The effect of individual short- and long-term psychotherapy on perceived social support: analysis of secondary outcomes of a randomized clinical trial.

PURPOSE: Social support is important for maintaining and restoring psychological well-being but the effects of individual psychotherapies on perceived social support are not well known. In this analysis of secondary outcomes from a randomized clinical study, we compared the effects of long-term psychotherapy and two short-term psychotherapies on social support during a 5-year follow-up. MATERIALS AND METHODS: Altogether 326 adult outpatients suffering from depressive and/or anxiety disorders were randomly assigned to long-term psychodynamic psychotherapy (LPP, n = 126), short-term psychodynamic psychotherapy (SPP, n = 101) and solution-focused therapy (SFT, n = 97). Outcome was measured by the global index and six subscores of the self-reported Brief Inventory of Social Support and Integration scale (BISSI) at baseline and at 1, 2, 3, 4 and 5 years after the beginning of the therapy. RESULTS: Social support improved in all therapy groups and the improvement was relatively stable, lasting several years after the end of therapy. Little difference in improvement was observed either between therapy orientations or durations. CONCLUSIONS: While no major differences were observed between treatment groups, the slight differences call for further research to verify these findings and to better understand how different therapies may improve perceived social support.

Short-Term versus Long-Term Mentalization-Based Therapy for Borderline Personality Disorder: A Randomized Clinical Trial (MBT-RCT).

INTRODUCTION: Borderline personality disorder (BPD) is a severe and prevalent psychiatric disorder. Mentalization-based therapy (MBT) is an evidence-based intervention for BPD, and several countries offer treatment programs for BPD lasting for years, which is resource demanding. No previous trial has compared short-term with long-term MBT. OBJECTIVE: The aim of the study was to assess the efficacy and safety of short-term versus long-term MBT for outpatients with BPD. METHODS: Adult outpatients (≥18 years) with subthreshold or diagnosed BPD were randomly assigned (1:1) to short-term MBT (5 months) or long-term MBT (14 months). The primary outcome was BPD symptoms assessed with the Zanarini Rating Scale for Borderline Personality Disorder. Secondary outcomes were functional impairment, quality of life, global functioning, and severe self-harm. All outcomes were primarily assessed at 16 months after randomization. This trial was prospectively registered at ClinicalTrials.gov, NCT03677037. RESULTS: Between October 4, 2018, and December 3, 2020, we randomly assigned 166 participants to short-term MBT (n = 84) or long-term MBT (n = 82). Regression analyses showed no evidence of a difference when assessing BPD symptoms (MD 0.99; 95% CI: -1.06 to 3.03; p = 0.341), level of functioning (MD 1.44; 95% CI: -1.43 to 4.32; p = 0.321), quality of life (MD -0.91; 95% CI: -4.62 to 2.79; p = 0.626), global functioning (MD -2.25; 95% CI: -6.70 to 2.20; p = 0.318), or severe self-harm (RR 1.37; 95% CI: 0.70-2.84; p = 0.335). More participants in the long-term MBT group had a serious adverse event compared with short-term MBT (RR 1.63; 95% CI: 0.94-3.07; p = 0.088), primarily driven by a difference in psychiatric hospitalizations (RR 2.03; 95% CI: 0.99-5.09; p = 0.056). CONCLUSION: Long-term MBT did not lead to lower levels of BPD symptoms, nor did it influence any of the secondary outcomes compared with short-term MBT.

Psychological interventions during breast cancer rehabilitation: a randomized controlled trial comparing structured short-term psychotherapy versus non-specific group discussion.

