background In the Netherlands the costs of long-term outpatient psychotherapy are no longer reimbursed by health insurance. This means that many patients now have no access to this form of treatment. This article discusses whether long-term psychotherapy deserves to be included in the range of treatments covered by health insurance.
aim To review the literature on the effectiveness of long-term outpatient psychotherapy in patients suffering from various specific mental disorders.
method To review the literature critically with the help of PubMed, Psycinfo and the Cochrane library databases and using the search terms for specific mental disorders combined with the key word 'psychotherapy' and terms relating to effectivity, e.g. 'effectiveness' or 'outcome'.
results Long-term psychotherapy is effective in patients with personality disorders, especially those included in clusters B or C. Patients with chronic or recurrent depression are less likely to suffer a relapse if they have received long-term psychotherapy. A few studies show that long-term psychotherapy is also effective in special groups of patients suffering from an eating disorder, bipolar disorder or a schizophrenic disorder.
conclusion Long-term psychotherapy is an effective form of treatment for various groups of patients and should definitely not be dropped from the range of psychotherapy treatments available to patients. Long-term psychotherapy is an important step between short-term outpatient psychotherapy and daycentre and inpatient treatment programmes.