Results

Effectiveness, sufficiency and suitability

Design and methods of the Helsinki Psychotherapy Study, and results on the effectiveness and cost-effectiveness of the two brief therapies, short-term psychodynamic and solution-focused, during the 1-year follow-up:

• Knekt P, Lindfors O (eds.). A randomized trial of the effect of four forms of psychotherapy on depressive and anxiety disorders. Design, methods, and results on the effectiveness of short-term psychodynamic psychotherapy and solution-focused therapy during a one-year follow-up. Helsinki: The Social Insurance Institution, Studies in social security and health 77, 2004.

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• Maljanen T, Tillman P, Härkänen T, Lindfors O, Laaksonen MA, Haaramo P, Knekt P. The cost-effectiveness of short-term psychodynamic psychotherapy and solution-focused therapy in the treatment of depressive and anxiety disorders during a one-year follow-up. J Ment Health Policy Econ 2012; 15: 13-23.

Results on the effectiveness of the solution-focused therapy, short-term and long-term psychodynamic psychotherapy during the 3-year follow-up:

• Knekt P, Lindfors O, Härkänen T, Välikoski M, Virtala E, Laaksonen MA, Marttunen M, Kaipainen M, Renlund C and the Helsinki Psychotherapy Study Group. Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychol Med 2008; 38: 689-703.

• Knekt P, Lindfors O, Laaksonen MA, Raitasalo R, Haaramo P, Järvikoski A, the Helsinki Psychotherapy Study Group. Effectiveness of short-term and long-term psychotherapy on work ability and functional capacity - A randomized clinical trial on depressive and anxiety disorders. J Affect Disord 2008; 107: 95-106.

• Knekt P, Laaksonen MA, Raitasalo R, Haaramo P, Lindfors O. Changes in lifestyle for psychiatric patients three years after the start of short- and long-term psychodynamic psychotherapy and solution-focused therapy. Eur Psychiatry 2010; 25: 1-7.

• Lindfors O, Knekt P, Virtala E, Laaksonen MA. The effectiveness of solution-focused and short- and long-term psychodynamic psychotherapy on self-concept during a 3-year follow-up. J Nerv Ment Dis 2012; 200: 946-953.

Reports covering the three randomized psychotherapies and psychoanalysis during the 5-year follow-up:

• Jyrä K, Knekt P, Lindfors O. The impact of psychotherapy treatments of different length and type on health behaviour during a five-year follow-up. Psychother Res 2017; 27: 397-409.

• Knekt P, Lindfors O, Laaksonen MA, Renlund C, Haaramo P, Härkänen T, Virtala E, and the Helsinki Psychotherapy Study Group. Quasi-experimental study on the effectiveness of psychoanalysis, long-term and short-term psychotherapy on psychiatric symptoms, work ability and functional capacity during a 5-year follow-up. J Affect Disord 2011; 132: 37-47.

• Knekt P, Lindfors O, Renlund C, Laaksonen MA, Haaramo P, Virtala E. Use of auxiliary treatment during a 5-year follow-up among patients receiving short- or long-term therapy. J Affect Disord 2011; 135: 221-230.

• Knekt P, Laaksonen MA, Härkänen T, Maljanen T, Heinonen E, Virtala E, Lindfors O. The Helsinki Psychotherapy Study: effectiveness, sufficiency, and suitability of short- and long-term psychotherapy. In: Levy R, Ablon JS, Kächele H (eds.). Psychodynamic psychotherapy research. Humana Press, 2012, 71-94.

• Knekt P, Lindfors O, Sares-Jäske L, Virtala E, Härkänen T. Randomized trial on the effectiveness of long- and short-term psychotherapy on psychiatric symptoms and working ability during a 5-year follow-up. Nord J Psychiatry 2013; 67: 59-68.

• Knekt P, Heinonen E, Härkäpää K, Järvikoski A, Rissanen J, Lindfors, O. Randomized trial on the effectiveness of long- and short-term psychotherapy on psychosocial functioning and quality of life during a 5-year follow-up. Psychiatry Res 2015; 229: 381-388.

• Knekt P, Lindfors O, Heinonen E, Maljanen T, Virtala E, Härkänen T. The effectiveness of three psychotherapies of different type and length in the treatment of patients suffering from anxiety disorders. In: Ochs M, Borcsa M, Schweitzer J (Eds.). Systemic Research in Individual, Couple, and Family Therapy and Counseling. European Family Association Series, Vol. 5. Cham: Springer International, 2020. 

• Maljanen T, Knekt P, Lindfors O, Virtala E, Tillman P, Härkänen T, the Helsinki Psychotherapy Study Group. The cost-effectiveness of short-term and long-term psychotherapy in the treatment of depressive and anxiety disorders during a 5-year follow-up. J Affect Dis 2015; 190: 254-263.

Reports covering the 10-year follow-up:

• Knekt P, Virtala E, Härkänen T, Vaarama M, Lehtonen J, Lindfors O. The outcome of short- and long-term psychotherapy 10 years after start of treatment. Psychological Medicine 2016; 46: 1175-1188.

