Comparing apples and oranges: How do patient characteristics and treatment goals vary between different forms of psychotherapy?

Abstract

The aim is to investigate whether different modalities and orientations of psychotherapy diverge with regard to patient characteristics and treatment goals, in a naturalistic setting for patients with substance use disorders. All psychotherapies (N=262) during a year were surveyed at the Centre for Dependency Disorders, Stockholm County Council. Data were collected from the psychotherapists (N=38). A therapist questionnaire was used, covering the topics of interest. Data regarding problems and goals were categorized using a qualitative clustering method. Differences between therapy formats were analysed using statistical methods. The prevalence of psychological problems among the patients was high (88%). Patients in cognitive behaviour therapy (CBT) and family therapy (FT) had less severe psychological problems than patients in the other psychotherapy formats. With regard to treatment goals, FT focused on improved family relations, group therapies on relational improvements, psychodynamic therapies on insight and improved functioning, while CBT focused on behaviour change and improved motivation for change. These findings suggest a shortcoming of the aim of the EST movement to consider reduction of target symptom as the only relevant treatment goal and to compare the efficacy of different treatments in this regard.