# Cognitive Therapy vs. Short‐Term Dynamic Psychotherapy in a Community Mental Health Setting: A Preliminary Analysis of Effects in Several Severity Domains

## TL;DR

This study compared cognitive therapy and short-term dynamic psychotherapy for patients with severe mental health issues and found both treatments were equally effective across several severity domains.

## Contribution

The study extends prior research by examining the effectiveness of two therapies in patients with severe symptoms across multiple domains, including interpersonal problems and quality of life.

## Key findings

- Cognitive therapy and short-term dynamic psychotherapy showed no superiority in treating severe depressive symptoms.
- Both therapies were equally effective for patients with severe mental and physical functioning.
- Patients with poor quality of life benefited equally from both types of therapy.

## Abstract

To investigate the effectiveness of cognitive therapy (CT) and short‐term dynamic psychotherapy (STDP) among patients with greater severity, defined in several ways, in a community mental health setting.

Using data from a randomized noninferiority trial, we examined five baseline severity variables as potential moderators of treatment effects: depressive symptoms, interpersonal problems, mental functioning, physical functioning and quality of life. The outcome was a change in depressive symptoms over the course of up to 5 months of treatment. Linear mixed‐effects models were implemented to compare slopes of change over time. We hypothesized that CT would be superior to STDP for those with severe depressive symptoms, severe mental and physical functioning and severely impaired quality of life, but STDP would be superior to CT for those with severe interpersonal problems.

There was no evidence of superiority within any of the five severity domains.

Findings inform the comparative effectiveness of CT and STDP among patients with greater severity and extend prior work by incorporating interpersonal, functioning and quality of life severity indicators.

There is no evidence that patients with more severe depressive symptoms will benefit more from cognitive therapy compared with short‐term dynamic psychotherapy.Psychotherapists should expect both cognitive therapy and short‐term dynamic psychotherapy to be equally effective for the treatment of patients with more severe mental and physical functioning.Patients with poor quality of life benefit equally from cognitive and dynamic psychotherapies.There is no evidence that patients with more severe interpersonal problems benefit more from short‐term dynamic psychotherapy compared with cognitive therapy.

There is no evidence that patients with more severe depressive symptoms will benefit more from cognitive therapy compared with short‐term dynamic psychotherapy.

Psychotherapists should expect both cognitive therapy and short‐term dynamic psychotherapy to be equally effective for the treatment of patients with more severe mental and physical functioning.

Patients with poor quality of life benefit equally from cognitive and dynamic psychotherapies.

There is no evidence that patients with more severe interpersonal problems benefit more from short‐term dynamic psychotherapy compared with cognitive therapy.