PURPOSE: Psycho-oncological treatment is recommended in cancer rehabilitation as it improves fatigue, anxiety, depression, and quality of life in breast cancer patients. The aim of our study was to compare a structured short-term psychotherapy and a non-specific group discussion provided during breast cancer rehabilitation. METHODS: Breast cancer patients were randomly assigned to structured group short-term psychotherapy or a non-specific group discussion during breast cancer rehabilitation. The patients completed questionnaires at the beginning and end of rehabilitation and three months after rehabilitation. The primary outcome was anxiety. Secondary outcomes were depression, distress, fatigue and health-related quality of life domains. RESULTS: In total, 160 patients (80 in both groups) were recruited and included in the analysis. There was no significant difference between both groups in the primary outcome anxiety at the end of rehabilitation (difference = -0.2; 95% CI -1.2 to 0.7) and three months after rehabilitation (difference = 0.2; 95% CI -0.9 to 1.3) and in any secondary outcome. Patients in the short-term psychotherapy group with high anxiety levels at baseline reported fewer depressive symptoms at the end of rehabilitation. CONCLUSIONS: Our study showed no difference between structured short-term psychotherapy and a non-specific group discussion. Patients with high baseline anxiety levels were more likely to benefit from short-term structured psychotherapy. Early identification of this subgroup and symptoms of mental illness should occur after initial treatment in breast cancer patients in order to offer a structured treatment for anxiety and depressive symptoms during rehabilitation. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00017571; 08/07/2019).

Effect of short-term dynamic psychotherapy on sexual function and marital satisfaction in women with depression: Clinical trial study.

Background and Aims: This study aimed to look at the influence of short-term dynamic psychotherapy on sexual function and marital satisfaction in women with depression. Methods: Through a clinical trial study using a pretest-posttest design and a control group, this study enlisted the participation of 60 women diagnosed with depression. The patients were interviewed before being randomly assigned to experimental or control groups. Data were obtained through the Beck Depression Inventory, the Enrique Marital Satisfaction Questionnaire, and the Female Sexual Function Questionnaire. The experimental group received intense short-term dynamic psychotherapy intervention, while the control group was on a 2-month waiting list. The SPSS 24 program utilized an analysis of variance to analyze the data. Results: The pre- and posttest study results revealed a significant difference in marital satisfaction, sexual function, and depression between the experimental and control groups (p < 0.01). Conclusion: During the posttest phase, a short-term intensive dynamic psychotherapy intervention helped the experimental group feel better about their marriage and improve their sexual function. It also helped them feel less depressed.

Mentalizing the therapist - Therapist experiences with short-term mentalization-based therapy for borderline personality disorder: A qualitative study.

Background: Mentalization-Based Therapy (MBT) was originally developed as a structured psychotherapy approach developed to treat borderline personality disorder (BPD) lasting up to 18 months in outpatient settings. However, a short-term (5 months) MBT program has recently been developed. No studies have investigated how MBT therapists experience the shift towards conducting short-term MBT for BPD. Objective: The objective of this study was to explore therapist experiences with conducting short-term MBT for outpatients with BPD in the Danish mental health services. Methods: Semi-structured qualitative interviews were conducted with seven therapists about their experiences with short-term MBT after a one-year pilot phase. The interviews were verbatim transcribed and analyzed using thematic analysis. Results: The following four major themes from the therapists' experiences with short-term MBT were found in the qualitative analysis: (1) The longer the better, (2) Change processes can be intellectual or experiential, (3) Short-term therapy is hard work, and (4) Termination is more challenging in short-term MBT. Conclusion: Most therapists were overall reluctant towards changing from long-term to short-term MBT. These therapist experiences could inform implementation of short-term MBT in mental health settings in the future.

Adapting Short-Term Mentalization-Based Therapy to ICD-11 Personality Disorder in Adolescents.