• Knekt P, Heinonen E, Lindfors O. Follow-up of the effectiveness of long-term psychodynamic psychotherapy and psychoanalysis 5 years after the end of psychoanalysis:  Minor differences in psychiatric symptoms and work ability. Neurol Psychiatry Brain Res 2018;30:163–166.

• Lindfors O, Knekt P, Lehtonen J, Virtala E, Maljanen T, Härkänen T. Effectiveness of psychoanalysis and long-term psychodynamic psychotherapy on personality and social functioning 10 years after start of treatment. Psychiatry Res 2019;272:774–783.

 Reports on the pretreatment predictors of outcomes and therapeutic alliance:

•  Alanne C, Heinonen E, Knekt P, Rissanen J, Virtala E, Lindfors O. Predicting improvement of work ability in modalities of short- and long-term psychotherapy: the differential impact of reflective ability and other aspects of patient suitability. J Clin Psych 2021, doi: 10.1002/jclp.23128 

• Heinonen E, Lindfors O, Laaksonen MA, Knekt P. Therapists' professional and personal characteristics as predictors of outcome in short- and long-term psychotherapy Journal of Affective Disorders. J Affect Disord 2012; 138: 301-312.

• Heinonen E, Knekt P, Jääskeläinen T, Lindfors O. Therapists' professional and personal characteristics as predictors of outcome in long-term psychodynamic psychotherapy and psychoanalysis. Eur Psychiatry 2014; 29: 265-274.

• Heinonen E, Lindfors O, Härkänen T, Virtala E, Jääskeläinen T, Knekt P. Therapists' professional and personal characteristics as predictors of working alliance in short-term and long-term psychotherapies. Clin Psychol Psychother 2014; 21: 475-494.

• Heinonen E, Knekt P, Härkänen T, Virtala E, Lindfors O. Associations of early childhood adversities with mental disorders, psychological functioning, and suitability for psychotherapy in adulthood. Psychiatr Res 2018; 264: 366-373.

• Heinonen E, Knekt P, Härkänen T, Virtala E, Lindfors O. Childhood adversities as predictors of improvement in psychiatric symptoms and global functioning in solution-focused and short- and long-term psychodynamic psychotherapy during a 5-year follow-up. J Aff Disord 2018; 235: 525-534.

• Joutsenniemi K, Laaksonen MA, Knekt P, Haaramo P, Lindfors O. Prediction of the outcome of short- and long-term psychotherapy based on socio-demographic factors. J Affect Disord 2012; 141: 331-342.

• Knekt P, Grandell L, Sares-Jäske L, Lindfors O. Poor suitability for psychotherapy – a risk factor for treatment non-attendance? J Affective Disord 2021; 295: 1432-1439. 

• Knekt P, Lindfors O, Keinänen M, Heinonen E, Virtala E, Härkänen T. The prediction of the level of personality organization on reduction of psychiatric symptoms, and improvement of work ability in short- vs. long-term psychotherapy during a 5-year follow-up. Psychology and Psychotherapy: Theory, Research and Practice 2017; 90: 353-376.

• Knekt P, Saari T, Lindfors O. Intelligence as a predictor of outcome in short- and long-term psychotherapy. Psychiatry Res 2014; 220: 1019-1027.

• Korhonen E, Lindfors O, Knekt P. Sosiaalisen tuen vaikutus työ- ja toimintakykyyn lyhyessä ja pitkässä psykoterapiassa [Social support as a predictor work ability and functional capacity in short- and long-term psychotherapy. Psykologia 2020; 55: 337-401.

• Laaksonen MA, Knekt P, Sares-Jäske L, Lindfors O. Psychological predictors on the outcome of short-term psychodynamic psychotherapy and solution-focused therapy in the treatment of mood and anxiety disorder. Eur Psychiatry 2013; 28: 117-124.

• Laaksonen MA, Knekt P, Lindfors O. Psychological predictors of the recovery from mood or anxiety disorder in short-term and long-term psychotherapy during a 3-year follow-up. Psychiatry Res 2013; 208: 162-173.

• Lindfors O, Knekt P, Virtala E.  Quality of object relations modifies the effectiveness of short- and long-term psychotherapy on self-concept. Open Journal of Psychiatry, 2013, 3: 345-350.

• Lindfors O, Knekt P, Heinonen E, Virtala E. Self-concept and quality of object relations as predictors of outcome in short- and long-term psychotherapy. J Affect Disord 2014; 152-154: 202-211.

• Lindfors O, Ojanen S, Jääskeläinen T, Knekt P. Social support as a predictor of the outcome of depressive and anxiety disorder in short-term and long-term psychotherapy.Psychiatry Res 2014; 216: 44-51.

• Marttunen M, Välikoski M, Lindfors O, Laaksonen MA, Knekt P. Pretreatment clinical and psychosocial predictors of remission from depression after short-term psychodynamic psychotherapy and solution-focused therapy: a 1-year follow-up study. Psychother Res 2008; 18: 191-199.

• Ollila P, Knekt P, Heinonen E, Lindfors O. Patients’ pre-treatment interpersonal problems as predictors of therapeutic alliance in long-term psychodynamic psychotherapy. Psychiatry Res 2016; 30:110-117.

