[The Dusseldorf short-term dynamic psychotherapy project (DKZP)]

Time-limited psychodynamic therapies in the outpatient setting are offered for a broad spectrum of psychogenic disorders. Meta-analyses prove their effectiveness mainly for neurotic disorders. We are interested in the suitability of the here applied CMP/SASB model (Tress et al. 1996) of psychodynamic short-term therapy for patients with psychosomatic and severe personality disorders. We extensively present the concept of Cyclic Mal-adaptive Pattern (CMP) in its clinically relevant parts as the core of psychogenic pathological developments. Particularly the introject, as the patient's attitude towards him- or herself, is of great importance for therapeutic change and its follow-up development. Within the DKZP (Duesseldorf Short-Term Psychotherapy Project), 36 male and female therapists, mostly interns at the local university clinic, treated 82 patients (m: 23/f: 59) with personality disorders (n = 26) and psychosomatic disorders (n = 31) as research groups and, in comparison, neurotic patients (n = 25) in a naturalistic design. 68 treatments have been completed so far, 11 patients have dropped out, the remaining 3 are still in therapy. Relevant research instruments are the Beeinträchtigungsschwere Score (BSS, an impairment score), Global Assessment of Functioning Scale (GAF), Cyclic Maladaptive Pattern (CMP), Symptom Check List (SCL-90-R), and Structural Analysis of Social Behavior (SASB) including process and content ratings, as well as the Intrex questionnaire. The treatments last 25 sessions. We carried out follow-up examinations after 6 months, 1 year, 2, and 5 years. Effect sizes for the whole sample by BSS and GAF are remarkably high, with further increase at follow-up interviews. Psychosomatic patients came off best, but personality disorders in comparison to neurotic patients profited surprisingly well. Effect sizes in self-rating (SCL and Intrex) were less high. However, in self-rating the changes of social functions are not sufficiently addressed. As a result, our form of focal therapy is well suited not only for neuroses, but also for psychosomatic disorders and personality disorders. An enlargement of the indication spectrum for this form of psychodynamic therapy to include these disorders is well founded and promising.