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Andrzej Werbart

Professor

Projects 2000 - 2012
Publications 2000 - 2012

Projects 2000 - 2012

Andrzej Werbart, principal investigator, David Forsström, and Madeleine Jeanneau:
Long-term outcomes of psychodynamic residential treatment for severely disturbed young adults: A naturalistic study at a Swedish therapeutic community
Institute of Psychotherapy, Stockholm, Department of Psychology, Stockholm University, Department of Public Health Sciences, Karolinska Institutet, Competence Center of Psychotherapy, Stockholm County Council, Sweden
1994-2012

Background: Psychodynamic inpatient treatments, often combining milieu therapy and psychotherapy, used to be one of the treatments of choice for patients with severe psychiatric diagnoses. However, due to the scarcity of well-conducted outcome studies, such combined treatment is increasingly rare in Western countries.

Aim: This study examined the long-term effectiveness of a treatment model at a Swedish therapeutic community for young adults with severe personality disorders, combining milieu therapy and in-patient long-term psychodynamic psychotherapy.

Method: Data were collected for the 56 residents between 1994 and 2008 at intake, termination and 2-year follow-up. Patient residency ranged from 2 to 60 months, with average psychotherapy duration of 30.2 months. Self-rated outcome was measured using the Symptom Checklist-90-R. Expert-rated outcomes comprised the Global Assessment of Functioning, the Strauss-Carpenter Outcome Scale and the Integration/Sealing-over Scale.

Results: All outcome measures showed significant improvement on a group level from intake to discharge. Most patients had maintained the therapeutic gains at the 2-year follow-up. The effect sizes were high and the Reliable Change Index provided evidence of good outcome for 92% of the patients at follow-up. The expert ratings gave somewhat larger effect sizes than the patients' self-ratings.

Conclusions: The effect sizes and success rates are at comparable level as in corresponding studies of long-term treatments of personality disorders. Most patients had a substantial individual improvement from intake to termination and follow-up. This indicates the effectiveness of this highly specialized and intensive treatment approach for severely disturbed young adult patients.

Andrzej Werbart, principal investigator, and Sonja Levander:
Private theories of pathogenesis and cure: patients in psychoanalysis and their analysts (PSA)
Institute of Psychotherapy, Stockholm
1997-2011

Background: Concerning official psychoanalytic theories of therapeutic action, the current situation is characterized by the abundance of pluralism and lack of integration. Both patients in different kinds of treatment and their clinicians develop implicit, private theories of pathogenesis and cure.

Aim: To investigate vicissitudes of implicit ideas of how psychoanalysis might be of help with the analysands' psychological problems, and how concordance and discordance between the participants interacts with the process of change.

Method: This prospective longitudinal study includs the total of 7 analyses. The Private Theories Interviews (PTI) with analysands and their psychoanalysts are conducted at the start of psychoanalysis, and then 6 months, 1.5 years, 3years, and 4.5 years after the first interview, at termination of the analysis, and 1.5 years post- termination. Transcripts are investigated by means of a serial case study methodology and inductive thematic analysis.

Results: Both utopian ideas and ideas of more attainable cure were found in both parties. The utopian ideas of wished-for cures persisted throughout the psychoanalytic process in both participants in more than half of the cases. Utopian ideas often created feelings of incompatibility between the analyst and the analysand. The abandonment of these ideas was related to more positive experienced outcome of psychoanalysis. Furthermore, we found personality differences in analysands' response to specific dimensions of the analytic process.

Conclusions: The study suggests that the psychoanalytic process might profit from the analyst's observance of incongruities between the parties' ideas and openness to work them through.

Financial support: The Bertil Wennborg Foundation and the Research Advisory Board, International Psychoanalytical Association.

Andrzej Werbart, principal investigator, David Forsström, et al.:
Psychoanalysis in Public Service Setting (PPSS): Outcomes and individual patterns of change
Institute of Psychotherapy, Stockholm, and Department of Psychology, Stockholm University
1998-2012

Background: There are only few studies of psychoanalysis in public service settings.

Aim: To examine individual differences in outcome of psychoanalysis in a public setting.

Method: 26 patients in psychoanalysis and their 10 analysts at the Institute of Psychotherapy are included. Outcome measures included Symptom Checklist -90, Self-Rated Health, SASB, Sense of Coherence and socio-demographic data. The patients were interviewd at termination and 2-year follow-up sing the Change After Psychotherapy Interview (CHAP).