Following the introduction of the 11th revision of the International Classification of Diseases (ICD-11), adolescents can now be diagnosed with a personality disorder based on severity ranging from mild to moderate to severe. This dimensional model has potential implications for treatment, as it allows clinicians and researchers to search for effective treatments targeting adolescents at different severity levels rather than offering all patients the same treatment. In this conceptual paper, we propose that the short-term mentalization-based therapy (MBT) program, originally developed to treat adults with borderline personality disorder (BPD), has potential clinical advantages for adolescents with ICD-11 personality disorder at the mild to moderate severity level. The short-term MBT program is a 5-month structured treatment approach including individual therapy, combined psychotherapy with the individual therapist also being one of the group therapists, and closed-group therapy to enhance cohesion and a feeling of security. The purpose of this paper is to make a case for the use of this format, as opposed to the traditional long-term MBT format, for adolescents with BPD. Future research should include large-scale randomized clinical trials powered to assess patient-important outcomes.

Bridging the gap between the emergency department and outpatient care: feasibility of a short-term psychiatric crisis intervention for children and adolescents.

Child and adolescent mental health systems are facing limited resources of available psychosocial interventions, often leading to long waiting lists for acceptance to treatment. We describe the feasibility of a short-term (8-10 sessions) psychological crisis intervention (CI) protocol for children and adolescents aged 8-17 years (n = 30, mean ± standard deviation 12.9 ± 2.4 years) who were referred to an outpatient mental health clinic due to suicidal ideation, aggression, severe anxiety, or extreme family conflict. The participants were assessed before and after the CI, and at a 3-6-months follow-up visit. The psychiatric assessments included clinical evaluation by a senior psychiatrist, and the completion of self-report questionnaires by both the participants and their parents. Following the establishment of the CI unit, the waiting lists for urgent cases were reduced from a median of 84 days in the two preceding years to 23 days in the following 3 years (H[2] = 18.5, p < 0.0001) for patients of the CI unit. A 1-year psychiatric follow-up after the end of the CI revealed that 72% did not require additional psychotherapy. The overall clinical evaluation measures (clinical evaluation, parents-report and child report) improved and had been preserved at the 3-6-months follow-up. Our results demonstrate the feasibility of a short-term CI protocol for expediting admission to treatment for urgent psychiatric cases.

Heart rate variability predicts outcome of short-term psychotherapy at the workplace.

The bio-psycho-social model highlights intra-individual and inter-individual interactions, including psychotherapy. The processing of these interactions within a person takes place, among others, in the central autonomic network (CAN). The CAN's autonomic output to the periphery can be indexed by heart rate variability (HRV), representing individual adaptive capacity. Further, the CAN influences the hypothalamus-pituitary-adrenal axis with its product cortisol. The aim consisted in investigating HRV and cortisol as well as their relation to symptom course in response to short-term psychotherapy. A single-arm, uncontrolled, explorative study was conducted at an outpatient psychotherapeutic consultation in the workplace offered to employees with mental or psychosomatic complaints. Questionnaires included symptoms of depression, irritation and functional impairment. Circadian profile of HRV and salivary cortisol concentrations collected pre and post short-term psychotherapeutic intervention (4-12 sessions) were assessed. Multilevel-linear mixed regressions were calculated. Out of 29 participants (mean age 42; 72% female), 24% were on sick leave from work. Cortisol concentrations were neither affected by intervention nor by symptom course. The proportion of individuals showing a vagally mediated HRV in the range of the lowest quartile assessed for age- and sex-matched healthy controls was reduced at follow-up (pre 34%, post 22%; p = .017). Higher vagally mediated HRV at baseline predicted lower symptom burden at follow-up. Thus, the results support the assumption that HRV reflects the capability of an organism to adapt and recover. Patients with reduced HRV might need additional psychotherapeutic sessions to achieve the same symptom improvements than patients with retained HRV.

