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Am J Psychiatry 1992; 149:151-158
Copyright © 1992 by American Psychiatric Association
The efficacy of brief dynamic psychotherapy: a meta-analysis
P Crits-Christoph
Department of Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia.
OBJECTIVE: Insurance companies, legislators, and funding agencies have
become increasingly concerned with efficacy and accountability in regard to
psychotherapy, and psychodynamic therapy is a primary target of concern
because it is widely practiced in outpatient settings. This paper is a
meta-analytic review of recent well-controlled studies of the efficacy of
brief dynamic therapy. METHOD: The meta-analysis included both published
studies, located through an extensive computerized search of psychiatry and
psychology journals, and studies reported at conferences. Eleven studies
met the inclusion criteria: use of a specific form of short-term dynamic
psychotherapy as represented in a treatment manual or manual-like guide;
comparison of brief dynamic therapy and a waiting list control condition,
nonpsychiatric treatment, alternative psychotherapy, pharmacotherapy, or
other form of dynamic therapy; provision of the information necessary for
calculation of effect sizes; at least 12 therapy sessions; and therapists
who were trained and experienced in brief dynamic therapy. The outcome
measures compared were target symptoms, psychiatric symptoms generally, and
social functioning. RESULTS: Brief dynamic therapy demonstrated large
effects relative to waiting list conditions but only slight superiority to
nonpsychiatric treatments. Its effects were about equal to those of other
psychotherapies and medication. CONCLUSIONS: These data confirm previous
indications that various psychotherapies do not differ in effectiveness,
although this finding should not be generalized to all patient populations,
outcome measures, and treatment types. Also, the highly controlled
conditions of these studies limit conclusions about actual practice. Future
studies should address various treatment lengths, follow-up assessments,
and specific treatments, patient groups, and outcome measures.
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