Results: Outcome data from a series of psychoanalyses conducted in a specialized public service setting are explored in-depth. Outcome data collected by different self-rating and expert-rating instruments are compared. In serial case studies we track the individual patterns of change in order to better understand how the patients benefited from psychoanalysis.

Financial support: The Research Advisory Board, International Psychoanalytical Association.

Andrzej Werbart, principal investigator, Lena Johansson, Peter Lilliengren, Björn Philips (doctoral project), et al.:
Young Adult Psychotherapy Project (YAPP)
Institute of Psychotherapy and Karolinska Institutet, Stockholm
1998-2009

Background: The evidence base in psychotherapy research can be enriched adopting a naturalistic stance and taking the patients' view into account.

Aim: To study psychoanalytic psychotherapy with young adults from the viewpoints of outcome and patients' ideas of cure, and how these two aspects are related to each other.

Method: 134 patients were included. Measures included Symptom Checklist -90, Self-Rated Health, GAF, IIP, SASB, Differentiation-Relatedness Scale and Helping Alliance. Ideas of cure were explored using the Private Theories Interview. Qualitative methods included ideal-type analysis and grounded theory.

Results: The patients were considerably more troubled than Swedish norm groups at intake. The patients showed improvement on all outcome measures at termination. The largest positive changes were with respect to the patients' overall health and functioning. A majority of the patients had ideas of cure that were in line with psychoanalytic psychotherapy. Patients who terminated therapy prematurely were significantly closer to the 'distancing' pole regarding ideas of cure, while completers closer the 'approaching' pole. Tentative theoretical models of therapeutic action were construted, starting from the patients' and the therapists' perspective. The patients and therapists both stress the importance of establishing a special kind of relationship enabling the patients to talk openly about their inner experiences. However, both parties had incompatible, implicit theories regarding what the problem in therapy was and what was needed to change it.

Conclusions: The introductory sessions seem to be of vital importance in helping patients to engage in a potentially beneficial therapy.

Financial support: Söderström-Königska Nursing Home Foundation and the Bank of Sweden, Tercentenary Foundation.

Andrzej Werbart and Gunnel Jacobsson (doctoral project), principal investigators:
Young Adult's Own Thinking, Understanding, and Managing of Everyday Life (YOUTH)
Institute of Psychotherapy, Stockholm, and Department of Education, Stockholm University
2000-2006

YOUTH is a study of private explanatory systems and personal strategies, created by young adults (aged 18-25; non-clinical population) in confrontation with strains and challenges on the threshold of adulthood.

Part 1: Using case study methodology, both successful and non-adaptive strategies are investigated, as well as differences between women's and man's private theories about their difficulties and ways of managing strains and challenges in life. The material includes PTI-interviews with 24 young adults, as well as interviews, questionnaires, and rating scales used in YAPP. Data is collected at 3 points of time: at the baseline, 1.5 and 3 years later.

Part 2: A survey in a representative random sample of young adults in Stockholm (N=630). In this part of the research programme a Private Theories Questionnaire was constructed and tested.

Part 3: A pilot study of private theories constructed by young adults in narratives collected online on the Net.

Financial support: Stockholm County Council, Secretariate for Research and Development.

Andrzej Werbart, principal investigator, students at the Department of Psychology, Stockholm University and at the Department of Clinical Neuroscience, Karolinska Institutet, Sweden:
Changes in the representations of self, mother and father among young adults in psychoanalytic psychotherapy
2003-2011

Background and aim: Studies of cognitive-affective schemas of self and significant others provide a method for investigating therapeutic change. The present study explores the changes in young adult patients' representations of their parents from prior to psychotherapy through long-term follow-up.

Method: Twenty-five women and 16 men from the Young Adult Psychotherapy Project (YAPP) were interviewed according to Sidney Blatt's unstructured Object Relations Inventory prior to psychoanalytic psychotherapy, at termination and at the 1.5-year follow-up, comprising 123 interviews in all. Typologies of the 246 parental descriptions were constructed by means of ideal-type analysis for male and female patients separately, and for representations of mother and father separately.

Results: The analysis resulted in 5 to 7 ideal types of mother and father representations. Prior to psychotherapy, women's representations of their fathers and men's representations of their mothers seemed most problematic. As to the content, the most common descriptions of the parent were the emotionally or physically absent parent, and the parent with his or her own problems. In most cases, the descriptions of the parent changed over time in terms of belonging to different ideal-type clusters. There were important improvements in the quality of the descriptions, and the changes continued after termination of psychotherapy. However, most of the parental representations were negative in all three interviews.

Discussion: The possible explanations of these findings are discussed.