The effectiveness of Sandplay Therapy versus Cognitive Behavioral Therapy: a comparative study / A eficácia da Terapia do Sandplay versus Terapia Cognitiva Comportamental: um estudo comparativo

Objective This study was designed to compare the effectiveness of Sandplay Therapy and Cognitive Behavioral Therapy in the reduction of clinical/borderline symptoms in children and adolescents. Method The participants were 21 victims of domestic violence with clinical or borderline scores on the Child Behavior Checklist and Young Self Report. They were also tested with Wechsler Abbreviated Intelligence Scale (T0) and designed by random to treatment and control groups. They were tested with the same instruments at T1 (after 20 sessions/ 20 weeks) and T2 (after 6 months). Results For the children, there were no changes across the groups, but a significant improvement in internalizing behavior problems in the sandplay group and in externalizing and total behavior problems in the Cognitive Behavioral Therapy group. For the adolescents, there was a significant improvement in externalizing behavioral problems in the sandplay group and in the total behavior problems for the Cognitive Behavioral Therapy group. Conclusion The results of this research do not allow to conclude that one technique is better than another since we did not have a consistent significative difference across the groups. These results may be due to the different approaches of the techniques. While Sandplay Therapy provides a free and protected space to allow the participants to express their feelings through images and histories, Cognitive Behavioral Therapy follows a program that focuses more on promoting behavior adaption to outside world. The application of this research design with a large population and with more sessions will allow to observe the consistence of these findings, providing a more solid ground to choose which technique would be more efficient for each specific case.

Objetivo Esta pesquisa tem como objetivo comparar a efetividade da terapia de sandplay com a terapia cognitiva comportamental na redução de sintomas clínicos ou limítrofes em crianças e adolescentes. Método Os participantes foram 21 vítimas de violência doméstica com sintomas clínicos ou limítrofes nas escalas Child Behavior Checklist ou Young Self Report. Os participantes foram também testados com a escala abreviada de inteligência Wechsler (T0) e designados randomicamente para os grupos de tratamento e controle. Os participantes foram testados novamente em T1 (20 sessões/20 semanas) e em T2 (6 meses). Resultados Para as crianças, não houve mudança entre os grupos, mas uma melhora nos problemas internalizantes no grupo de sandplay e nos problemas externalizantes e total de problemas no grupo de terapia cognitiva comportamental. Para os adolescentes, houve uma melhora significativa nos problemas externalizantes no grupo de sandplay e no total de problemas no grupo de terapia cognitiva comportamental. Conclusão Os resultados desta pesquisa não permitem concluir que uma técnica é melhor que outra, pois não tivemos uma diferença significativa consistente entre os grupos. Esses resultados podem ser devidos às diferentes abordagens das técnicas. Enquanto a Sandplay Therapy oferece um espaço livre e protegido para permitir que os participantes expressem seus sentimentos por meio de imagens e histórias, a Cognitive Behavioral Therapy segue um programa que se concentra mais em promover a adaptação do comportamento ao mundo exterior. A aplicação deste desenho de pesquisa a uma grande população e com mais sessões permitirá observar a consistência destes resultados, proporcionando terreno sólido para escolher qual técnica seria mais eficiente para cada caso específico.

A Systematic Review and Bayesian Network Meta-Analysis Investigating the Effectiveness of Psychological Short-Term Interventions in Inpatient Palliative Care Settings.

This paper reviews and summarises the evidence of short-term psychosocial interventions (up to 12 sessions delivered within less than eight weeks) on anxiety, depression, and emotional distress in palliative patients in inpatient settings. We screened publications from the following five databases, Embase, PubMed, PsycINFO, Web of Science, and CINAHL, from their inception to 10 September 2021. The eligible studies included controls receiving standard palliative care, actively treated controls, and wait-list controls. Nine studies met the eligibility criteria and reported the effects of five psychosocial interventions in a total of N = 543 patients. We followed PRISMA-guidelines for outcome reporting and the Cochrane Risk of Bias Assessment Tool for assessing study quality. This paper used the network meta-analysis to compare multiple treatments by providing greater statistical power and the cross-validation of observed treatment effects, using the R package BUGSnet. Compared to control groups, the following psychosocial interventions in inpatient settings showed to be superior: life review interventions were the best ranked treatment for improving anxiety and distress, while the top ranked treatment for reducing depression was outlook intervention. The short-term psychosocial interventions investigated in this meta-analysis, especially life review intervention, are feasible and can potentially improve anxiety, depression, and distress in palliative inpatients and should therefore be offered in inpatient settings.

