Ever since depression has been conceived as a recurrent, often chronic disorder and short-term psychotherapy yielded disappointing results at follow-up, research has focused on the effectiveness of long-term therapy in the treatment of depression. The current study aimed at elucidating the research questions on which long-term therapies deliver stable results and which variables contribute to the stability of the effects. The effectiveness of analytical psychotherapy (PA), psychodynamic psychotherapy (PT) and cognitive behavioral therapy (CBT) was investigated in a prospective, controlled, randomized, intention to treat design in the treatment of a diagnostically homogeneous group of 100 patients with unipolar depression. The measurement instruments collated symptoms, interpersonal problems and intrapsychic structure from the perspective of patients, therapists and external observers at pretreatment, posttreatment and during a 3-year follow-up period. The therapeutic process was recorded every 6 months; moreover, each therapy session was audiographically recorded and evaluated by the therapist. All three therapies proved to be very effective but only PA demonstrated stable benefits across the 3aEuroyear follow-up period. A process-outcome approach provided evidence that the processes initiated by PA continued after the end of treatment. Predictors of successful outcome were a comorbid personality disorder and the therapeutic relationship. Above all, the therapeutic technique and to some extent therapy dosage were of prognostic significance. The current study yielded empirical evidence that recurrent mental disorders, such as depression, profit from long-term psychotherapy beyond the alleviation of symptoms, especially when comorbid personality disorders are involved. The data support the assumption that the technique and therapy dosage contribute to the stability of effects and furthermore, that the internalization of the therapeutic attitude may play a pivotal role as a mechanism of change.     «

Ever since depression has been conceived as a recurrent, often chronic disorder and short-term psychotherapy yielded disappointing results at follow-up, research has focused on the effectiveness of long-term therapy in the treatment of depression. The current study aimed at elucidating the research questions on which long-term therapies deliver stable results and which variables contribute to the stability of the effects. The effectiveness of analytical psychotherapy (PA), psychodynamic psychoth...     »