. A central factor is the competence of the therapist, the personality, attitude, and interpersonal skills of the respective psychotherapist.
AIM
To investigate the detailed process and course of psychoanalytic therapeutic work using the Psychoanalytic Core Competency Q-Sort.
METHODS
We conducted a retrospective, single-center observational reanalysis of data from 90 depressed patients originally included in the Munich Psychotherapy Study, which was conducted at Medical University Vienna as a psychotherapy research center. All patients were analyzed using audio recordings of the sessions. One-third of the patients received behavioral therapy, 1/3 received psychodynamic psychotherapy and 1/3 received classical psychoanalytical treatment. Data from the first and last sessions of psychoanalytic treatments of severely depressed patients were used to document intervention processes and their effects on outcome.
RESULTS
Using Core Competency Q-Sort Coding to provide a detailed description of the process and course of therapeutic work, interesting findings were made regarding the core analytical competencies that revolve around curative work on the unconscious and on implicit memory: On the one hand more confrontational interventions were used significantly more intensively in the first sessions (P < 0.05) and contributed to remarkable therapeutic success (effect size: r = -0.58; P = 0.05); conversely, attitude elements tended to be more effective towards the end of treatment. In addition to the statistical evaluations, individual cases are presented that show that each encounter is unique.
CONCLUSION
Precise adaptation and attunement to the patient’s inner life and socialization history-relevant representations in the present moment ensured a successful therapeutic process.
Core Tip: This article investigated long-term effectiveness of professional competencies, which deals with detailed description of process and progression of therapeutic work using Core Competency Q-Sort Coding. Interesting findings were made with regard to core competencies that cluster around healing work on implicit memory: More confrontational interventions were used significantly more intensively in first sessions and contributed to remarkable therapeutic success; attitude elements tended to be more effective towards the end of treatment. Individual case evaluations show that working through representations relevant to the patient’s inner life and socialization history in the present moment can help achieve successful therapeutic processes.