Financial support: The Bank of Sweden, Tercentenary Foundation, and the Secretariate for Research and Development, Stockholm County Council.

Andrzej Werbart, principal investigator, Camilla von Below et al.:
Depression among young men and women in psychotherapy: patient perspective on own problems, medication and psychotherapy in relation to outcome
Institute of Psychotherapy, Stockholm County Council, and the Psychotherapy Section, Department of Clinical Neuroscience, Karolinska Institutet
2005-2009

Background: Growing incidence of mental ill-health and depression among young adults, and women in particular, is reported in Sweden.

Aim: The first aim was a longitudinal follow-up of young adult psychotherapy patients with diagnoses within the depression spectrum. The the second aim was to explore patients' experiences of overcoming depression.

Method: The material consisted of data collected in YAPP. Of the 87 diagnosed cases in YAPP, 23 patients (26%) had pre-treatment Mood Disorder diagnosis. Both quantitaive and qualitative methods were used.

Results: At termination, 45% 16 of patients still had a diagnosis of Mood Disorder, while 1.5 years later 20% had this diagnosis. The percentage of patients on medication remained unchanged. The patients significantly improved at termination and at 1.5 years follow-up in respect of self-reported symptoms, self-rated health, positive and negative aspects of self-concept, and the differentiation-relatedness of self and object representations. Grounded theory analysis resulted in 15 distinct categories, organized into five general domains: experiences of positive change, in-therapy contributions to positive change, extra-therapeutic contributions to positive change, obstacles in therapy and negative experienced outcomes. Exploration of interplay between these domains resulted in a process model for the way out of depression. The positive changes experienced extended beyond symptom relief. The patients emphasised finding out how they wanted to live and how they started forming their lives in that direction. Obstacles in therapy interplayed with the experience of being stuck in depression.

Discussion: These findings are related to age-specific challenges on the threshold of adulthood.

Financial support: Bank of Sweden, Tercentenary Foundation, the Centre for Health Care Science, and the Clas Groschinsky Memorial Fund.

Andrzej Werbart, principal investigator, Camilla von Below, Annika Lindgren, Vendela Palmstierna, et al.:
Patients' view of helpful and hindering factors in psychoterapy in relation to longitudinal outcomes: Post-termination changes
Institute of Psychotherapy, Stockholm, Child- and Adolescent Psychiatry, Stockholm County Council, Karlinska Institutet, and Department of Psychology, Stockholm University
2007-2010

Background and aim: There is a need of long-term follow-up of the effects of psychotherapy, as well as appplying the patient perspective on process and outcome.

Methods: The material consists of quantitative and qualitative data collected in YAPP.

Results: All outcome measures changed significantly from intake to follow-up. Lower therapist-rated alliance predicted greater change in psychiatric suffering for patients reporting more psychiatric symptoms at intake. A qualitative study of changes in parental representations showed that most common descriptions of the parent were the emotionally or physically absent parent, and the parent with his or her own problems. Dissatisfied patients lacked confidence in their relationship to the therapist, felt unable to express their own feelings, lacked direction in therapy and wanted more response from the therapist. They felt abandoned by an insufficiently flexible therapist, a therapy lacking intensity, and links missing between therapy and everyday life. In the most successful therapies, helpful factors in therapy and in life reinforced each other in a positive feedback loop. In a growth-promoting and secure relationship the patients and the therapists could overcome obstacles to their collaboration. The patients obtained support in close relationships, could cope with strains in life and continued to apply therapeutic experiences after termination. The therapists experienced the therapeutic work in a strikingly similar way.

Conclusions: The long-term effectiveness of psychoanalytic psychotherapy for young adults was supported. Hypotheses were generated about the benefits of a therapist listening to the patient's ideas and making interpretative interventions focusing on obstacles to the therapeutic work.

Financial support: Secretariate for Research and Development, Stockholm County Council.

Andrzej Werbart, principal investigator, and Peter Lilliengren (doctoral project):
Therapists' view of helpful and hindering factors in psychoterapy with young adults
Institute of Psychotherapy, Stockholm, and Department of Psychology, Stockholm University
2007-2010

Background: Studying experienced therapists' implicit theorizing may contribute to our understanding of what is helpful and what hinders treatment with particular patient populations.

Aim and method: In this study, 16 therapists' views of curative factors, hindering factors and outcome were explored in 22 interviews conducted at termination of individual psychoanalytic psychotherapy with young adults. The material consists of data collected in YAPP. Grounded theory methodology was used to construct a tentative model of therapeutic action based on the therapists' implicit knowledge.

