Long-Term Outcome of Long-Term Psychoanalytically Oriented Therapies: First Findings of the Stockholm Outcome of Psychotherapy and Psychoanalysis Study

Abstract

The scarcity of findings on the effectiveness of psychodynamic long-term psychotherapy and psychoanalysis is a problem, at least in countries where these treatments are the general treatment of choice. In this study, a sample of 405 patients in various stages before, during, and after treatment was drawn from a population of 1,200 patients who had received or were on a waiting list for public subsidized long-term psychoanalytically oriented psychotherapy or psychoanalysis. The average duration was 40 months for the psychotherapies and 51 months for the psychoanalyses. All patients completed a questionnaire, including the Symptom Checklist-90 (SCL-90), Sense of Coherence Scale (SOCS), and Social Adjustment Scale (SAS), on 3 occasions with 12-month intervals. Using a partly within- and between-subjects design, group means were regressed on an ordinal time scale covering 7 stages in the treatment process: before, early during, during, late during, soon after, after, and late after treatment. The slopes indicated small to moderate effect sizes (d = 0.4-0.6) for psychotherapy and moderate to very large effect sizes (d = 0.4-1.5) for psychoanalysis. The largest effect sizes were on the SCL-90 and the lowest on the SAS for both groups. The proportions of patients with more ‘healthy’ scores compared with the worst scoring 10% in a nonclinical norm group increased from roughly 30% to 55% in the psychotherapy group and from 10% to 75% in the psychoanalysis group. The results underscore the importance of long-term follow-up when evaluation of long-term treatments is concerned.