Wirksamkeit Personzentrierter Therapie im Vergleich zu kognitiv-behavioralen und psychodynamischen Therapien, wie sie im Rahmen des britischen National Health Service praktiziert werden

Abstract

Outcomes of Person-Centered Therapy in comparison to Cognitive-Behavioral and Psychodynamic Therapies as Practiced in United Kingdom National Health Service Settings.
Background. Psychotherapy’s equivalence paradox is that treatments have equivalently positive outcomes despite non-equivalent theories and techniques. We compared the outcomes of contrasting approaches practiced in routine care.
Method. Clients (n = 1,309) who received cognitive-behavioural therapy (CBT), Person-centred therapy (PCT) and psychodynamic therapy (PDT) at one of 58 NHS primary and secondary care sites during a three-year period completed the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at the beginning and end of their treatment. Therapists indicated which treatment approaches were used on an End of Therapy form. We compared outcomes of six groups: three treated with CBT, PCT, or PDT only, and three treated with one of these plus one additional approach (e.g., integrative, supportive, art), designated CBT + 1, PCT + 1, or PDT + 1, respectively.

Results. All six groups averaged marked improvement (pre-post effect size = 1.36). Treatment approach and degree of purity (“only” vs “+1” ) each accounted for statistically significant but comparatively tiny proportions of the variance in CORE-OM scores (respectively, 1 % and .5 % as much as pre-post change). Distributions of change scores were largely overlapping.
Conclusions. Results for these three treatment approaches as practiced routinely across a range of NHS settings were generally consistent with previous findings that theoretically different approaches tend to have equivalent outcomes. Caution is warranted because of limited treatment specification, non-random assignment, lack of a control group, missing data, and other issues.