RESEARCH APPENDIX
EXAMPLE EVIDENCE BASED REVIEW
FOR ADLERIAN PSYCHOTHERAPY
**********ROUGH DRAFT NOT FOR CIRCULATION**********
As Jonathan’s therapist, I wonder what type of therapy would be most suitable for him,
my depressed 35 year old male adult. My clinical intuition tells me to use Adlerian
therapy. I want to know what empirical support exists to help me to justify my choice of
treatment modality..
Patient or problem of interest-Jonathan is a depressed male less than 35 years old.
Intervention – Adlerian therapy
Control – control group (any)
Outcome of interest-symptom reduction or reports of improvement
Background: Is there any evidence to show Adlerian therapy is effective for depressed
adult male clients?
Aim: My aim is to assess the quality and quantity of empirical research evidence to
support the claim that Adlerian therapy is efficacious and effective with depressed male
clients. Especially, are there any high quality studies conducted since 1990? What useful
information can I glean from the empirical literature to help my practice.
SEARCH METHOD:
Sites: 1) Medline
2) Psych Info
3) Cochrane
Limiters:
Years: 1/1/1990 to 2/22/2006
Date: February 22, 2006
EVIDENCE BASED SEARCH FOR ADLERIAN THERAPY
ASK: For Jonathon, is there any evidence to show that Adlerian therapy is effective in
treating depression in male adults?
P-depression male adult
I- Adlerian
C-control group
O-utcome (relief of symptoms)
Search Strategy:
ACCESS: Pub Med
Date: February 7, 2006; Repeated February 22, 2006
Keywords for all searches: Adult male AND depression AND Adlerian therapy
ACCESS: Pub Med
Keywords: Adult male AND Depression AND Adlerian therapy
Found: 0 hits
Keyword Change: Depression AND Adlerian therapy
Found: 0 hits
Keyword Change: Adlerian therapy
Found: 6 hits
No RCT were available
ACCESS: Psych Info
Keywords: Adult male AND Depression AND Adlerian therapy
Found: 0 hits
Keyword Change: Depression AND Adlerian therapy
Found: 1
No RCTs
Keyword Change: Adlerian therapy
Found: 30 hits; Limit setter (refereed journals; 1990 and after)
Book reviews 2; Also in PubMed ;
ACCESS: Cochrane Collaboration
Keyword Changes: Depression AND Adlerian therapy AND Control
Adult depression AND Adlerian therapy
Found: No Hits
Depression AND Adlerian therapy
Found: No hits
Results of Search of Feb. 22, 2006: Pub Med, Psych Info, and Cochrane show no
listings of publications of RCT or methodologically sound systematic comparisons of
treatment of adult depression with Adlerian therapy between years 1990 and 2006 at this
time.
I also not that many of the studies are published in a journal, Individual
Psychology, that is peer reviewed, but sponsored by the members of the Adlerian
society. I must consider that allegiance biases can enter into these publications. There are
no systematic reviews, RCTs, or even case control studies.The majority of evidence is
based on single case studies, theoretical discussions. I have summarized the studies in
Table 1.
Conclusion after Search: I found that there were no studies that looked at a sample of
depressed individuals who were treated with Adlerian therapy. There was only one article
that addressed Adlerian therapy with a depressed patient. When I expanded my search, I
found there were a number of articles in refereed journals concerned with Adlerian
therapy in general. The summary shows that out of 32 articles, there are 7 case studies, 2
empirical studies, and the remainder are discussions of theory and practice. I obtained the
empirical studies and will critique their quality in the next section.
From this search process, it is not possible to say with any certainty that Adlerian
therapy is efficacious or effective in the clinical treatment of depression in adult males.
There is not sufficient evidence to draw empirically sound conclusions from this
literature. Of course, there are also limited search process.
What interesting and useful information can I draw as a clinician from this review? I can
not tell my client that I know with certainty that Adlerian therapy will be effective in
treating depression. I can discuss the fact that there are many therapists who have used
this method and that it makes clinical sense.
