Treatment length and termination contracts in dynamic psychotherapy: A comparison of findings from two independent studies of brief dynamic psychotherapy

Abstract

The associations between use of specific techniques and treatment outcome were very similar in two independent studies of brief dynamic psychotherapy in Edmonton. Canada, and Oslo. However, the associations between treatment length and outcome were the opposite in the two studies. The Edmonton study used a fixed time limit, while the Oslo study used open-ended treatment, which may have contributed to the difference. Patients with a high quality of object relations (QOR) were able to make optimal use of the expected treatment length in both time-limited and formally open-ended brief therapy, with regard to treatment-specific changes found at follow-up. In contrast, low QOR patients tended to do relatively better with fewer sessions than 20 in time-limited therapy (Edmonton) but more than 35–40 sessions in formally open-ended therapy (Oslo). These findings elucidate the complex interaction among patient characteristics, treatment length, type of outcome, and contractual factors in psychotherapy.