Followup in psychoanalysis: clinical and research values

Psychoanalysis has never developed a tradition of systematic followup study to evaluate outcome and to improve technique and theory for a variety of reasons, partly theoretical, stemming from the conception of the unfolding transference neurosis and its analytic resolution as the precondition for cure, and partly historical, having to do with the happenstance of its development as a private practice-based discipline and training outside of the academic setting. Freud, however, was never bound by such strictures and published whatever post-treatment data he acquired on all his best-known case histories. But following Freud most analysts, with some notable exceptions, eschewed followup activity as unanalytic. It is this tradition that more recent studies like those of Pfeffer in New York and the Psychotherapy Research Project of The Menninger Foundation in Topeka have squarely challenged. Data are presented from the Menninger project dealing specifically with the impact of routine planned followup on issues of treatment termination and resolution and on the nature of the post-treatment period. The degree and kind of patient cooperation with the followup inquiry, the impact of followup on treatment termination and resolution (both impeding and facilitating), and the role of followup intervention in relation to return to formal post-treatment therapy (or consolidating against it), are all discussed.