Results: The results indicated that Developing a Close, Safe and Trusting Relationship was viewed as the core curative factor in interaction with the Patient Making Positive Experiences Outside the Therapy Setting and the therapist Challenging and Developing the Patient's Thinking about the Self. The therapeutic process was experienced as a joint activity resulting in the patient Becoming a Subject and acquiring an Increasing Capacity to Think and Process Problems. The Patient's Fear about Close Relationships was seen as hindering treatment and leading to Core Problems Remaining.

Discussion: The model is discussed in relation to major theories of therapeutic action in the psychoanalytic discourse and previous research focusing on young adults' view of curative and hindering factors in psychotherapy. Implications for practice and further research are suggested.

Financial support: Clas Groschinsky Memorial Fund and the Centre for Health Care Science, Karolinska Institutet.

Andrzej Werbart, principal investigator, Sverker Sikström and David Arvidsson:
Changes in self- and object representations following psychotherapy measured by a theory-free, computational, semantic space method
Institute of Psychotherapy, Stockholm, and Departments of Psychology, Stockholm University, Lund University and Gothenburg University
2008-2011

Background: Theory-driven measures of object representations may be useful for evaluating the particular theory they were designed for. However, they may be at risk of ignoring other potentially important characteristics.

Aim: To propose a theory-neutral, computational and data-driven method for assessing changes in semantic content of object representations following long-term psychodynamic psychotherapy.

Method: Young adults in psychodynamic psychotherapy were compared with an age-matched, non-clinical sample at three time points. Verbatim transcripts of descriptions of the self and parents were quantified in a semantic space constructed by Latent Semantic Analysis.

Results: In the psychotherapy group, all representations changed from baseline to follow-up, whereas no comparable changes could be observed in the comparison group.

Discussion: The semantic space method supports the hypothesis that long-term psychodynamic psychotherapy contributes to sustained change of affective-cognitive schemas of self and others.

Financial support: None.

Andrzej Werbart, principal investigator, Alexandra Billinghurst, Johan Schubert, et al.:
Quality Assurance of Psychotherapy in Sweden (QAPS)
Institute of Psychotherapy and Stockholm County Council
2007-2009

Background: There is a need for various sources of evidence and research methods in order to build an empirical knowledge base applicable to routine psychotherapy practice.

Aim: To describe, follow up and evaluate the effectiveness of psychotherapy in public services in a standardized way.

Method: QAPS is a core battery of well-established theory-neutral instruments with on-line data entry. The patient questionnaire consists of socio-demographic data and the self-rating scales SRH, SCL-90, QOLI, HAQ and CSQ-8, and is administrated at the beginning, during and at the end of psychotherapy, and twice as follow-up. The psychotherapists fill in the questionnaire at the beginning and end of psychotherapy.

Results: QAPS is running from 2007. At present, 15 psychiatric, psychotherapeutic units and GP-units are involved in the project and the data base includes more than 1.500 patients and 320 therapists. QAPS offers great possibilities to extract different types of information from the database. This can be done by the psychotherapists regarding their patients, by the units as regards all patients at the unit there or the entire material. Questions which may be answered include: who is in psychotherapy, what types and forms of psychotherapy are practiced, how does the group of patients - and the treatment they get - change over time, what is the outcome of the various psychotherapies and how does it differ between treatments?

Discussion: First experiences from the implementation of the system in routine psychiatric care underline the clinical usefulness of monitoring patient progress and feedback to therapists.

Financial support: Stockholm County Council.

Andrzej Werbart, principal investigator, Lars Levin and Mo Wang:
Which psychotherapy suits whom? A naturalistic study of interaction effects in psychotherapy in public servrice settings
Stockholm Centre for Psychiatric Research and Education, Karlinska Institutet; Child- and Adolescent Psychiatry, Stockholm County Council;, and Department of Psychology, Stockholm University
2010-2012

Background: Defining empirically supported treatments exclusively in terms of randomized controlled trials has numerous limitations.

Aim: This naturalistic study presents patient pre-treatment characteristics and compares outcomes for three psychotherapy types practised in psychiatric routine care. Further comparisons include patients who did not start psychotherapy after the initial assessment and patients who started their treatment, patients who discontinued and those who remained in treatment, as well as patient-initiated and therapist-initiated dropout.

Method: Data were collected over a 3-year period at 13 outpatient psychiatric care services participating in the online Quality Assurance of Psychotherapy in Sweden (QAPS) system. Of the 1,498 registered patients, 14% never started psychotherapy, 17% dropped out from treatment and 36% dropped out from data collection. Outcomes were studied for 180 patients who received CBT, PDT or integrative/eclectic psychotherapy.

