A qualitative investigation of motivations, experiences, and perceived outcomes among therapists administering intensive, long-term psychodynamic psychotherapy.

This qualitative study examined therapist motivations for providing intensive, long-term psychodynamic psychotherapy to patients with complex mental disorders, their significant experiences, perceptions of treatment outcomes, and connections between motivations and perceived outcomes. Fifteen therapists (psychiatrists, clinical psychologists, and social workers) from a single public mental health project ("Lechol Nefesh") participated. Data were collected through semistructured interviews and analyzed using thematic analysis, supplemented by ideal-type analysis. Core motivations included professional development, deeper therapeutic engagement, working with challenging populations, and social mission; significant experiences involved profound emotional encounters and shifts beyond traditional therapeutic settings, and outcomes ranged from emotional holding and prevention of deterioration to notable changes in functioning and personality. Ideal-type analysis yielded four emergent trajectories (holding, developing-improving, socially improving, and deepening-diverse), which were derived from the data rather than predefined categories. Findings illuminate therapists' choices of demanding long-term care and emphasize that intrinsic motivations are strongly linked to professional experiences and evaluations of treatment success. The study underscores the importance of nurturing these motivational factors to support therapists in long-term dynamic therapy, highlighting the value of this intensive approach for severe mental disorders. (PsycInfo Database Record (c) 2026 APA, all rights reserved).