[Report of the Dutch Health Council on the cost-effectiveness of long-term psychotherapy]

A recent report from the Health Council of the Netherlands considers the cost-effectiveness of long-term psychotherapy (more than 25 sessions over a period of more than one year). It is concluded that knowledge about the efficacy and effectiveness of this form of therapy is scarce, and the cost-effectiveness is largely unknown. A plea is made for further research and for restraints in the administration of such therapy. However, research into the efficacy of long-term psychotherapy requires a controlled design, with the selection and randomisation of patients. This precludes definitive conclusions with regard to the cost-effectiveness in open patient groups. Moreover, psychotherapy is not only aimed at a cure, but also to a fairly large extent at care. Finally, if it is difficult to determine the efficacy of psychotherapy then this is even more so the case for long-term psychotherapy, as the success may be attributable to a wide range of intervening events that occur during the course of treatment.