President's update: Anna Freud Centre Mood Disorders Evidence Review moving to open access

In my recent President’s update, I committed to providing members with a full account of the work undertaken on the Anna Freud Centre (AFC) Mood Disorders Psychodynamic Psychotherapy Evidence Review report. I want to honour that promise so that members can understand exactly what has been done, where we are today, and what to expect in the weeks ahead.

As one of the most significant and sustained pieces of work the College has undertaken, the report deserves transparency. I hope this update helps bring clarity and marks a meaningful step forward.

How this work began

The origins of this project lie with our membership.

At the Members’ Requisition General Meeting (MRGM) on 3 May 2022, members expressed significant concerns about the treatment of psychodynamic psychotherapy in the College’s 2020 Clinical Practice Guideline for Mood Disorders. Four resolutions were passed by substantial majorities.

Those resolutions were non-binding and not every resolution was subsequently implemented in the form proposed. However, they provided the Board with a clear indication of the strength of member concern and called for further examination of the evidence.

The College subsequently established the Mood Disorders Psychodynamic Psychotherapy Evidence Review Steering Group, chaired by Professor Bruce Singh AM, bringing together clinicians with relevant expertise from Australia, Aotearoa New Zealand and internationally, alongside people with lived and living experience.

Commissioning the external review

Following a formal Request for Quotation process, the Anna Freud Centre (AFC) in the United Kingdom was appointed by the College in October 2023 to undertake the review.

Led by Professor Peter Fonagy OBE, Dr Max Moser and Dr Chloe Campbell the work comprised three interrelated components: a systematic review and meta-analysis examining LTPP and comparator treatments for mood disorders; a qualitative meta-synthesis of the perspectives of consumers, treatment providers and carers; and a qualitative interview study involving participants in Australia and Aotearoa New Zealand, co-designed with people with lived experience.

The Steering Group met regularly with the AFC throughout the project, providing oversight and advice while the AFC undertook the research.

What the report adds to the evidence

The AFC report represents a substantial body of work examining the evidence concerning long-term psychodynamic psychotherapy.

The AFC concluded that findings across its three studies support LTPP as an effective treatment for some people with mood disorders, including some people with complex presentations. Its quantitative analysis reported reductions in depressive symptoms and global distress, while the qualitative work identified perceived benefits including changes in relationships, functioning, self-understanding and the experience of treatment.

The work also highlights areas where the evidence remains incomplete and where further research is needed, including understanding the role of the therapeutic relationship, trust and the development of self-insight.

The scope and populations considered in the AFC work are not identical to those addressed in the 2020 Mood Disorders CPG, and direct comparisons therefore require care.

The AFC report is an evidence review and body of original research. Importantly, it is not a Clinical Practice Guideline and should be considered alongside the wider evidence base, existing and future College guidance, clinical expertise, and the circumstances, preferences and values of individual patients.

The AFC report has also generated academic discussion and critique, including questions about aspects of its scope, methodology, inclusion criteria and interpretation of the evidence. We believe it is important to acknowledge that openly.

Scientific knowledge advances through scrutiny and debate. The role of the College is not to resolve legitimate scientific disagreement by assertion, but to support rigorous examination of the evidence, be transparent about how evidence has been developed and enable members and the wider scientific community to critically examine it.

Open access to the report is an important part of that responsibility.

The journey of the report

The AFC provided an early version of its report to the College in August 2024. The Steering Group reviewed the work and provided feedback, and an updated final report was accepted by the Steering Group in October 2024.

Consistent with College governance processes, the report was subsequently considered by the Committee for Evidence-Based Practice and the Practice, Policy and Partnerships Committee before progressing to the Board. The Board approved the report in October 2024, with an embargoed copy released to members in November 2024.

The Board initially restricted public release while the AFC sought publication of the component research in peer-reviewed academic journals. Members were provided access to the report through the College website, while updates were provided through the Mood Disorders Hub, President’s updates, a podcast and presentations at Congress.

The peer-review and publication process has taken longer than originally anticipated.

During this period, the College also shared embargoed copies with relevant external organisations and supported dissemination of the AFC’s emerging peer-reviewed work. The AFC research and findings were presented at the RANZCP 2025 Congress, with the presentation subsequently made available to members.

Recognising the work involved

This has been a substantial institutional undertaking spanning several years.

The Steering Group contributed considerable expertise and time. The AFC undertook an extensive program of research. The Practice, Policy and Partnerships Committee (PPPC), Committee for Evidence-Based Practice (CEBP) and Board provided governance scrutiny, while College staff coordinated the research relationship, consultation, stakeholder engagement and dissemination.

We acknowledge and thank everyone who has contributed to this work, including the members whose concerns initiated the process, the Steering Group, the AFC researchers, people with lived and living experience, College committees and staff.

Moving to open access

The complete AFC report will be made publicly available from 1 September 2026.

The AFC’s academic manuscripts have progressed through peer-reviewed publication, including a meta-analysis manuscript, which has been recently accepted for publication in an academic journal.

The PPPC has also considered a proposal from the bi-national Faculty of Psychotherapy Committee concerning recognition of the AFC report within the RANZCP Best Practice Resource Framework. On 21 July 2026, the PPPC approved the AFC Mood Disorders report as a RANZCP Best Practice Resource.

Recognition within the Best Practice Resource Framework does not convert the AFC report into a Clinical Practice Guideline or, in itself, constitute a recommendation that LTPP should be used for any particular patient or clinical presentation. That said, designation of the report as a Best Practice Resource signifies the report’s high quality and its utility to psychiatrists, trainees, and the wider community across Australia and Aotearoa New Zealand.

The College will work with the bi-national Faculty of Psychotherapy Committee and other relevant groups to consider what further educational resources, position statements or other work may appropriately follow.

Moving forward

The public release of the complete AFC report on 1 September is an important next step. It will ensure this substantial body of work is openly accessible to members, researchers, consumers and the broader community.

We hope this marks a constructive way forward, with open evidence, respectful dialogue and our shared focus on providing the best possible care for our patients and communities.

Dr Astha Tomar
President

Professor Bruce Singh AM
Chair, Mood Disorders Psychodynamic Psychotherapy Evidence Review Steering Group