Mentalizing the patient-Patient experiences with short-term mentalization-based therapy for borderline personality disorder: A qualitative study.

Background: Mentalization-based therapy (MBT) is an evidence-supported psychotherapy approach for borderline personality disorder (BPD) that has been implemented in mental health services worldwide. Originally, MBT was developed as an 18-months program for BPD. However, a short-term (5 months) MBT program has been developed. Research into patient experiences with long-term MBT for BPD is scarce, and no studies have investigated patient experience with short-term MBT for BPD. Objective: The objective of this study was to explore patient experience with short-term MBT for BPD in the Danish mental health services. Methods: Semi-structured qualitative interviews were conducted with 12 outpatients diagnosed with BPD, who attended short-term MBT for 5 months. The interviews were verbatim transcribed and analyzed using thematic analysis with double coding. Results: The analysis resulted in four subordinate themes: (1) Treatment duration - too short or appropriately short?, (2) The group as a "safe space," (3) Bad experiences impacted treatment negatively, and (4) My life has changed for the better. Conclusion: The results suggest that most of the patients were overall satisfied with short-term MBT, which they experienced as having a positive impact on their lives. However, a subgroup of patients wanted more therapy. This study highlighted the strengths and limitations of short-term MBT for BPD as experienced by the patients, and points to barriers in developing service-user informed short-term treatment options for BPD.

Predicting improvement of work ability in modalities of short- and long-term psychotherapy: The differential impact of reflective ability and other aspects of patient suitability.

OBJECTIVES: We investigated how patients' psychological capacities to engage in psychotherapy predict changes in work ability in short- and long-term psychotherapy. METHODS: A cohort study of 326 patients, aged 20-46 years and suffering from mood and anxiety disorders, treated by short-term solution-focused, short-term psychodynamic, or long-term psychodynamic psychotherapy, followed-up for 5 years. The Suitability for Psychotherapy Scale, assessed at baseline, was the predictor. Outcomes were assessed at baseline and at six follow-up occasions using the Work Ability Index as the primary indicator. RESULTS: Patients with good pretreatment psychological suitability for psychotherapy, good reflective ability in particular, improved more than patients with poor suitability in short-term psychodynamic psychotherapy. Comparisons between therapy groups showed poorer suitability to predict more improvement in solution-focused and in long-term psychodynamic psychotherapy than in short-term psychodynamic psychotherapy. CONCLUSION: Patients' psychological suitability for psychotherapy has a different impact on work ability in different therapy modalities and durations.

Efficacy of parent-infant psychotherapy compared to care as usual in children with regulatory disorders in clinical and outpatient settings: study protocol of a randomised controlled trial as part of the SKKIPPI project.

BACKGROUND: The first years of life are a significant period for child development, when children are particularly sensitive and prone to crises. This early phase lays the foundation for healthy growth. Clinical assessment of psychological symptoms in early infancy and adequate treatment are both important in improving the diagnostic outcome and preventing later long-term developmental consequences. The most common psychological problems in the first 3 years of life are regulatory disorders. The aim of this trial is to investigate the efficacy of Parent-Infant Psychotherapy (PIP) for infants and young children (aged 0-36 months, diagnosed with at least one regulatory disorder) and their mothers, compared to care as usual (CAU). METHODS: In this open multicentre randomised controlled trial, 160 mother-infant dyads are randomised to receive PIP or CAU for 6 weeks of intervention in clinical or outpatient (including home treatment) settings. The primary outcome is the maternal sensitivity (sensitivity scale of the Emotional Availability Scales (EAS)) after 6 weeks. Secondary outcomes include assessment of interaction, mental health problems, attachment, development, psychological factors, treatment adherence, health care system utilisation, and costs, after 6 weeks and 12 months. DISCUSSION: This study will evaluate whether a manualised focus-based short-term psychodynamic psychotherapeutic intervention in mother-child dyads improves the care situation for families of children diagnosed with regulatory disorders, and helps prevent long-term psychopathologies. Assessment of the intervention in different settings will support the development of more tailored interventions for affected infants and their mothers. TRIAL REGISTRATION: German Clinical Trial Register, ID: DRKS00017008 . Registered 03/20/2019.

