Relational psychodynamic therapy – process and outcome

My research and teaching practice primarily focus on psychotherapy with relational psychodynamic orientation. I define this category rather broadly as contemporary psychodynamic therapy methods in which the importance of a good relationship between patient and therapist is emphasized. In this category I include mentalization-based treatment, brief relational therapy and affect-focused therapies. My research is rather varied as for treatment methods and research designs. It includes both randomized controlled trials and naturalistic studies. The studies concern therapy outcome/effect, psychotherapy process, and the influence of patient and therapist factors. 

My research concerns a variety of psychological problems but I have a special interest in personality disorders. My teaching assignments are mostly at the advanced psychotherapy-training programme, with main responsibility for the course on theory and treatment methods in relational and interpersonal psychotherapy. I am a licensed psychologist, licensed psychotherapist, and associate professor in psychology. 

Research

Mentalization-based treatment for dual diagnosis

I am the project leader of Mentalization-Based Treatment for Dual Diagnosis – A Randomized Controlled Trial (MBTDD). The aim of the study was to investigate whether MBT in combination with standards dependency care is more effective than standard dependency care alone for patients with concurrent borderline personality disorder (BPD) and substance dependence, with regard to severity of BDP, substance use including alcohol, suicidal acts, self harm, retention in treatment, psychiatric symptoms, interpersonal problems, social adaptation, reflective functioning. 

The study was carried out at the Center for Dependency Care, Stockholm County Council, in collaboration with the Center for Psychiatry Research, Karolinska Institutet, Stockholm. Co-reserchers are associate professor Peter Wennberg, professor Johan Franck and doctoral candidate/project coordinator Per Konradsson. The trial was conducted in accordance to Good Clinical Practice (GCP) and monitored in accordance to IHC-GCP by Karolinska Trial Alliance. 

The study was a randomized controlled trial with 46 included patients. In the trial MBT in combination with standard dependency care was compared with the control condition standard dependency care alone. The MBT treatment had duration of 18 months, with one individual and one group session per week, as well as a short psychoeducation course in mentalization. 

Project treatments were carried out between 2009 and 2015. Primary outcome analysis are carried out at the moment. Some studies based on baseline data and data from video-recorded sessions have already been conducted. Up to now four master’s theses in psychology have been authored based on data from the project. Three article manuscripts have been authored based on this research and have been sent to international scientific journals, one of which is recently published. More project research within the project is planned.

Psychology students’ training therapies

I am also the project leader for an ongoing research project at Linköping University, which is called Effects of treatments conducted by psychology students under supervision. Co-researcher is Lise Bergman Nordgren, Ph. D. and the study started during 2014. This is a naturalistic outcome study of the training therapies that are conducted at Linköping University by student in the final phase of the Psychology Programme (leading to a M Sc in Psychology). In this study, we also investigate therapist factors and their impact on therapy outcome. The study includes about eighty psychology students. As every student treats several patients during their clinical course, we expect a high number of included patients. This will give us data enough to permit advanced statistical analyses and increase the possibility for conclusive results. 

Connected with this project and together with Lise Bergman Nordgren and professor emeritus Rolf Sandell, I try to develop an observer rating for therapists’ relational competence. In our current project, our aim is to examine whether therapist relational competence is a predictor of therapy outcome. In future studies, we aim at using the scale in studies of the association process-outcome, in order to examine in depth how much of the therapeutic effect is influenced by relational factors versus specific therapeutic technique.

Affect phobia therapy for alcohol dependence

Another series of research studies that I supervise concerns Affect Phobia Therapy for Patients with Alcohol Dependence. These studies belong to the doctoral project of doctoral candidate My Frankl, for whom I am the main supervisor. Assistant supervisors are associate professor Peter Wennberg and professor Rolf Holmqvist. Two studies have been conducted so far: one experimental small N study with multiple baseline design including three alcohol dependent females in affect phobia therapy (APT) (submitted manuscript) and a psychometric evaluation of the affect phobia test (submitted manuscript). A third study that will be conducted during 2015-2016 is an open trial including 24 participants focusing on APT in group format for patients with comorbid substance dependence and ADHD. A fourth study is planned – a randomized controlled trial of APT in individual format for patients with alcohol dependence. All studies mentioned are conducted at the Center for Dependency Disorders, Stockholm County Council.

Participation in other projects

Besides the research projects mentioned above, I am co-researcher in two projects conducted by professor Rolf Holmqvist: 

Randomized trial of the effects of CBT and Brief Relational Therapy, compared to TAU, in the treatment of adolescent depression
Development of a pracitce-based research network for studies of the effects of psychological treatments in primary care and psychiatric care. 

For more information about these projects, please visit professor Holmqvist’s webpage.

Previous research

My doctoral project at Karolinska Institutet concerned young adults in psychoanalytic psychotherapy, their ideas of cure, and how those are associated with the psychotherapy process and outcome. This work was done during 2000-2005 as a part of the research project Young Adult Psychotherapy Project (YAPP) with professor Andrzej Werbart as project leader.

Subsequently from 2006, I worked at the Center for Dependency Disorders, Stockholm County Council, with affiliation to Karolinska Institutet. Together with associate professor Peter Wennberg I conducted the project Matching and Outcome of Psychotherapy at Addiction Clinics in Sweden (MOPACS) during 2006-2009. This was a naturalistic outcome study of psychotherapies conducted at the Center for Dependency Disorders, in which we also investigated the impact of various possible matching factors. During my employment at Center for Dependency Disorders I was also assistant supervisor for Maija Konstenius, Ph. D., and her doctoral project focused on patients with comorbid substance dependence and ADHD.

Research groups

Research leader for the research group in clinical psychology and psychotherapy

Teaching

Psychology programme
Postgraduate psychotherapist programme
 

Supervision of PhD students

My Frankl
Carl-Johan Uckelstam
Ylva Söderberg Gidhagen (co-supervisor)
 

Commissions

Collaboration coordinator at the Department of Behavioural Sciences and Learning
 

The research group in clinical psychology and psychotherapy

Publications

2017

Clara Möller, Linda Karlgren, Anton Sandell, Fredrik Falkenström, Björn Philips

Mentalization-based therapy adherence and competence stimulates in-session mentalization in psychotherapy for borderline personality disorder with co-morbid substance dependence

In Psychotherapy Research

Article in journal

Ylva Gidhagen, Björn Philips, Rolf Holmqvist

Outcome of psychological treatment of patients with substance use disorders in routine care

In Journal of Substance Use

Article in journal

2016

Rolf Holmqvist, Björn Philips, John Mellor-Clark

Client and therapist agreement about the clients problemsAssociations with treatment alliance and outcome

In Psychotherapy Research

Article in journal

2015

Rolf Holmqvist, Björn Philips, Michael Barkham

Developing practice-based evidence: Benefits, challenges, and tensions

In Psychotherapy Research

Article in journal

Rolf Holmqvist, Björn Philips, Michael Barkham

Implementing routine outcome monitoring in clinical practice: Benefits, challenges, and solutions

In Psychotherapy Research

Article in journal