I’m sure that I’ve indicated a bias in many of my posts that short-term psychotherapy is better and more effective than long-term therapy.  It’s true that in general it is my preference.  The preference is based, however, more on the tendency of therapists to keep clients in services for the long periods of time without focusing on problem resolution than it is on an across the board belief that short-term therapy is better.  So I thought for a change of pace I’d comment on an article that asserts that long-term psychotherapy is better than short-term.

Unfortunately, the title of the attached article, “Long-Term Psychotherapy Beats Short-Term” is more than a little misleading.  After its assertion that long-term therapy beats short term it goes on to clarify that long-term therapy has been shown in a study to be more effective at treating “complex mental disorders”. That, of course, is a huge distinction since a large percentage of therapy clients do not come in with complex mental disorders.  They come in with mild to moderate symptoms of depression or anxiety, relationship problems, and a range of other problems in living.  And for these clients long-term therapy does not “beat” short-term therapy.  Instead it either digresses from the presenting problem or keeps people in services after their concerns are resolved.

I will agree with the author that clients coming in with complex mental health problems often need to stay in treatment for much long periods of time.  Most notably, trauma survivors including survivors of sexual trauma, combat, and longer histories of domestic violence may need a lengthy course of therapy or repeated courses of therapy to significantly resolve the associated problems.  Now, as far as psychodynamic psychotherapy is concerned I think that those therapists that are truly skilled at providing it may have success with complex mental disorders but they can’t just focus on helping people understand themselves. They also need to go further and address immediate and serious problems in living such as emotional dysregulation, problems with relationships, and dissociative symptoms to name a few. The article is far too simplistic in its claims and doesn’t take into consideration the highly intricate issues that people with complex mental disorders face.

So, yes, long-term therapy is needed for most clients with highly complex issues. Is long-term psychodynamic psychotherapy the answer?  I highly doubt it.  In upcoming blogs I will address some of the other therapies that are effective with complex issues. http://www.webmd.com/mental-health/news/20080929/long-term-psychotherapy-beats-short-term