The self-coping method in online psychological aid at COVID-19 pandemic.

BACKGROUND: Today pandemic has set challenges for psychologists and psychotherapists in providing online first psychological aid to the community. AIM: At such moments, society especially needs psychological support, which should be feasible, short-term, and effective. SETTINGS AND DESIGN: A method of self-coping, based on the concepts of behavioral and cognitive psychology. The following principles underlie the method: a person can cope with his/her conditions; the accumulation of unconscious feelings, sensations, images leads to the development of problem states; self-awareness of them through the conscious observation leads to their attenuation and extinction. MATERIALS AND METHODS: The method consists of five steps. The first step is the differentiation of feelings, sensations, and appropriate images. The second stage is the observation of one's condition related to images. In the third stage, the client observes spontaneous images and related feelings and sensations. The fourth step involves observing spontaneous images. Fifth stage: A client obtains skills of ecological behavior: A person expresses feelings but does not exhibit them in a destructive way. The Add-on tools help at jam up issues. RESULTS: The pre-pandemic experience of using this method has shown high efficiency, comprehensibility, and simplicity. The method has proven its usefulness in online consulting, positively perceived by clients, who note its ease of understanding, training, and use. CONCLUSION: The method has shown an efficacy during the pandemic and suggested to be effective in various conditions (obsessive/anxiety disorders, eating disorders, alcohol abuse, etc.).

Avaliação de resultados de psicoterapia psicodinâmica breve em contexto institucional / Outcome evaluation of short-term psychodynamic psychotherapy in institutional context

Esse estudo de casos múltiplos investigou a efetividade da psicoterapia psicodinâmica breve (PPB) e o processo de mudança intra e interpessoal de pacientes atendidos no ambulatório uma empresa. Participaram do estudo 03 funcionários com queixas psicológicas diversas. A coleta dos dados incluiu medidas de autorrelato para a avaliação da mudança da psicoterapia (OQ-45 ­ Outcome Questionnaire), sintomas psicopatológicos (BSI ­ Brief Symptom Inventory), mecanismos de defesa (DSQ- 40-Defensive Style Questionnaire) e empatia (EMRI - Escala Multidimensional de Reatividade Interpessoal), aplicadas na 1a, 6a e na 12a sessão (término do tratamento). Em todos os casos foi constatado abrandamento sintomatológico e melhora nos relacionamentos interpessoais e em dois casos as mudanças sintomáticas foram clinicamente significativas e confiáveis. O estudo sugere que a PPB pode promover mudanças significativas na saúde mental dos trabalhadores e que as intervenções mais efetivas são aquelas que incidem sobre crises. Estudos em maior escala são necessários para generalizar os achados.

This systematic multiple case study investigates the effectiveness of short-term psychodynamic psychotherapy (STPP) and the process of intra and interpersonal change of patients attended at a company. The sample consisted of 03 workers with different psychological complaints. Data collection included self-reported measures for the assessment of change in psychotherapy (OQ-45 ­ Outcome questionnaire), psychopathological symptoms (BSI ­ Brief Symptom Inventory), defense mechanisms (DSQ- 40-Defensive Style Questionnaire), and empathy (EMRI ­ Multidimensional Scale of Interpersonal Reactivity), applied in the 1st, 6th and 12th sessions (end of treatment). In all cases there was a decrease in symptoms and improvement in interpersonal relationships and in two the symptomatic changes were clinically significant and reliable. Results suggest that STPP can promote significant changes in workers' mental health and that the most effective interventions are those that address crises. Major studies are needed to generalize the findings.

