Open Door Review

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A22M6)*0*_!@>_!I*0M(_!/>_!G!A$*&:)%6_!N>![+,-P^>!/647#)<)D$72! '(A?-)@,#A&3%(%@#?-O&GHe _!-g+E -dP>!! Laaksonen, MA, Sirkiä C, Knekt P, Lindfors O. (2014). Self-reported immature defense style as a predictor of outcome in short- and long-term psychotherapy. Brain and Behavior . Open Access, Doi:10.1002/brb3.190. A$*&:)%6_!N>_!I*0M(_!/>_!H0$*)*0*_!'>_!G!V$%(2<2_!'>![+,-]2^>!Q0<:E7)*701(!2*&!UB2<$(4!):!)3j07(!%0<2($)*6!26! 1%0&$7()%6!):!6B$(23$<$(4!:)%!6#)%(E!2*&!<)*D(0%9!1647#)(#0%214>! N">#+@B&"!&/!!%?,)<%&;)("#*%#(O&IJGVIJl _!+,+E +-->!! A$*&:)%6_!N>_!Nj2*0*_!Q>_!iJJ6M0_!G!I*0M(_!/>![+,-]3^>!Q)7$2! '(A?-)@,#A&3%(%@#?-O&GIg _!]]E.->!! i)B(60**$09$_!I>_!A22M6)*0*_!@>_!I*0M(_!/>_!H22%29)_!/>_!G!A$*&:)%6_!N>![+,-+^>!/%0&$7($)*!):!6)7$)E&09)D%21#$7! :27()%6!)*!(#0!)B(7)90!):!6#)%(E!2*&!<)*DE(0%9!1647#)(#0%214>! N">#+@B&"!&/!!%?,)<%&;)("#*%#(O&IlI _!PP-EP]+>!! W(*&,!>-001(3! The aims of this ongoing study are to evaluate the prediction of patient factors on the alliance and the outcome of short-, long-, and short- vs long-term therapy (Knekt et al. 2012). The prediction study is based on a cohort design and the data is coming from the Helsinki Psychotherapy Study. The participants are 367 outpatients from psychiatric services in the Helsinki region having long-standing depressive or anxiety disorder causing work dysfunction. Patients with psychotic disorder, severe personality disorder, adjustment disorder, bipolar disorder or substance abuse were excluded. Solution-focused therapy included 12 and short-term psychodynamic psychotherapy 20 therapy sessions, both therapies lasting about half a year. The long-term therapies were open-ended, psychodynamic psychotherapy lasting about 3years with about 240 sessions and psychoanalysis lasting about 5 years and about 650 sessions. All the therapists had received standard training and were experienced. The outcome assessment covers different measures of psychiatric symptoms and recovery, need for treatment, work ability, personality functioning, social functioning, lifestyle, and cost-effectiveness. These outcome measures are administered longitudinally: prior to start of treatment and at 14 pre-chosen time points during a 10-follow-up from start of treatment. The predictors, mainly determined at baseline, included patients’ psychiatric symptoms, psychological functioning, social functioning, and genetic factors (i.e. DNA determined from blood samples). The main focus of the study is the search for evidence-based criteria to be used in choosing an appropriate treatment for a patient. An interview-based pre-treatment suitability assessment measure of patient’s personality characteristics and interpersonal dispositions has been developed and found to be useful in the selection of short- or long-term psychotherapy (Laaksonen et al. 2012, 2013). Several other patient factors, assessed by interview or questionnaires, have also emerged as potential predictors of prognosis in different therapies. Further study will extend the scope of the predictors of suitability and will evaluate the relative importance of them. Several original contributions have been published from this sub-study (Joutsenniemi et al. 2012, Laaksonen et al. 2014, Lindfors et al. 2014a, 2014b), and a number of studies are ongoing (see cited literature above and our homepage). @)15-1.*$#! This study gives criteria, based on multiple patient perspectives, for whom long-term therapy seems necessary and who may recover by short-term therapy. The role of the therapeutic alliance in the prediction and mediation of the change processes will also be possible. The findings can thus be

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