How can long-term therapies be compared with shorter term treatment? Design problems and solution proposals exemplified by the APD study

Long-term psychotherapy is not recommended in the current guidelines, which are based on the criteria of evidence-based medicine, as there is a lack of confirmation for long-term psychotherapy by efficacy studies. Using the example of psychoanalytic long-term psychotherapy this article describes six dilemmas which impede the realization of efficacy studies for long-term psychotherapy. Finally, basic elements of a study design are proposed, which are considered as being adequate to compare (psychoanalytic) long-term psychotherapy with shorter treatment forms in terms of outcome and cost-effectiveness. The anxiety and personality disorders (APD) study is briefly described as an example of a study realizing the proposed design.     «

Long-term psychotherapy is not recommended in the current guidelines, which are based on the criteria of evidence-based medicine, as there is a lack of confirmation for long-term psychotherapy by efficacy studies. Using the example of psychoanalytic long-term psychotherapy this article describes six dilemmas which impede the realization of efficacy studies for long-term psychotherapy. Finally, basic elements of a study design are proposed, which are considered as being adequate to compare (psych...     »