Methodological reports

• Härkänen T, Knekt P, Virtala E, Lindfors O. A case study in comparing therapies involving informative drop-out, non-ignorable non-compliance and repeated measurements. Stat Med 2005; 24: 3773-3787.

• Härkänen T, Arjas E, Laaksonen MA, Lindfors O, Haukka J, Knekt P. Estimating efficacy in the presence of non-ignorable non-trial interventions in the Helsinki Psychotherapy Study. Stat Methods Med Res 2013 [Epub ahead of print].

• Härkänen T, Maljanen T, Lindfors O, Virtala E, Knekt P. Confounding and Missing Data in Cost-Effectiveness Analysis: Comparing different methods. Health Econ Rev 2013,  [Epub ahead of print].

• Hannula JA, Lahtela K, Järvikoski A, Salminen JK, Mäkelä P. Occupational Functioning Scale (OFS) - An instrument for assessment of work ability in psychiatric disorders. Nord J Psychiatry 2006; 60: 372-378.

• Knekt P, Lindfors O, Laaksonen MA. Effectiveness of long-term psychodynamic psychotherapy. Commentary. Evid Based Ment Health 2009; 12: 56.

• Laaksonen MA, Lindfors O, Knekt P, Aalberg V. Suitability for Psychotherapy Scale (SPS) and its reliability, validity, and prediction. Br J Clin Psychol 2012; 51: 351-375. 

• Lindfors O, Laaksonen M, Knekt P. Psykoterapian tarpeen ja soveltuvuuden arviointi haastattelumenetelmällä. [Assessment of the need and suitability of psychotherapy by means of clinical interview]. Psykoterapia 2016; 35: 3-19.

• Lindfors O, Knekt P, Virtala E, Haaramo P, Laaksonen MA. Concurrent validity of the Quality of Object Relations Scale (QORS) in relation to proxy assessment of the theoretical scale constituents. Psychopathology 2013; 46: 111-119.

• Stenius J, Lindfors O, Antikainen R, Wahlström J, Sares-Jäske L, Knekt P. Associations between the Rorschach Ego Impairment Index and measures on intrapsychic and interpersonal functioning. Open J Psychiatry 2018; 8: 1-19.

• Stenius J, Knekt P, Heinonen E, Holma J, Antikainen R. & Lindfors O. Predicting the Working Alliance Over the Course of Long-Term Psychodynamic Psychotherapy With the Rorschach Ego Impairment Index, Self-Reported Defense Style, and Performance-Based Intelligence: An Evaluation of Three Methodological Approaches. Psychoanalytic Psychology 2021; 38(1): 58-67. 

• Valkonen H, Lindfors O, Laaksonen MA, Knekt P. Association between the Rorschach Ego Impairment Index (EII-2) and the Level of Personality Organization. Psychiatr Res 2012; 200: 849-856.

Qualitative study

• Happo H, Wahlström J, Lindfors O. Mitä psykoterapiassa opitaan? Kokemuksia lyhyestä psykodynaamisesta psykoterapiasta ja voimavarasuuntautuneesta terapiasta. [What is to be learned in psychotherapy? Experiences from short-term psychodynamic psychotherapy and solution-focused therapy]. Psykologia 2014; 5: 339-369.

• Junttila O, Härkäpää K, Lindfors O, Järvikoski A. Psykoterapia ja opiskelukyvyn muutos [Psychotherapy and changes in the ability to study]. Kuntoutus 2012; 1: 43-57.

• Valkonen J, Ehrling L, Lindfors O, Helsingin Psykoterapiaprojektin tutkijaryhmä. Psykoterapian merkitykset ja haastattelukontekstit - katsaus laadulliseen tutkimukseen Helsingin Psykoterapiaprojektissa [Meanings of psychotherapy and contexts of interview - a review of qualitative research in the Helsinki Psychotherapy Study]. Psykoterapia 2006; 25: 45-59.

• Valkonen J, Hänninen V, Lindfors O. Maskuliinisuus miesten masennustarinoissa. [Masculinity in men's narratives of depression ]. Psykologia 2012; 47: 266-278.

• Valkonen J, Hänninen V, Lindfors O. Outcomes of psychotherapy from the perspective of the users. Psychother Res 2011; 21: 227-240

• Valkonen J, Lindfors O. Perinteinen maskuliinisuus miesten psykoterapian haasteena. [Traditional masculinity as a challenge to psychotherapy]. Psykoterapia 2012; 31: 330–347.

• Vehviläinen S, Ehrling L, Peräkylä A, Lindfors O, Helsingin Psykoterapiaprojektin tutkijaryhmä. Diagnostinen seurantahaastattelu vuorovaikutuksena [Diagnostic follow-up interview as a form of interaction]. Psykologia 2007; 42: 332-349.

• Vehviläinen S, Lindfors O. Itsereflektio ja kohentunut vointi haastattelupuheessa [Self-reflection and reports of improved condition in interview talk]. Aikuiskasvatus 2005; 3: 191-202.