Long‐term outcome and post‐treatment effects of psychoanalytic psychotherapy with young adults

What is it about?

Aims: This study examined the long-term effectiveness of a treatment model at a Swedish therapeutic community for young adults with severe personality disorders, combining milieu therapy and in-patient long-term psychodynamic psychotherapy. Methods: Data were collected for the 56 residents between 1994 and 2008 at intake, termination and 2-year follow-up. Patient residency ranged from 2 to 60 months, with average psychotherapy duration of 30 months. Self-rated outcome was measured using the Symptom Checklist-90-R. Expert-rated outcomes comprised the Global Assessment of Functioning, the Strauss-Carpenter Outcome Scale and the Integration/Sealing-over Scale. A series of Mixed Model ANOVAs with one within fixed-factor (time) was performed to examine the outcomes for the total sample of completers. Effect sizes for within-group change and percentages of improved, unchanged and deteriorated patients were calculated for patients participating in the data collection on all three time points. Results: All outcome measures showed significant improvement on a group level from intake to discharge. Most patients had maintained the therapeutic gains at the 2-year follow-up. The effect sizes were high and the Reliable Change Index provided evidence of good outcome for 92% of the patients at follow-up. The expert ratings gave somewhat larger effect sizes than the patients’ self-ratings. Conclusions: The effect sizes and success rates are at comparable level as in corresponding studies of long-term treatments of personality disorders. Most patients had a substantial individual improvement from intake to termination and follow-up. This indicates the effectiveness of this highly specialized and intensive treatment approach for severely disturbed young adult patients.

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