Intensive Short-term Dynamic Psychotherapy in a private psychiatric office: clinical and cost effectiveness

Am J Psychother. 2002;56(2):225-32. doi: 10.1176/appi.psychotherapy.2002.56.2.225.


Objective: To assess the cost and clinical effectiveness of psychiatrist-provided Intensive Short-term Dynamic Psychotherapy (ISTDP) of patients referred to a private office.

Methods: ISTDP was provided to 89 patients referred to a private psychiatric office in Vancouver, Canada. Pretherapy self-report scores, (BDI, BAI, BSI, IIP [see full names in text]) medication costs, disability costs and healthcare costs were compared with posttherapy values and normative values.

Results: Patients' mean self-report scores went from the abnormal to normal range after an average of 14.9 hours of therapy. Returns to work, reduced healthcare utilization, and medication stopping accounted for a cost reduction of over Cdn$400,000 at one year after therapy.

Conclusions: ISTDP appears to be an effective and cost-effective form of intervention when provided by a psychiatrist in a private office. Randomized controlled studies are warranted to further examine the cost benefits and efficacy of ISTDP.

MeSH terms

  • Adult
  • Canada
  • Cost-Benefit Analysis / economics
  • Female
  • Humans
  • Male
  • Mental Disorders / economics*
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Outcome Assessment, Health Care / economics*
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Private Practice / economics*
  • Program Evaluation / economics*
  • Psychiatric Status Rating Scales
  • Psychotherapy / economics*
  • Self Disclosure
  • Time Factors