Improvement of Search: I can expand this search by expanding the time frame to an
earlier date. However, based upon knowledge of other searches and reviews, I know
there is little research on Adlerian therapy and I have most likely not missed any major
studies. My aim is to keep current with new research.
Selected for Interesting Reading:
The search produced one study that examined a form of Adlerian therapy (FEP) and
compared it with cognitive therapy clients. While the abstract is interesting, it seems that
the authors are looking at a very narrow definition and topic areas of emotional
expression. I selected a second article to review because it mentioned some very
interesting results. Therapists who receive treatment for their own depression tends to
choose analytic or Adlerian therapy! Food for thought.
SUMMARY OF ARTICLES AFTER 1990 (PubMed AND Psych Info And
Cochrane)
Keywords and keyword changes: Adlerian therapy and depression; Adlerian therapy
Found: Total of articles: PubMed (6); Psych Info (31); Cochrane (0);
Irrelevant: 1 in both searches; 3 repeated in search; 2 book reviews
Total = 31
First author & Topic of study
Design
Outcome
date
Disque (2004) Emotion, experience, early
No data
1
recollection
Santamaria, N. Personality and stress
Classified
Correlation
2
(2000)
levels
according to
between
lifestyle
Twemloe, S.W Violence &
Review of theory
3
(2000)
psychoanalaysis
Fennell, (1998) Parent education
Clinical trial
More positive
4
parental
thoughts of
children
Last (1997)
Childhood memories
Case report
Memories
5
helpful
Kern (1996)
Diabetic compliance &
Correlational
Lifestyle
6
inventory
variables
correlated with
compliance
Wolfle (1992)
Conversion neurosis and
Case report
Remission of
7
encephalomyelitis
neurological
symptoms
Kopp (2004)
Early metaphors & client
Therapy method
No data
8
generated metaphors
discussions
Watts (2003)
Relational constructivist
Discuss theory
No data
9
approach
Carich (2001)
Sex offenders
Discuss treatment
No data
10
Cash (2001)
Sexually abused children
Discuss treatment
No data
11
Watts (2000)
Encouragement and
Discuss therapy
No data
12
solution focused
methods
Stein, (2000)
Missing developmental
Discuss treatment
Part of case
13
experiences
(German)
study reported
Lehmkuhl
Manniacci
(1998)
Kopp (1998)
Commentary
Early recollections
German
Discuss theory
Early
recollections/metaphor
Discuss theory &
practice
No data
Part of case
study
No data
14
15
16
Walton (1998)
Schneider
(1998)
Rotter (1998)
DeOrneles
(1997)
LaFountain
(1996)
Memorable observation as
technique for
understanding parenting
Journal writing in therapy
Discuss theory
No data
17
Discuss therapy
No data
18
Early memories in couples
therapy
Family art
Discuss therapycolumn
Case study
No data
19
Kottman
(1995)
Clarke (1995)
Slavik (1994)
Gay and lesbian therapy
Case study
information
Empirical study
Therapy Ss
pre-test/post-test;
were sig.
therapy (n=177)
higher on 3
vs. control n=134); measures of
personality;
Ss with social
interest in
goals attained
goals to a
higher degree
Discuss therapy
No data
Encouragement
Empirical study
Discuss therapy
Case study
Rister (1993)
Britzman
(1992)
Lawson (1991)
Hypnosis
Wellness
Bliss (1991)
Eating disorder
Commentary
Discuss therapy
and wellness
Discuss language
of therapy
Case study
Laser (1990)
Trictotillomania
Case study
Carich (1990)
Hypnosis and math phobia
Case Study
Carich (1990)
Task assignments
Discuss therapy
Social interest
Therapy
20
No data
Case
information
No data
No data;
questionnaire
No data
23
24
Excerpts from
7 successful
Eriscksonian
cases
Symptoms still
stopped at 1.5
year follow up
Eliminated
phobia
No data
28
21
22
25
26
27
29
30
31