The Effectiveness of Three Psychotherapies of Different Type and Length in the Treatment of Patients Suffering from Anxiety Disorders

  • Paul KnektEmail author
  • Olavi Lindfors
  • Erkki Heinonen
  • Timo Maljanen
  • Esa Virtala
  • Tommi Härkänen
Part of the European Family Therapy Association Series book series (EFTAS)


Data on the comparative effect of short- and long-term psychotherapy in anxiety disorders is scarce.

The study compared outcomes of two short-term therapies and one long-term psychotherapy in the treatment of patients with anxiety disorders in secondary analyses of a large randomized trial. Altogether 50 outpatients with anxiety disorders as the only axis I diagnosis were randomized to long-term psychodynamic psychotherapy (LPP), short-term psychodynamic psychotherapy (SPP), and solution-focused therapy (SFT) and were followed for 5 years. The outcome measures were psychiatric symptoms, work ability, need for psychiatric treatment, remission, and cost-effectiveness. During the first year of follow-up, no significant outcome differences were noted. During the following 3 years, LPP and SFT more effectively reduced symptoms, improved work ability, and elevated the remission rate than SPP. No significant differences between LPP and SFT were seen. At the end of the follow-up, the use of auxiliary treatment was lowest in SFT, whereas no other outcome differences were noted. The average total direct costs were about three times higher in LPP than in the short-term therapy groups. In conclusion, the resource-oriented SFT may be a cost-effective option in this patient group, while unconsidered allocation of patients to LPP does not appear to be cost-effective.


Anxiety Effectiveness Long-term psychotherapy Psychodynamic Randomized trial Short-term psychotherapy Solution-focused 



This study was supported by a grant from the Academy of Finland (grant no. 138876); the Finnish Cultural Foundation; the Deutsche Gesellschaft für Systemische Therapie, Betratung und Familietherapie (DGSF); and the Systemische Gesellschaft (SG). The foundations had no role in the design, analysis or writing of this article.

The statistical analyses were carried out by Mr. Julius Rissanen.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Paul Knekt
    • 1
    Email author
  • Olavi Lindfors
    • 1
  • Erkki Heinonen
    • 1
  • Timo Maljanen
    • 2
  • Esa Virtala
    • 1
  • Tommi Härkänen
    • 1
  1. 1.Finnish Institute for Health and WelfareHelsinkiFinland
  2. 2.Social Insurance InstitutionHelsinkiFinland

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