Short-Term Psychodynamic Psychotherapy for the Treatment of Mental Illness: A Review of Clinical Effectiveness and Guidelines

Key Message

Findings from two systematic reviews showed that short-term psychodynamic psychotherapy (STPP) could be more effective than control conditions (wait list, treatment as usual) in patients with depression or with common mental disorders at up to six to nine months post-treatment in most psychological outcome categories, while these effects did not reach statistical significance after nine or more months after the end of treatment. Two randomized controlled trials found that there were no statistically significant differences between STPP and cognitive behavioural therapy (CBT) in adults with major depressive disorder in depression symptoms and quality of life measures, and in adverse events rates between the two treatment modalities. Clinical practice guidelines developed by the US Department of Veterans Affairs and Department of Defense and the National Institute for Health and Care Excellence (NICE) working groups recommend STPP for patients with mild to moderate major depressive disorder who declined pharmacotherapy or who declined or didn’t have access to first-line psychotherapies such as CBT and interpersonal therapies. A clinical practice guideline developed by NICE recommends STPP for adults with social anxiety disorder who decline cognitive behavioural and pharmacological interventions.