Results: There were no significant differences in psychological pre-treatment distress between these three groups, and patients showed significant post-treatment improvements. There were no statistically significant differences in effectiveness between psychotherapy types. In ongoing studies, early predictors of non-starting and dicontinuation of treatment are identified, using advanced statistical methods.

Conclusions: Overall, the psychotherapy delivered by the Swedish public health services included in this study is effective for the majority of patients who complete treatment. The theoretically different psychotherapy approaches had equivalent outcomes. The observed variation in improvement size and type depended on the outcome measure, indicating that most patients may experience reduced symptoms through brief psychotherapy, but not necessarily an increased life satisfaction to the same extent.

Financial support: Stockholm County Council, Secretariate for Research and Development.

Peter Lilliengren (doctoral project) and Andrzej Werbart, principal investigators:
Attachment to Therapist and Long-Term Changes after Psychoanalytic Psychotherapy with Young Adults
Department of Psychology, Stockholm University
2011-2014

Background: According to Bowlby, the therapist ideally functions as an attachment figure for the patient, enabling safe affective exploration and corrective emotional experience in the therapeutic relationship. If a secure attachment is developed (Mallinckrodt, 2010) the patient is expected to experience the therapist as (i) a “secure base”, (ii) as “stronger and wiser”, (iii) as a “safe haven”, and the patient would also (iv) seek proximity to the therapist in times of distress and (v) experience separation anxiety in relation to breaks and termination. Further, insecure attachment to the therapist would be expected to be characterized by either deactivation (attachment behaviors and/or feelings are denied or generally toned down) or hyper activation (attachment behaviors and/or feelings are heightened or exaggerated).

Aim: To explore the mediating role of patients' attachment to their therapists for the long-term outcome. Method: In a first step, an observer rating scale for patient attachment to therapist is developed and used on interview material from YAPP. The aim of the scale is to enable measurement of patient attachment to therapist for studying mediation in long-term outcome in psychoanalytic psychotherapy with young adults.

Results: The scale is under construction.

Financial support: Vårstavi Foundation and Department of Psychology, Stockholm University.

Publications 2000-2012

Peer reviewed international publications

1. Arvidsson, D., Sikström, S., & Werbart, A. (2011). Changes in self- and object representations following psychotherapy measured by a theory-free, computational, semantic space method. Psychotherapy Research, 21, 430-446. DOI: 10.1080/10503307.2011.577824
   
   
2. von Below, C., Werbart, A., & Rehnberg, S. (2010). Experiences of overcoming depression in young adults in psychoanalytic psychotherapy. European Journal of Psychotherapy and Counselling, 12, 129-147. DOI: 10.1080/13642537.2010.482745
   
   
3. von Below, C., & Werbart, A. (2012). Dissatisfied psychotherapy patients: A tentative conceptual model grounded in the participants' view. Psychoanalytic Psychotherapy. (In press)
   
   
4. Fatouros Bergman, H., Preisler, G., & Werbart, A. (2006). Communicating with patients with schizophrenia: Characteristics of well functioning and poorly functioning communication. Qualitative Research in Psychology, 3, 121-146. DOI: 10.1191/1478088706qp047oa
   
   
5. Fatouros-Bergman, H., Spang, J., Merten, J., Preisler, G., & Werbart, A. (2012). Stability of facial affective expressions in schizophrenia. Schizophrenia Research and Treatment. Special issue Schizophrenia as a Disorder of Communication. (In press)
   
   
6. Fatouros Bergman, H., Spang, J., Werbart, A., Preisler, G., & Merten, J. (2011). Interplay of gaze behaviour and facial affectivity in schizophrenia. Psychosis: Psychological, Social and Integrative Approaches, 3, 148-150. DOI: 10.1080/17522439.2010.488297
   
   
7. Jacobsson, G., Tysklind, F., & Werbart, A. (2011). Young adults talk about their problems. Scandinavian Journal of Psychology, 52, 282-289. DOI: 10.1111/j.1467-9450.2011.00874.x
   
   
8. Johansson, L., & Werbart, A. (2009). Patients' view of therapeutic action in psychoanalytic group psychotherapy. Group Analysis, 42, 120-142. DOI: 10.1177/0533316409104361
   
   
9. Levander, S., & Werbart, A. (2003). Different views of a psychotic breakdown: Complementary perspectives of a bewildering experience. Psychoanalytic Psychotherapy, 17, 163-174. DOI: 10.1080/1474973031000105311
   
