Long-term psychodynamic therapy better than short-term
Long-term psychodynamic psychotherapy is superior in the long term to short-term psychodynamic psychotherapy. Short-term produces benefits more quickly than long-term therapies. After 3 years of follow-up, however, the situation was reversed with a stronger treatment effect in the long-term psychodynamic treatment group both for patients with depressive and anxiety symptoms.
If a patient is capable and will benefit from psychodynamic psychotherapy which should be assessed by professionals before hand, than this kind of treatment to my opinion can be of great help to them not only for their complaints but also on the longer term.
Long-term Psychodynamic psychotherapy was out of fashion lately due to the development of other forms of psychotherapy such as cognitive behavioral psychotherapy. These forms of psychotherapy have advantages. They are easier to educate, of short duration and efficacious and cheaper. Moreover, efficacy of long-term psychodynamic psychotherapy was hardly studied in randomized controlled trials. Evidence for it’s efficacy was non existent.
Short-term psychodynamic psychotherapy has been found to be equally effective as other short-term individual treatments, such as cognitive, interpersonal, supportive therapy and solution-focused therapy. The effects of short-term psychodynamic psychotherapy have also been shown to be stable or even to increase during follow-up.
Besides the lack of decent research to the efficacy of long-term dynamic psychotherapy no research was done to the stability of the treatment effects of short-term dynamic psychotherapy. Moreover, long follow-up after treatment with psychotherapy is very rare.
The recent publication of a randomized controlled trial is very welcome.
In the Helsinki Psychotherapy Study, 326 out-patients with mood (84.7%) or anxiety disorder (43.6%) were randomly assigned to three treatment groups (long-term psychodynamic psychotherapy, short-term psychodynamic psychotherapy, and solution-focused therapy) and were followed up for 3 years from start of treatment.
What is solution focused psychotherapy?
Solution-focused therapy, which is a brief goal-focused treatment developed from therapies applying a problem-solving approach and systemic family therapy.
What is short-term psychodynamic psychotherapy?
Short-term psychodynamic psychotherapy is a brief, focal, transference-based therapeutic approach which helps patients by exploring and working through specific intra-psychic and interpersonal conflicts.
Short-term psychodynamic psychotherapy is characterized by the exploration of a focus, which can be identified by both the therapist and the patient. This consists of material from current and past interpersonal and intra-psychic conflicts and the application of confrontation, clarification and interpretation in a process in which the therapist is active in creating the alliance and ensuring the time-limited focus.
What is long-term psychodynamic psychotherapy?
Long-term psychodynamic psychotherapy is an open-ended, intensive, transference-based therapeutic
approach which helps patients by exploring and working through a broad area of intra-psychic and interpersonal conflicts.Confrontation, clarification and interpretation are major elements, as well as the therapist’s actions in ensuring the alliance and working through in the therapeutic relationship to attain conflict resolution and greater self-awareness. Therapy includes both expressive and supportive
elements, the use of which depends on patient needs.
The main differences between short and long-term are the focus in short-term versus the “broad area” in long-term, the importance of the transference and conflict resolution and self awareness in the long-term therapy.
Results
Short-term psychodynamic psychotherapy was more effective in reducing symptoms of depression than long-term psychodynamic psychotherapy at the 7–12 months follow-up, after 3 years of follow-up, long-term psychodynamic psychotherapy was statistically significantly more effective than short-term psychodynamic psychotherapy
During the following 2 years, the symptoms persisted at the level reached in the two brief therapy groups, whereas in the long-term psychodynamic psychotherapy group the improvement continued during the entire 3-year period.
These results are in accordance with the fact that long-term psychodynamic therapists working long term focus on working more slowly and deeply, aiming to produce more global changes by affecting the patient’s longterm vulnerability to stressors.
For solution focused therapy the same conclusions are applicable. It didn’t differ in outcome from short-term psychotherapy.
Now all that is needed is enough psychotherapists capable of doing this form of psychotherapy but most important insurance companies financing these forms of psychotherapy. If you health or life insurance company decides to not full-finance treatments you should look for a viatical settlement provider in order to be able to pay for thems.
Is there a problem or not in your country concerning the availability of long-term psychodynamic psychotherapy, please let me know in the comments.
Related post on this blog: Supportive Psychotherapy mostly Novice Pilots Flying In The Dark Without Maps
Knekt, P., Lindfors, O., Härkänen, T., Välikoski, M., Virtala, E., Laaksonen, M., Marttunen, M., Kaipainen, M., Renlund, C. (2008). Randomized trial on the effectiveness of long-and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychological Medicine, 38(05) DOI: 10.1017/S003329170700164X
Flickr
Twitter
RSS
LinkedIn
GoodReads
Last
August 29, 2008 @ 8:02 am
In Canada part of the problem with access to long-term psychodynamic therapy is directly related to cost. As a patient I paid for 2 years of psychodynamic therapy (with some cognitive therapy. It is very expensive.
