Abstract

Background

Dose–effect relationship data suggest that short-term psychotherapy is insufficient for many patients with chronic distress or personality disorders (complex mental disorders).

Aims

To examine the comparative efficacy of long-term psychodynamic psychotherapy (LTPP) in complex mental disorders.

Method

We conducted a meta-analysis of controlled trials of LTPP fulfilling the following inclusion criteria: therapy lasting for at least a year or 50 sessions; active comparison conditions; prospective design; reliable and valid outcome measures; treatments terminated. Ten studies with 971 patients were included.

Results

Between-group effect sizes in favour of LTPP compared with less intensive (lower dose) forms of psychotherapy ranged between 0.44 and 0.68.

Conclusions

Results suggest that LTPP is superior to less intensive forms of psychotherapy in complex mental disorders. Further research on long-term psychotherapy is needed, not only for psychodynamic psychotherapy, but also for other therapies.

(Reprinted with permission from the British Journal of Psychiatry 2011;199:15–22)

Volume 12
Issue 3

Summer 2014
Pages 336-346

Psychotherapy: New Evidence and New Approaches

We thank Dr Martin Rock (Yeshiva University, New York, USA) for information concerning the study by Clarkin et al, and Drs D. Huber and G. Klug and Drs A. Bateman and P. Fonagy for giving us access to their data. We also thank John Clarkin, PhD (Weill Medical College of Cornell University, New York, USA), Ivan Eisler, PhD (Institute of Psychiatry, King’s College London, UK), Paul Knekt, PhD (National Public Health Institute, Helsinki, Finland) and Martin Svartberg, MD, PhD (Department of Psychiatry, Mount Sinai Hospital, Toronto, Ontario, Canada) for information about their studies.

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