   
10. Levander, S., & Werbart, A. (2012). Personality related responses to the psychoanalytic process: A systematic multicase study. Psychoanalytic Psychology, 29, 1-16. DOI: 10.1037/a0024713
    
    
11. Lilliengren, P., & Werbart, A. (2005). A model of therapeutic action grounded in the patients' view of curative and hindering factors in psychoanalytic psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 42, 324-339. DOI: 10.1037/0033-3204.42.3.324
    
    
12. Lilliengren, P., & Werbart, A. (2010). Therapists' view of therapeutic action in psychoanalytic psychotherapy with young adults. Psychotherapy: Theory, Research, Practice, Training, 47, 570-585. DOI: 10.1037/a0021179
    
    
13. Lindgren, A., Werbart, A., & Philips, B. (2010). Long-term outcome and post-treatment effects of psychoanalytic psychotherapy with young adults. Psychology and Psychotherapy: Theory Research and Practice, 83, 27-43. DOI: 10.1348/147608309X464422
    
    
14. Philips, B., Wennberg, P. & Werbart, A. (2007). Ideas of cure as a predictor of premature termination, early alliance, and outcome in psychoanalytic psychotherapy. Psychology and Psychotherapy: Theory Research and Practice, 80, 229-245. DOI: 10.1348/147608306X128266
    
    
15. Philips, B., Wennberg, P., Werbart, A., & Schubert, J. (2006). Young adults in psychoanalytic psychotherapy: Patient characteristics and therapy outcome. Psychology and Psychotherapy: Theory Research and Practice, 79, 89-106. DOI: 10.1348/147608305X52649
    
    
16. Philips, B., Werbart, A., & Schubert, J. (2005). Private theories and psychotherapeutic technique. Psychoanalytic Psychotherapy, 19, 48-70. DOI: 10.1080/02668730512331341573
    
    
17. Philips, B., Werbart, A., Wennberg, P., & Schubert, J. (2007). Young adults' ideas of cure prior to psychoanalytic psychotherapy. Journal of Clinical Psychology, 63, 213-232. DOI: 10.1002/jclp.20342
    
    
18. Werbart, A. (2000). Our need of taboo: Pictures of violence and mourning difficulties. Free Associations, 46, 21-48. Also: human-nature.com/free-associations/werbart.html
    
    
19. Werbart, A. (2002). Internet Discussion Review “The meaning of dreams in the psychotic state: Theoretical considerations and clinical applications” by Paola Capozzi and Franco De Masi. International Journal of Psychoanalysis, 83, 551-563.
    
    
20. Werbart, A. (2005). Between private construction of meaning and canons of science: Freud's case studies noch einmal. International Journal of Psychoanalysis, 86, 1441-1461. DOI: 10.1516/EJ86-V8CP-345T-QFQN
    
    
21. Werbart, A. (2007). Utopic ideas of cure and joint exploration in psychoanalytic supervision. International Journal of Psychoanalysis, 88, 1391-1408. DOI: 10.1516/ijpa.2007.1391
    
    
22. Werbart, A. (2009). Minding the gap between clinical practice and empirical research in psychoanalysis. Review of H. Kächele, J. Schachter, & H. Thomä, 'From psychoanalytic narrative to empirical single case research: Implications for psychoanalytic practice'. International Journal of Psychoanalysis, 90, 1459-1466. DOI: 10.1111/j.1745-8315.2009.00225_3.x
    
    
23. Werbart, A. (2010). Book review of H. Kächele, J. Schachter, & H. Thomä, 'From psychoanalytic narrative to empirical single case research: Implications for psychoanalytic practice'. Psychotherapy Research, 20, 731-733. DOI: 10.1080/10503307.2010.504970
    
    
24. Werbart, A., in collaboration with Grünbaum, C., Jonasson, B., Kempe, H., Kusz, M., Linde, S., Lundén O'Nils, K., Sjövall, P., Svenson, M., Theve, C., Ulin, L., & Öhlin, A. (2011). Changes in the representations of mother and father among young adults in psychoanalytic psychotherapy. Psychoanalytic Psychology, 28, 95-116. DOI: 10.1037/a0022344
    
    
25. Werbart, A., Forsström, D., & Jeanneau, M. (2012). Long-term outcomes of psychodynamic residential treatment for severely disturbed young adults: A naturalistic study at a Swedish therapeutic community. Nordic Journal of Psychiatry, 64, Early Online: 1-9. DOI: 10.3109/08039488.2012.654508
    
    
26. Werbart, A., & Levander, S. (2005). Understanding the incomprehensible: Private theories of first-episode psychotic patients and their therapists. Bulletin of the Menninger Clinic, 69, 103-136.
    
