Outcome of Individual Outpatient Psychotherapy in Adults Under Clinically Representative Conditions in Austria

Abstract

Background

While randomised controlled trials have established the efficacy of psychotherapy, their applicability to routine care is limited. Naturalistic studies offer ecological validity, but representative data for the effectiveness of psychotherapy in Austrian outpatient private settings are lacking.

Aim

This study examined psychotherapy outcomes under real-world conditions in Austria.

Method

Austrian psychotherapists in outpatient private practice were invited to participate by enrolling patients in the study (recruitment: September 2020 to December 2023). Outcomes were assessed at the start of therapy (baseline assessment) and at the end of therapy or study (post assessment). Outcome questionnaires included the Positive Mental Health Scale (PMH), the WHO Disability Assessment Schedule (WHODAS), the Patient Health Questionnaire-9 (PHQ-9), the Generalised Anxiety Disorder Scale-7 (GAD-7), and the Standardised Assessment of Severity of Personality Disorder (SAS-PD).

Results

Eighty-seven psychotherapists from the four psychotherapeutic clusters (psychoanalytic-psychodynamic, humanistic, systemic, behavioural) participated in the study. Of 163 patients completing the baseline-assessment, 58 (35.6%) provided post-assessment data (treated by 39 psychotherapists). Missing post-assessment values were estimated using the Baseline Observation Carried Forward method, yielding small to moderate effect sizes (d = 0.21 to 0.48), and the Expectation Maximisation method, resulting in small to large effects (d = 0.32 to 1.08). Analyses based on the patients with complete baseline- and post-assessment revealed small to large effects (d = 0.36 to 1.03).

Conclusions

Results indicate that psychotherapy in Austrian private practice yields significant improvements in mental health. Future studies should investigate strategies to enhance recruitment to ensure a more comprehensive database for psychotherapy research in Austria.