Long-term effects of long-term psychoanalytic and long-term behavior therapy: A comparative study from the general practices of psychotherapists

The prospective study compares 31 patients in long-term behavior therapy with 31 patients in psychoanalytically oriented long-term therapy. A naturalistic design was applied within the German health system. All patients underwent a diagnostic interview (SCID) by an external interviewer. Only patients who fulfilled the DSM III-R criteria for a depression or an anxiety disorder were included in the study. Although the diagnoses of the patients undergoing long-term behaviour therapy and long-term psychoanalytical psychotherapy were comparable, we found that they differed in various ways. The differences arose in a number of characteristics, such as education, access to psychotherapy (recommended by professionals versus patients introducing themselves), usage of psychotropic medication, and the strain of symptoms. The average duration of long-term behavior therapy was 2.4 years and 64 sessions. The average duration of psychoanalytically oriented long-term therapy was 3.6 years and 209 sessions. Symptoms (SCL-90-R) and interpersonal problems (IIP) were examined at the beginning, after 1 year, 2.5 years, 3.5 years and after 7 years. Both groups showed significant degrees of improvement within the first 3.5 years and remained stabilized in the following 3.5 years regarding the symptomatic aspects. Focussing on the interpersonal problems, group PA showed further improvement after the 3.5-year period. The BT group however, showed no further improvement after 3.5 years but stabilized. The evaluated phase-model of psychotherapeutic change for short-term therapy was confirmed more clearly for long-term therapies of psychoanalytical orientation than for long-term therapies of behavioral orientation.