    
27. Werbart, A., & Levander, S. (2006). Two sets of private theories in analysands and their analysts: Utopian versus attainable cures. Psychoanalytic Psychology, 23, 108-127. DOI: 10.1037/0736-9735.23.1.108
    
    
28. Werbart, A., & Levander, S. (2011). Vicissitudes of ideas of cure in analysands and their analysts: A longitudinal interview study. International Journal of Psychoanalysis, 92, 1455-1481. DOI: 10.1111/j.1745-8315.2011.00485.x
    
    
29. Werbart, A., & Wang, M. (2012). Predictors of not starting and dropping out from psychotherapy in Swedish public service settings. Nordic Psychology. (In press).
    
    

Books and book chapters

1. Werbart, A. (2000). Samlade skrifter av Sigmund Freud, band 6, Fallstudier. Inledning (s. 9-58), Redaktionella inledningar samt fackgranskning och redaktionellt arbete som volymansvarig. Stockholm: Natur och Kultur. Även i Månpocket, Stockholm 2002.
   
   
2. Werbart, A. (2011). Intersubjektivität und therapeutische Technik: Was ist neu und was alt? In P. Diederichs, J. Frommer, & P. Wellendorf (Hrsg.), Äußere und innere Realität: Theorie und Behandlungstechnik der Psychoanalyse im Wandel (pp. 171-181). Stuttgart, Germany: Klett-Cotta.
   
   
3. Werbart, A., & Kolev, N. (2000). Psykets höljen. Förord till Anzieu, D. Hudjaget (s. 11-34). Stockholm: Natur och Kultur.
4. Werbart, A., & Levander, S. (2000). Pain in the body - pain in the soul: The need of private explanations when not feeling well. In P. Nilsson & K. Orth-Gomér (Eds.) Self-rated health in European perspective (pp. 136-151). Stockholm: Swedish Council for Planning and Coordination of Research (FRN).
   
   
5. Werbart, A., Levander, S., Sahlberg, B., Ginner, H., Philips, B., Jacobsson, G., & Claesson, M. (2002). The research programme on private theories of pathogenesis and cure. In P. Fonagy (Ed.), An open door review of outcome studies in psychoanalysis, 2nd rev. ed. (pp. 211-214). London: International Pychoanalytical Association.
   
   
6. Werbart, A., Lilliengren, P., & Philips, B. (2008). Patienters syn på verksamma faktorer. I R. Holmqvist & B. Philips (red.), Vad är verksamt i psykoterapi? (kap. 8, s. 160-179). Stockholm: Liber.
   
   
7. Werbart, A., & Lindbom-Jakobson, M. (2001). The “living dead” - survivors of torture and psychosis. In P. Williams (Ed.), A language for psychosis: Psychoanalysis of psychotic states (pp. 98-114). London: Whurr Books.
   
   

Other publications (articles and reports in Swedish)

1. Claesson, M. & Werbart, A. (2002). Unga vuxna i psykoterapi I: Vilka är de? Psykoterapi: Forskning och utveckling, rapport 22. Stockholm: Sektionen för psykoterapi och Psykoterapiinstitutet.
   
   
2. Cullberg, J., Sandell, R., Schubert, J., & Werbart, A. (2009). Nya riktlinjer raderar ut den dynamiska psykoterapin. Läkartidningen, 106(14), 1024-1026.
   
   
3. Cullberg, J., Sandell, R., Schubert, J. & Werbart, A. (2009). Oklarheter om psykoterapins framtid. Läkartidningen, 106, 1410.
   
   
4. Cullberg, J., Sandell, R., Schubert, J., & Werbart, A. (2009, 5 april). Viktig behandling kan försvinna. Svenska Dagbladet, s. 5.
   
   
5. Diamond, D., Blatt, S. J., Stayner, D. & Kaslow, N. (2001). Bedömning av differentiering-relaterande i själv- och objektrepresentationer II: Manualen. Sv. övers. G. Blomquist, A. Werbart, S. Levander & Y. Hjälmdahl. Psykoterapi: forskning och utveckling, rapport 21. Stockholm: Sektionen för psykoterapi och Psykoterapiinstitutet.
   
