Background: There is clear evidence for the efficacy of psychotherapy. However, there is a lack of large-scale naturalistic studies on the course of psychological problems and its predictors in people in psychotherapeutic routine care.
Material And Methods: Between September 1998 and February 2000, 627 insurees of the "Deutsche Krankenversicherung", a major German health insurance company, who received outpatient psychotherapy (psychodynamic psychotherapy, analytic psychotherapy, or cognitive behavioral treatment), gave informed consent to participate in this study. During a two-year period, participants' health status was comprehensively assessed using standardised instruments. Hierarchical linear models were used to estimate courses of improvement in and transitions between the phases before, during, and after treatment.
Results: Psychological, interpersonal and physical problems improved substantially in all 3 forms of treatment. However, courses of improvement also varied among domains and form of treatment. The helping alliance was an ubiquitous, but not very strong predictor of treatment outcome.
Conclusions: These results could be used as the basis for comprehensive quality management in psychotherapeutic care.
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