Short-term versus long-term psychotherapy for adult psychiatric disorders: a protocol for a systematic review with meta-analysis and trial sequential analysis.

BACKGROUND: Psychiatric disorders are highly prevalent and associated with great symptomatic, functional, and health economic burdens. Psychotherapy is among the recommended and used interventions for most psychiatric disorders and is becoming widely accessible in mental health systems. The effects of specific forms of psychotherapy (e.g., psychodynamic therapies, cognitive and behavioral therapies, humanistic therapies, and systemic therapies) have been assessed previously in systematic reviews, but the appropriate psychotherapy duration for psychiatric disorders has not been reviewed. The aim of this systematic review will be to synthesize the evidence of the effects of short-term compared with long-term psychotherapy for all adult psychiatric disorders. METHODS/DESIGN: A comprehensive search for relevant published literature will be undertaken in Cochrane Central Register of Controlled Trials (CENTRAL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Latin American and Caribbean Health Sciences Literature (LILACS), PsycINFO, Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Conference Proceedings Citation Index-Science (CPCI-S), and Conference Proceedings Citation Index-Social Science & Humanities (CPCI-SSH) to identify relevant trials. We will search all databases from their inception to the present. We will include randomized clinical trials comparing a short-term and a long-term version of the same psychotherapy type for adult psychiatric disorders including attention deficit hyperactivity disorder, psychotic disorders, depressive disorders, bipolar disorders, anxiety disorders, obsessive-compulsive disorder, trauma- and stressor-related disorders, eating disorders, and personality disorders (as defined by standardized diagnostic criteria). We will rely on the trialists defining their compared interventions as short term and long term (or similar terminology). Primary outcomes will be quality of life, serious adverse events, and symptom severity. Secondary outcomes will be suicide or suicide attempts, self-harm, and level of functioning. Two review authors will independently extract data and perform risk of bias assessment using the Cochrane risk of bias tool. A meta-analysis will be performed as recommended by the Cochrane Handbook for Systematic Review of Interventions, bias will be assessed with domains, and Trial Sequential Analysis will be conducted to control random errors. Certainty of the evidence will be assessed by GRADE. DISCUSSION: As psychotherapy is among the treatments of choice for most adult psychiatric disorders, a systematic review evaluating the benefits and harms of short-term compared with long-term psychotherapy is urgently needed. It is the hope that this review will be able to inform best practice in treatment and clinical research of these highly prevalent and burdensome disorders. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019128535.

Sustained Reduction in Health Care Service Usage after Adjunctive Treatment of Intensive Short-Term Dynamic Psychotherapy in Patients with Bipolar Disorder.

The aim of this study was to evaluate changes in long-term health care costs and symptom severity after adjunctive intensive short-term dynamic psychotherapy (ISTDP) individually tailored and administered to patients with bipolar disorder undergoing standard psychiatric care. Eleven therapists with different levels of expertise delivered an average of 4.6 one-hour sessions of ISTDP to 29 patients with bipolar disorders. Health care service costs were compiled for a one-year period prior to the start of ISTDP along with four one-year periods after termination. Two validated self-report scales, the Brief Symptom Inventory and the Inventory of Interpersonal Problems, were administered at intake and termination of ISTDP. Hospital cost reductions were significant for the one-year post-treatment period relative to baseline year, and all cost reductions were sustained for the follow-up period of four post-treatment years. Self-reported psychiatric symptoms and interpersonal problems were significantly reduced. These preliminary findings suggest that this brief adjunctive psychotherapy may be beneficial and cost-effective in select patients with bipolar disorders, and that gains may be sustained in long-term followup. Future research directions are discussed.

Can interpersonal psychotherapy be delivered by a community agency?