   
6. Edenius, A., Jacobsson, G., & Werbart, A. (2003). Att jaga en flyende grupp. Psykologtidningen, 2003:18, 8-9.
   
   
7. Falkenström, F., Werbart, A., Ankarberg, P., & Jacobsson, A. (2008). Psykoterapins evidens en fråga om resultat i den kliniska vardagen. Psykologtidningen, 2008:13, 28-30.
   
   
8. Ginner, H., Werbart, A., Levander, S., & Sahlberg, B. (2001). Tillförlitlighet i studier av subjektiva förklaringssystem: Ett kodningssystem för privata teorier om patogenes och kur. Psykoterapi: Forskning och utveckling, rapport 19. Stockholm: Sektionen för psykoterapi och Psykoterapiinstitutet.
   
   
9. Hjälmdahl, Y., Claesson, M., Werbart, A. & Levander, S. (2001). Bedömning av differentiering-relaterande i själv- och objektrepresentationer I: En validitetsstudie. Psykoterapi: forskning och utveckling, rapport 20. Stockholm: Sektionen för psykoterapi och Psykoterapiinstitutet.
   
   
10. Jacobsson, G., Lindgren, A., Werbart, A., & Boalt Boëthius, S. (2004). Unga vuxnas förhållningssätt vid påfrestningar i livet: En enkätundersökning. Psykoterapi: Forskning och utveckling, rapport 27. Stockholm: Sektionen för psykoterapi och Psykoterapiinstitutet.
    
    
11. Lundén-O'Nils, K. & Werbart, A. (2006). Inför starten av psykoterapi: Unga mäns bilder av sina fäder. Insikten, 15(1), 29-34.
    
    
12. Philips, B., Wennberg, P. & Werbart, A. (2004). Unga vuxna i psykoanalytisk psykoterapi. Matrix 21(4), 280-289.
    
    
13. Salomonsson, B., Sandell, R., Werbart, A., & Rydelius, P. A. (2011). Psykoanalytisk behandling vid störningar i mor-barnrelationen. Läkartidningen, 108, 984-987.
    
    
14. Werbart, A. (2001). Freuds fallstudier: Inifrånperspektiv och den vetenskapliga metoden. Divan 3-4/2001, 63-75.
    
    
15. Werbart, A. (2002). Drömmar som vänder blad. Recension av Jean-Michel Quinodoz ”Les rêves qui tournent une page”. Divan 3-4/2002, 75-78.
    
    
16. Werbart, A. (2004). Vilken psykoterapeut passar mig? Hur unga vuxna patienter ser på sina terapeuter. Matrix, 21(4), 290-304.
    
    
17. Werbart, A. (2007). Psykoterapi och evidens - ett eller flera synsätt? Svenska psykoanalytiska föreningens bulletin, 43, 49-54.
    
    
18. Werbart, A. (2007). Psykoterapi och evidens - ett eller flera synsätt? Divan 3-4/2007, 5-9.
    
    
19. Werbart, A. (2009). Patienten som gemensam faktor. Glimtar från forskningsfronten, nr 25, 4-6. Barn- och ungdomspsykiatri, Stockholms läns landsting.
    
    
20. Werbart, A. (2009). Unga vuxnas perspektiv på hjälpsamma och hindrande faktorer i individualterapi och gruppterapi. Glimtar från forskningsfronten, nr 25, särtryck. Barn- och ungdomspsykiatri, Stockholms läns landsting.
    
    
21. Werbart, A. (2011). Mentalisera (och forska) mera med familjer. Glimtar från forskningsfronten, nr 32, 3-4. Barn- och ungdomspsykiatri, Stockholms läns landsting.
    
    
22. Werbart, A. (2011). Psykoterapin har mycket att lära av patienten. Psykologtidningen, 2011:10, 29-31.
    
    
23. Werbart, A., & Levander, S. (2000). Varför blev jag sjuk och vad kan göra mig frisk? Patienters och terapeuters privata teorier om patogenes och kur. Insikten, 9(4), 39-45.
    
    
24. Werbart, A., & Levander, S. (2006). Capire l'incomprensible: teorie private tra pazienti psicotici e loro terapeuti, a proposito del primo episode psicotico. Laboro presentato al Convegno Trauma e Psicosi, Milano, Italia, 10 giugno 2006. www.spiweb.it [PDF]
    
    
25. Wiman, M. & Werbart, A. (2002). Unga vuxna i psykoterapi II: Hur uppfattar de själva sina problem? Psykoterapi: Forskning och utveckling, rapport 23. Stockholm: Sektionen för psykoterapi och Psykoterapiinstitutet.
    
    

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