As time goes by. Long-term outcomes of psychoanalysis and long-term psychotherapy

Generalizations about the outcomes of psychotherapy are essentially based o n research on brief therapies with quite short follow-up. The present paper is a survey of some of the findings in an effectiveness study of psychoana lysis and long-term psychotherapy, typically psychoanalytically oriented, i n private practice. The design was a three-wave panel comprising more than 700 patients. At the end of the third wave, 418 patients in different phase s of treatment remained in the sample. Across a reconstructed time scale co vering roughly seven years, before, during, and after treatment, the 74 psy choanalysis cases described a very positive development, whereas the develo pment among the 331 psychotherapy cases was moderately positive. The findin gs emphasize the importance of extended follow-up. When therapist variables are considered, therapeutic experience had complex or mixed associations w ith patients outcome. Especially positive were high age and many years, in private practice, after licensing. Therapeutic ideals and attitudes divided the therapist group in three subgroups, one of which was characterized by purely classical psychoanalytic views on the values of support, friendlines s etc. Therapists in the classically psychoanalytic cluster were found to d o poorly with patients in psychotherapy, in contrast to patients in psychoa nalysis. It is concluded that psychoanalysis and psychodynamically oriented psychotherapy are qualitatively different.