OBJECTIVES: There are limited options for depressed patients to have access to evidence-based psychotherapies in the community. This pilot study explored the feasibility of delivering interpersonal psychotherapy (IPT) to clients in a community support agency. METHOD: A total of 18 clients with depression completed at least eight sessions of IPT (range 8-13) and 17 completed a range of pre- and post-treatment measures. RESULTS: Clients had a high level of depression and were functioning poorly. All found the delivery of IPT in the community useful and would recommend therapy to others. There was a significant reduction in self-report and clinician-rated depression, and improvement in social functioning. CONCLUSIONS: This study supports the notion that therapy can be delivered by appropriately trained non-mental-health clinicians in the community with good effect and adds to the range of options for delivery of psychiatric care.

Redefining Outcome Measurement: A Model for Brief Psychotherapy.

CONTEXT: The zeitgeist for short-term psychotherapy efficacy has fundamentally shifted away from evidence-based practices to include evidence-informed practices, resulting in an equally important paradigm shift in outcome measurement designed to reflect change in this short-term modality. OBJECTIVE: The present article delineates a short-term psychotherapy structure which defines four fundamental stages that all brief therapies may have in common, and are represented through Cognitive Behavioral Therapy, Solution-Focused Brief Therapy, Narrative Therapy, and Emotion-Focused Therapy. METHOD: These four theoretical approaches were analyzed via a selected literature review through comparing and contrasting specific and common tasks as they relate to the process of psychotherapy and change. Once commonalities were identified within session, they were categorized or grouped into themes or general stages of change within the parameters of a four to six session model of short-term therapy. Commonalities in therapeutic stages of change may more accurately and uniformly measure outcome in short-term work, unlike the symptom-specific psychometric instruments of longer-term psychotherapy. RESULTS: A systematic framework for evaluating the client and clinician adherence to 20 specific tasks for these four short-term therapies is presented through the newly proposed, Brief Task Acquisition Scale (BTAS). It is further proposed that the client-clinicians' adherence to these tasks will track and ultimately increase treatment integrity. CONCLUSION: Thus, when the client-clinician relationship tracks and evaluates the three pillars of (1) stage/process change, (2) task acquisition, and (3) treatment integrity, the culmination of these efforts presents a new way of more sensitively measuring outcome in short-term psychotherapy. Data collection is suggested as a first step to empirically evaluate the testable hypotheses suggested within this current model. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message The clinician practitioner will note that the proposed Brief Services model removes the subjectivity of client satisfaction as a reliable outcome measure, and relies upon client and therapist adherence to specific tasks and stages of change within and across short-term psychotherapy. The clinical significance of the BTAS for the practitioner is three fold. The psychometric instrument (1) tracks stage or process change, (2) guides task acquisition, and (3) incorporates greater treatment integrity unlike other outcome measures. The BTAS present a new way of conceptualizing change in short-term psychotherapy regardless of modality or presenting issue, making it a more flexible and usable instrument for the clinician. The BTAS may measure outcome more sensitively and accurately, thus offering the client, therapist and client-therapist more information regarding change at each stage and at the end of short-term psychotherapy.

EEG-neurofeedback and psychodynamic psychotherapy in a case of adolescent anhedonia with substance misuse: mood/theta relations.

There is substantial evidence confirming the efficacy of neurofeedback with applications in clinical, educational and optimal performance domains. However, a psychodynamically informed NF-approach needs exploration. A male (19 y), college student whose first year was being seriously compromised after severe, 18-month, polydrug misuse, was treated with 11 sessions including a 2-month follow-up of neurofeedback combined with short-term psychodynamic psychotherapy. Pre/post-treatment and follow-up assessment with the Brief Psychiatric Rating Scale (BPRS) and the Montgomery-Asberg Depression Rating Scale confirmed that levels of psychopathology dropped almost to zero. Correlational evidence disclosed that SMR/theta training was positively associated with reduction in psychopathological ratings, largely due to theta amplitude reduction; the strongest relation being with reduced BPRS activation. Alpha/theta training was not correlated with clinical improvement. The combined treatment was found to be highly effective with the student who learned to deal with feelings of anhedonia and alienation. There was no relapse during the follow-up phase. Further research is recommended.