Browsing by Author "Obsilova, Linda"

Objectives: It is estimated that over one third of patients in clinical trials do not improve significantly in therapy, and up to 10% even deteriorate. The prevalence of treatment failure calls for treatment personalization based on specific client characteristics. This study examined the predictive value of client’s baseline sense of coherence (SOC) on the probability of treatment failure in short and long psychotherapy over a 5-year period. Higher SOC was hypothesized to predict a) less failure and b) sufficiency of short therapy. Methods: The Helsinki Psychotherapy Study comprised 326 outpatients (76.1% female, aged 20-46) with depressive or anxiety disorders. Participants were randomized to solution-focused (n = 97), short-term psychodynamic (n = 101), or long-term psychodynamic psychotherapy (n = 128). Baseline SOC was assessed with the 29-item Orientation to Life Questionnaire. Treatment failure, assessed yearly, included absence of reliable and clinically significant change in the Symptom Check List score, auxiliary treatment, and treatment non-attendance. Failure rates were estimated using logistic regression analysis. Results: High SOC did not predict less failure nor the sufficiency of short therapy. Instead, short therapies were most effective for individuals with the lowest SOC, and long therapy for those with moderately high SOC, for whom long therapy was also superior to short therapy. Individuals with very high SOC used less auxiliary treatment if assigned to long therapy. Additionally, treatment non-attendance of those with moderately low to moderately high SOC was higher in long therapy. Conclusions: SOC predicts treatment failure, though not as expected. Further research is needed to confirm these findings and explore mechanisms underlying the relationship between SOC and treatment outcome.