Is Longer-Term Psychodynamic Psychotherapy More Effective than Shorter-Term Therapies? Review and Critique of the Evidence
Identifieur interne : 000143 ( Pmc/Checkpoint ); précédent : 000142; suivant : 000144Is Longer-Term Psychodynamic Psychotherapy More Effective than Shorter-Term Therapies? Review and Critique of the Evidence
Auteurs : Sunil S. Bhar [Australie] ; Brett D. Thombs [Canada] ; Monica Pignotti ; Marielle Bassel [Canada] ; Lisa Jewett [Canada] ; James C. Coyne [États-Unis] ; Aaron T. Beck [États-Unis]Source :
- Psychotherapy and Psychosomatics [ 0033-3190 ] ; 2010.
Abstract
In 2008, Leichsenring and Rabung performed a meta-analysis of 8 studies of longer-term psychodynamic psychotherapy (LTPP). The work was published in the Journal of the American Medical Association (vol. 300, pp 1551–1565), and they concluded that LTPP was more effective than shorter-term therapies.
Given that such claims have the potential to influence treatment decisions and policies, we re-examined the meta-analysis and the 8 studies.
We found a miscalculation of the effect sizes used to make key comparisons. Claims for the effectiveness of LTPP depended on a set of small, underpowered studies that were highly heterogeneous in terms of patients treated, interventions, comparison-control groups, and outcomes. LTPP was compared to 12 types of comparison-controls, including control groups that did not involve any psychotherapy, short-term psychodynamic psychotherapy, and unvalidated treatments. Additionally, the studies failed to protect against threats to bias, and had poor internal validity.
Overall, we found no evidence to support claims of superiority of LTPP over shorter-term methods of psychotherapy.
Url:
DOI: 10.1159/000313689
PubMed: 20424498
PubMed Central: 2889262
Affiliations:
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>In 2008, Leichsenring and Rabung performed a meta-analysis of 8 studies of longer-term psychodynamic psychotherapy (LTPP). The work was published in the Journal of the American Medical Association (vol. 300, pp 1551–1565), and they concluded that LTPP was more effective than shorter-term therapies.</p>
</sec>
<sec><title>Method</title>
<p>Given that such claims have the potential to influence treatment decisions and policies, we re-examined the meta-analysis and the 8 studies.</p>
</sec>
<sec><title>Results</title>
<p>We found a miscalculation of the effect sizes used to make key comparisons. Claims for the effectiveness of LTPP depended on a set of small, underpowered studies that were highly heterogeneous in terms of patients treated, interventions, comparison-control groups, and outcomes. LTPP was compared to 12 types of comparison-controls, including control groups that did not involve any psychotherapy, short-term psychodynamic psychotherapy, and unvalidated treatments. Additionally, the studies failed to protect against threats to bias, and had poor internal validity.</p>
</sec>
<sec><title>Conclusion</title>
<p>Overall, we found no evidence to support claims of superiority of LTPP over shorter-term methods of psychotherapy.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Psychother Psychosom</journal-id>
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<title-group><article-title>Is Longer-Term Psychodynamic Psychotherapy More Effective than Shorter-Term Therapies? Review and Critique of the Evidence</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Bhar</surname>
<given-names>Sunil S.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>a</sup>
</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
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<contrib contrib-type="author"><name><surname>Thombs</surname>
<given-names>Brett D.</given-names>
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<xref ref-type="aff" rid="aff2"><sup>b</sup>
</xref>
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<contrib contrib-type="author"><name><surname>Pignotti</surname>
<given-names>Monica</given-names>
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<xref ref-type="aff" rid="aff3"><sup>c</sup>
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<contrib contrib-type="author"><name><surname>Bassel</surname>
<given-names>Marielle</given-names>
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<xref ref-type="aff" rid="aff2"><sup>b</sup>
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<contrib contrib-type="author"><name><surname>Jewett</surname>
<given-names>Lisa</given-names>
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<xref ref-type="aff" rid="aff2"><sup>b</sup>
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<contrib contrib-type="author"><name><surname>Coyne</surname>
<given-names>James C.</given-names>
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<xref ref-type="aff" rid="aff4"><sup>d</sup>
</xref>
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<contrib contrib-type="author"><name><surname>Beck</surname>
<given-names>Aaron T.</given-names>
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<xref ref-type="aff" rid="aff4"><sup>d</sup>
</xref>
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<aff id="aff1"><sup>a</sup>
Swinburne University of Technology, Hawthorn, Vic., Australia</aff>
<aff id="aff2"><sup>b</sup>
McGill University and Jewish General Hospital, Montréal, Qué., Canada</aff>
<aff id="aff3"><sup>c</sup>
Florida State University, Tallahassee, Fla.</aff>
<aff id="aff4"><sup>d</sup>
University of Pennsylvania, Philadelphia, Pa., USA</aff>
<author-notes><corresp id="cor1">*Sunil S. Bhar, Faculty of Life and Social Sciences, Swinburne University of Technology, Mail H24, PO Box 218, Hawthorn, Vic. 3122 (Australia), Tel. +61 3 9214 8371, Fax +61 3 9214 5898, E-Mail <email>sbhar@swin.edu.au</email>
</corresp>
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<pub-date pub-type="ppub"><month>6</month>
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<volume>79</volume>
<issue>4</issue>
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<lpage>216</lpage>
<history><date date-type="received"><day>18</day>
<month>5</month>
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<date date-type="accepted"><day>6</day>
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<permissions><copyright-statement>Copyright © 2010 by S. Karger AG, Basel</copyright-statement>
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<abstract><sec><title>Background</title>
<p>In 2008, Leichsenring and Rabung performed a meta-analysis of 8 studies of longer-term psychodynamic psychotherapy (LTPP). The work was published in the Journal of the American Medical Association (vol. 300, pp 1551–1565), and they concluded that LTPP was more effective than shorter-term therapies.</p>
</sec>
<sec><title>Method</title>
<p>Given that such claims have the potential to influence treatment decisions and policies, we re-examined the meta-analysis and the 8 studies.</p>
</sec>
<sec><title>Results</title>
<p>We found a miscalculation of the effect sizes used to make key comparisons. Claims for the effectiveness of LTPP depended on a set of small, underpowered studies that were highly heterogeneous in terms of patients treated, interventions, comparison-control groups, and outcomes. LTPP was compared to 12 types of comparison-controls, including control groups that did not involve any psychotherapy, short-term psychodynamic psychotherapy, and unvalidated treatments. Additionally, the studies failed to protect against threats to bias, and had poor internal validity.</p>
</sec>
<sec><title>Conclusion</title>
<p>Overall, we found no evidence to support claims of superiority of LTPP over shorter-term methods of psychotherapy.</p>
</sec>
</abstract>
<kwd-group><title>Key Words</title>
<kwd>Effectiveness</kwd>
<kwd>Efficacy</kwd>
<kwd>Long-term therapy</kwd>
<kwd>Meta-analysis</kwd>
<kwd>Psychotherapy</kwd>
<kwd>Systematic review</kwd>
</kwd-group>
<counts><table-count count="5"></table-count>
<ref-count count="41"></ref-count>
<page-count count="9"></page-count>
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