Effects of duration in psychotherapy on patterns of change for symptoms related to anxiety, depression, and anger

This study investigated differential patterns of change within the psychotherapeutic process. It was predicted that the amount of change occurring between the first and fourth sessions of psychotherapy would be significantly greater than the changes between any other contiguous points in therapy. The relationship between clients', therapists', and significant others' ratings of anxiety and depression at comparable points in therapy was also explored. It was predicted that there would be increased concordance among measures as psychotherapy sessions accrued.;Ten adult subjects entering psychotherapy at a private mental health facility formed the psychotherapy group. The ages of the six men and four women ranged from 25 to 63 years of age. Three subjects received diagnoses within affective disorders, three within anxiety disorders, and four within adjustment disorders. They completed four self-report scales at intake, and after the 1st, 4th, 8th and 13th session of psychotherapy: Back Depression Inventory, State-Trait Anxiety Inventory, Profile of Mood States, and Multiple Affect Adjective Check List. Licensed psychologists, certified social workers, or intern psychologists treated subjects with cognitive-behavioral therapy.;Twenty-four adult subjects in a time elapsed control group completed these self-report measures at comparable points in time. These subjects were not in psychotherapy. The ages of the 9 males and 15 females ranged from 23 to 62 years of age.;The psychotherapy group reported significantly higher levels of anxiety, depression, anger, and fatigue than the time elapsed control group throughout the psychotherapeutic process. The effect of therapy on the scores of the psychotherapy group was statistically and clinically nonsignificant. No differential patterns of change were noted.;There was a general trend toward concordance between self-report ratings and therapists' ratings (Brief Outpatient Psychopathology Scale) of anxiety and depression as psychotherapy progressed. Self-report and significant others' ratings (Personel Adjustment and Role Skills Scale) of anxiety and depression were poor predictors of each other at comparable points in therapy.;A secondary analysis of an additional eight subjects who either benefited or did not benefit from psychotherapy indicated that they maintained post-termination levels of complaints throughout follow-up after an early termination from therapy.