Debunking the myths of therapy

The myth that long term therapy is superior to short term therapy has been debunked, thanks to Swinburne University researcher, Dr Sunil Bhar. 

In a paper published in the Psychotherapy and Psychosomatics journal Bhar and his co-authors, including world-renowned psychologist Dr Aaron Beck, scrutinised the controversial findings of a highly-publicised 2008 German study.

The researchers found that the German study, which claimed to show that long term therapy (around 50 sessions over a year) was more effective than short term therapy, was flawed on many levels. 

“The claim that long term therapy was superior to short term therapy was contradictory to popular opinion in the psychological community,” said Bhar. “Many psychologists were now concerned that patients would seek long term therapy in situations where it was not the best option for them – costing them unnecessary time and money.

“Because of this we really wanted to go over the study, conducted by Leichsenring and Rabung, with a fine tooth comb.”

Bhar said that they found many problems with the research, which analysed the results of eight previous studies.

“These problems included the researchers’ definition of short term therapy, the conditions they were comparing and the statistical analysis of their results.

“One of the biggest concerns was that the research did not consider the effectiveness of different treatments for different conditions – instead it lumped all sorts of mental illnesses together including neurosis, borderline personality disorders and anorexia nervosa,” he said.

“From this Leichsenring and Rabung drew the conclusion that long term therapy was more effective than short term therapy. This is like saying that Panadol is more effective than Nurofen –  but for what? Of course it is going to vary depending on the condition.”

Another issue the researchers found with the Leichsenring and Rabung study was their miscalculation of effect sizes.

“In determining how significant their findings were, the researchers actually used the wrong conversion formula,” said Bhar. “This meant that their conclusion that long term therapy outperformed short term therapy was based on faulty  statistics.”

According to Bhar the German researchers’ definition of short term therapy was also problematic. “The group they defined as having had ‘short term therapy’ included patients who were still on waiting lists, and those that had spent  just a few minutes with a novice therapist,” he said. “Hardly a true representation of most short term therapy sessions.”

Bhar hopes his analysis will lead to better designed studies that look at the effectiveness of therapy for different conditions. “I think ultimately this will lead to better outcomes for patients."

The Leichsenring and Rabung study was published in the Journal of the American Medical Association.

The Bhar et al study was published in the Psychotherapy and Psychosomatics journal and  downloaded here   

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