Outcomes of psychotherapies differ in the long run – with short-term therapy often insufficient

Patients treated with long-term psychotherapy, lasting on average for 3 years, recovered from symptoms and gained good work ability more frequently than patients allocated to short-term therapies of approximately 6 months, according to the latest findings of the Helsinki Psychotherapy Study. Although long-term therapy seems to be more effective than short-term therapy in the long run, short-term therapy is more cost-effective, due to the greater treatment costs of long-term therapy. A considerable portion of patients who received short-term therapy did not recover as a result, however.

In the Helsinki Psychotherapy Study, altogether 326 patients with mood or anxiety disorder were randomized to either short-term (solution-focused or psychodynamic) or long-term psychodynamic psychotherapy during the period 1995 to 2000. The study is thus far the only randomized clinical trial comparing the effectiveness and suitability of short- and long-term psychotherapies with an adequately long follow-up, extending up to 10 years into the future. Results based on the 5-year follow-up of the study and also results based on other studies with a long follow-up are together reported in the newly published review article of the Finnish medical journal Duodecim.

The choice of psychotherapy for a certain patient cannot be made according to the average effectiveness or general cost-effectiveness of a therapy form. Instead, specific information is needed that would show for whom short-term therapy would be sufficient and for whom long-term therapy would be needed. To examine this, additional studies with a long follow up are required to identify those factors that would enable a reliable pre-treatment assessment regarding the suitability of a therapy for a specific patient.

Reference:

Knekt, Paul, Lindfors, Olavi, Sares-Jäske, Laura, Laaksonen, Maarit. Psykoterapioiden vaikuttavuus masennukseen pitkissä seurannoissa. [The effectiveness of psychotherapy on depression in the long term] Duodecim 2012; 128(3): 267-74.

Further information:

Helsinki Psychotherapy Study

Paul Knekt
professor
tel. +358 20 610 8774

Olavi Lindfors
development manager
tel. +358 20 610 8618

National Institute for Health and Welfare, THL
firstname.lastname@thl.fi