Psychotherapy has long been recognised as an effective tool for treating mental disorders and improving mental health. However, questions about its effectiveness are still relevant, especially when it comes to new forms of provision or specific periods (for example, the provision of psychotherapy during the Covid-19 pandemic). It was as a result of the pandemic that the Czech Republic established the Increasing Access to Psychosocial Support programme in 2022, under which selected insurance companies contributed a certain amount to psychotherapy for their clients. Therefore, the current Czech study, conducted by members of the Center for Psychotherapy Research team, focused on evaluating the effectiveness of short-term psychotherapy with private psychotherapists funded by this preventive programme.
The study was created by a team of authors Tomáš Řiháček and Michal Čevelíček, together with Petr Doležaland Jan Nehyba. The researchers had two main objectives:
- To find out how much change in psychotherapy was achieved by clients who benefited from the insurance contribution. These changes were measured for depressive, anxiety and somatic symptoms (e.g. chronic pain or insomnia).
- To discover factors that might be related to the magnitude of this change (e.g., client age or therapist length of experience).
The study included 2057 adult clients. Therapy was provided by 228 therapists who received different training and advocated different approaches. Data on the clients were collected using the DeePsy application developed by a team of staff from Brno University of Technology and Masaryk University, including Tomáš Řiháček. Clients completed questionnaires at the beginning and end of the therapy, which had a maximum of 10 sessions.
The severity of the problems plays a primary role
The results showed that the therapy led to a statistically significant reduction of depressive symptoms in 21% of clients, anxiety symptoms in 33% of clients and somatic symptoms in 11%. The lower effect of psychotherapy on somatic symptoms may be explained by the fact that, unlike psychological symptoms, psychotherapy affects somatic symptoms only indirectly, through psychological mechanisms. Nevertheless, the results suggest that even short-term therapy can bring significant improvements.
The only significant factor that was related to the resulting change after psychotherapy was the initial severity of the difficulties. Clients with higher symptom severity before therapy showed greater rates of improvement after therapy. In contrast, factors such as the therapist's length of experience or theoretical orientation were minimally related to psychotherapy outcome.
Thus, the health insurance pilot programme shows that even short-term psychotherapy can bring significant improvements in clients' mental health. At the same time, the magnitude of change found in depression and anxiety is consistent with the effectiveness of psychotherapy commonly reported in similar studies abroad. However, the authors mention that the fact that a large proportion of the sample consisted of clients with low levels of symptoms may have influenced the results. Therefore, they say it is possible that some factors did not show up in the analysis. The authors also point out that the absence of a control group makes it impossible to distinguish the effect of therapy from other sources of change.
Translated with DeepL.com (free version)
Recommended Citation:
Řiháček, T., Čevelíček, M., Doležal, P., & Nehyba, J. (2024). Effectiveness of psychotherapeutic care within preventive programs of health insurance companies. Czechoslovak Psychology, 68(3), 308-330. https://doi.org/10.51561/cspsych.68.3.308
