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To the Editor: In their meta-analysis of the effectiveness of LTPP, Drs Leichsenring and Rabung¹ concluded that LTPP was significantly superior to shorter-term methods of psychotherapy with regard to overall outcome, target problems, and personality functioning. There are multiple problems with their meta-analysis that mitigate the scientific credibility of this conclusion.

First, the designation of "shorter-term methods of psychotherapy" included 5 treatments that did not constitute formal psychotherapy as it is generally understood. These treatments consisted of a waitlist control condition, nutritional counseling, standard psychiatric care, low-contact routine treatment, and treatment as usual (TAU) in the community. Such "mixing apples and oranges" is problematic in meta-analyses.

Second, the selection of studies appears biased in favor of LTPP. One study² supportive of LTPP had previously been classified in a meta-analysis by Leichsenring and Rabung³ as involving short-term psychodynamic psychotherapy (STPP) but was reclassified in the present meta-analysis as involving long-term psychodynamic . . . [Full Text of this Article]

Aaron T. Beck, MD
abeck@mail.med.upenn.edu

Sunil S. Bhar, PhD
Department of Psychiatry
University of Pennsylvania
Philadelphia

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