Overall Treatment Results

PRP was conceived as a study of changes that come about and how they are brought about in psychoanalysis and in long-term and intensive psychoanalytic psychotherapies. It has already been emphasized (see p.) that PRP was not a comparative study of the efficacy, the reach, and the limitations of these two modalities, psychoanalysis and psychotherapy, against each other in relation to comparable patients. Our naturalistic design—the commitment to offer treatment to each prospective patient who wanted and could use it, and especially the commitment to offer each prospective patient that treatment modality deemed clinically most indicated for him or her in terms of the current extant knowledge in the field—meant that we were in a position only to study each kind of therapy against itself, against its own indications, in order to see how well it realized or fell short of the usual expectations for it.

Therefore, though we had 22 patients in psychoanalysis (at least started in psychoanalysis; as noted earlier, 6 of these were converted subsequently to psychotherapy) and 20 in varyingly expressive and supportive psychoanalytic psychotherapy from the start, the rough global judgments of how each patient did overall do not provide any information (even soft information) on the comparative efficacy of these two major approaches, though they do provide some (soft) information about the extent to which each of these approaches fulfilled its own promise with the patients deemed appropriate for it. As I indicate in this chapter and the next, the two major treatment modalities did about equally well for the patients who received them, both on a rough 4-point improvement scale (my judgments at this overview point of really good improvement, moderate improvement, equivocal improvement, and no change or treatment failure) and in scored changes on the 100-point anchored HSRS (see pp. 5, 79).

Of course, one must also bear in mind i