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Unread April 18th, 2005, 09:48 PM
James Pretzer James Pretzer is offline
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Join Date: Jun 2004
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Default Long-term outcome in CT/CBT?

Earlier in this discussion Doug William asked about the long-term results of CT & CBT given humans' proclivity to revert back to old behaviors. This is indeed an area where all approaches to psychotherapy face quite a bit of uncertainty. Long-term follow-ups are difficult and expensive to do (given the high level of mobility in our culture, simply finding the subjects 5 years following treatment is difficult) and therefore these studies aren't done very often.

Steve Hollon wrote a brief article (reference below) where he discusses a couple dozen studies that he sees demonstrating that CT has enduring effects. However, many of these studies involved one- to two-year follow-ups. I don't know of any studies with a 10- or 20-year follow-up other that one case of CBT for agoraphobia with an 11-year follow-up.

It certainly is reasonable to think that improvement is likely to persist in the long run if it persists through the first year or two since there are a number of problems where the risk of relapse is highest during the period immediately following treatment and decreases over time. However, not everything that is reasonable is true.

My clinical experience is that on the rare occasions when I hear from a former client years after the conclusion of treatment, it often turns out that they have maintained the gains they made in therapy. However, it is important not to place too much emphasis on a few case examples. It is quite possible that the clients who do well in the long run are most likely to refer their friends and relatives to me, to send me a note a few years after treatment, or to say "Hi" if they see me in public.

Data about the long-term outcome of various treatment options would be quite useful. My bet is that the long-term results aren't yet as good as we'd like, but that CT/CBT would compare quite favorable with other treatment options.
Hollon, S. D. (2003). Does cognitive therapy have an enduring effect? Cognitive Therapy and Research, 27, 71-75.
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