Varieties of long-term outcome among patients in psychoanalysis and long-term psychotherapy - A review of findings in the Stockholm Outcome of Psychoanalysis and Psychotherapy Project (STOPPP)

This paper reports the main findings of a large-scale study of subsidised p sychoanalysis and long-term psychotherapy. More than 400 people in various phases, before, during and after subsidised psychoanalysis or long-term psy chodynamic psyche therapy, were followed up for a period of three years wit h personal interviews, questionnaires and official statistics. Our analyses revealed progressive improvement the longer patients were in treatment-imp ressively strong among patients in psychoanalysis-on self-rating measures o f symptom distress and morale. Improvement, however was equally weak in bot h groups on a self-rating measure of social relations. Dosage factors (trea tment duration and session frequency in combination) partly accounted for t he outcome differences between those referred to psychoanalysis and those r eferred to long-term psychotherapy. Attitudes and ideals among therapists a nd analysts concerning the goals and means of psychotherapy were also assoc iated with patient outcome, although in rather complex ways. A significant part of the outcome differences between patients in psychoanalysis and in p sychotherapy could be explained by the adoption, in a large group of therap ists, of orthodox psychoanalytic attitudes that seemed to be counterproduct ive in the practice of psychotherapy but not in psychoanalysis. It is sugge sted that this effect may be a negative transfer of the psychoanalytic stan ce into psychotherapeutic practice and that this may be especially pronounc ed when the attitudes are not backed tip by psychoanalytic training.