Cognitive Therapy vs. Short‐Term Dynamic Psychotherapy in a Community Mental Health Setting: A Preliminary Analysis of Effects in Several Severity Domains

OBJECTIVE: To investigate the effectiveness of cognitive therapy (CT) and short-term dynamic psychotherapy (STDP) among patients with greater severity, defined in several ways, in a community mental health setting. METHOD: Using data from a randomized noninferiority trial, we examined five baseline severity variables as potential moderators of treatment effects: depressive symptoms, interpersonal problems, mental functioning, physical functioning and quality of life. The outcome was a change in depressive symptoms over the course of up to 5 months of treatment. Linear mixed-effects models were implemented to compare slopes of change over time. We hypothesized that CT would be superior to STDP for those with severe depressive symptoms, severe mental and physical functioning and severely impaired quality of life, but STDP would be superior to CT for those with severe interpersonal problems. RESULTS: There was no evidence of superiority within any of the five severity domains. CONCLUSIONS: Findings inform the comparative effectiveness of CT and STDP among patients with greater severity and extend prior work by incorporating interpersonal, functioning and quality of life severity indicators.