When I was accepted into a psychodynamic Group Therapy program for three months through the psychiatric ward I jumped at the opportunity. Problem was the three months was just long enough to bring out all kinds of feelings in me, but not long enough to resolve anything. For te final three weeks of the group I kept saying I needed more help, but none was offered and I left confused and feeling like that was all that could be done for me.
My pdoc now practices a variety of therapies with me now, including psychodynamic technigues. I believe the psychodynamic therapies have helped me the most, but it has taken me literally years of meeting weekly, or twice weekly and I still feel like I have lots I need to work on. Overall though, my life is richer and I finally, for the first time in my life feel like I have the opportunity to move in the right direction. I wish everyone could have the positive experience with therapy I have had over the past 7 years. While it took me years to get help, I now feel the help I have is superb.
August 29, 2008 @ 8:31 am
In The Netherlands the health insurance will only pay for a limited amount of sessions. Some insurance companies do accept long term psychodynamic psychotherapy but at higher monthly payment.
Regards Dr Shock
August 29, 2008 @ 11:26 pm
In Canada, if you see a psychotherpist you have to pay privately (although many companies offer 6 sessions a year through benefits packages).
However, if you receive therapy with a psychiatrist I believe 2/50 minutes sessions a week are covered by medical, unless the psychiatrist receives special permission to provide more sessions.
I feel blessed to both have met a psychiatrist who provides therapy and who is good at being a therapist. From what I gather most Canadian psychiatrists do not provide regular therapy, rather they provide medication and treatment advice and the if patients want/need therapy they see privately paid psycotherpists.
Long-term psychodynamic psychotherapy effective for complex mental disorders | Dr Shock MD PhD
October 2, 2008 @ 6:13 am
[…] a mean follow-up duration of 93 weeks. This is in accordance with a previous post on this blog: Long-term psychodynamic psychotherapy better than short-term Long-term psychodynamic psychotherapy is superior in the long term to short-term psychodynamic […]
October 16, 2008 @ 11:40 pm
hi, I came across from aquas blog :o)
I am in UK, waited for years after initial assessment for actual psychotherapy on NHS, I did look into paying privately but it was ascary leap to take, how much would I need? I am just finishing my second year, I supect my experience is rare & I know all the time I take upp means others waiting longer as I did. But my therapist is rare, having spent many years seeking help, it’s such a relief to find someone who actually listens & thinks. I do have a blog somewhere which details some of my more negative experiences _ I just don’t use it that often now!
Great site BTW
Mini UK
November 14, 2008 @ 9:57 pm
My coverage is through an HMO. Apparently, the focus is on educating patients and sending them on their way in as short of time as possible. This means a short-term cost savings for the HMO, but in the long term, some patients will be lost. The HMO uses psychiatrists as pill dispensers; the psychiatrist talks to the patient for 10 minutes and adjusts medication based on that short conversation.
I was recently forced into seeing a new therapist – an MFT instead of a psychologist since my psychologist left to a new job out of the state. She kept inferring that my years of seeing a psychologist were wasted as she did not see any clear goals. I had goals, but some my problems were very deep-rooted and blurred the lines of multiple diagnoses. I feel as if I am still untangling some of my issues. I’ve made progress on a cognitive level, but my coping skills are still weak.
My visits with my former psychologist were one of the few stabilizing forces in my life and I was quite sad when I found out I would not be able to see my psychologist. It feels like a loss in my life.
I found the new MFT rather daunting and not at all confidence inspiring. Her tone was somewhat shrill and her manner was abrupt. When I said I was having lots of tearful moments, she said I needed a medicine adjustment. I don’t think my issues are quite that simple as I’ve had them nearly all my life. Combined with situational problems that I’ve been trying to manage, I feel unsteady and unsupported and scared.
The MFT felt like I just needed some classes and did not need any more therapy. She said “You have already had 50 sessions already.” She mentioned she already had lots of patients and would have a hard time squeezing me into a class. I was a little angry because I did not choose her specifically – she was assigned to me. I was also told I was being assigned a psychologist but they gave me an MFT.
Now I’m feeling like perhaps I am not worth the effort. I’m just too tired to deal with anything anymore, let alone a mental health professional that thinks I am a waste of her time.
Thanks in advance for any advice or comments, good or bad.
July 11, 2010 @ 8:35 am
Psychotherapy Counselling is the relationship between a client and a trained professional like psychologist that focuses on the client’s concerns and difficulties. Counselling help the individuals in improving the understanding of themselves, including their thought patterns, behaviours, feelings and the problems they are facing in their lives.
To know more about us please visit on our following website. you can get more information about psychotherapy and counseling
http://www.counsellingfor200rupees.com
Thanks&Regards
ksh-usa