Costs and benefits of psychotherapy.

Abstract

Cost-benefit analyses to translate treatment costs and effects into monetary units. For a cost-benefit analyses of psychotherapy data, direct costs can be most easily and reliably estimated; but indirect costs of treatment and the effects of treatment are difficult to estimate. Among these are such considerations as lost pay, disruption of relationships, embarrassment and anxiety. There are also costs associated with not having treatment--e.g., compromise of personal and familial immunologic systems, lost productivity. But, for the sake of simplicity, we focus on the direct monetary costs of treatment. We have developed theoretical frameworks--the dosage and phase models--within which to approach a cost-benefit analysis of psychotherapy. The dosage model specifies a lawful relationship between number of sessions and therapeutic benefit. The phase model utilizes a three-component conception of psychotherapy--remoralization, remediation, and rehabilitation--and allows for differential cost-benefit analyses for specific therapeutic benefits.