[Therapy goals, change of goals and goal attainment in the process of psychoanalytically oriented and behavior long-term therapy--a comparative study from the private practices of insurance-registered psychotherapists].
In a prospective naturalistic design 31 patients with long-term behavior therapy (average 63 treatment hours) and 31 patients with psychoanalytically-oriented long-term therapy (average 185 treatment hours) were compared. All patients were examined by extern interviewers with the Structured Clinical Interview for Diagnosis (SCID) before they were included in the study. Only patients that showed DSM-III-R criteria of a depressive or anxiety disorder were included. At four times the patient goals in therapy and the actual state was examined: At the beginning of treatment, after 1, after 2,5 and after 3,5 years. At all times the patients could formulate new goals and release old ones. The symptoms were registered by SCL-90-R and the interpersonal problems were recorded by IIP-D. After 3,5 years a follow-up interview was conducted. Although all patients were comparable in their diagnoses the patients in behavior therapy and those in psychoanalytically-oriented therapy differed in a number of characteristics, for example by the way they gained access to therapy (doctors' subscription versus personal initiative for an appointment), the education, the consuming of psychotropic medication and the strain of symptoms. The patients did not differ remarkably in their goals in therapy. The symptoms as a goal did not have the highest priority in both groups, but the category "self-worth-problems" was found in both groups with a high priority. About one third of therapy goals were redefined by the patients in both groups within one year. After 2,5 years the number of goals in the category "interpersonal conflicts" increases remarkably in both treatment groups. For both groups we found the extent of reaching aimed goals in therapy (recorded by GAS) was significant over time. The results seem to prove that psychotherapy under naturalistic conditions aims more at improving the general level of functioning than at reducing the symptoms.
Brockmann
Josef
J
Freie Praxis, Frankfurt. j.brockmann@tuc-kunden.de
Schlüter
Thomas
T
Eckert
Jochen
J
D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy; D001521:Behavior Therapy; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy; D005260:Female; D006040:Goals; D006801:Humans; D007348:Insurance, Health; D008134:Long-Term Care; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy*; D011446:Prospective Studies; D011575:Psychoanalytic Therapy