Criticisms and questions regarding effectiveness[edit] Within the psychotherapeutic community there has been some discussion of empirically based psychotherapy. Virtually no comparisons of different psychotherapies with long follow-up times have been done.[59] The Helsinki Psychotherapy Study[60] is a randomized clinical trial, in which patients were monitored for 10 years after the onset of short-term (6 months) psychodynamic or solution-focused, or long-term (3 years) psychodynamic study treatments. The effectiveness, suitability and sufficiency of the therapies were compared also with that of psychoanalysis (5 years), within a quasi-experimental design. The assessments were completed at the baseline and 14 times thereafter during the follow-up. The results of the 3- and 5-year follow-up indicate that the length of therapy is important when predicting the outcome of therapy. Patients in the two short-term therapies improved faster, but in the long run long-term psychotherapy and psychoanalysis gave greater benefits. Several patient and therapist factors appear to predict suitability for different psychotherapies. Follow-up evaluations of this study will continue up to 2014. There is considerable controversy about which form of psychotherapy is most effective, and more specifically, which types of therapy are optimal for treating which sorts of problems.[61] Furthermore, it is controversial whether the form of therapy or the presence of factors common to many psychotherapies best separates effective therapy from ineffective therapy. Common factors theory asserts it is precisely the factors common to the most psychotherapies that make any psychotherapy successful: this is the quality of the therapeutic relationship. The dropout level is quite high; one meta-analysis of 125 studies concluded that the mean dropout rate was 46.86%.[62] The high level of dropout has raised some criticism about the relevance and efficacy of psychotherapy.[63] There are different drop-out rates depending on how drop-out is defined. Another large meta-analysis reports drop-out rates not larger than 20 to 25%.[64] Psychotherapy outcome research—in which the effectiveness of psychotherapy is measured by questionnaires given to patients before, during, and after treatment—has had difficulty distinguishing between the success or failure of the different approaches to therapy. Those who stay with their therapist for longer periods are more likely to report positively on what develops into a longer-term relationship. This suggests that some treatment may be open-ended with concerns associated with ongoing financial costs. As early as 1952, in one of the earliest studies of psychotherapy treatment, Hans Eysenck reported that two thirds of therapy patients improved significantly or recovered on their own within two years, whether or not they received psychotherapy.[65]
Posted on: Thu, 27 Nov 2014 06:15:13 +0000