Long-term psychodynamic therapy better than short-term

Sigmund Freud, psychotherapy

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.


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