Severity of psychiatric symptoms as a predictor of benefits from psychotherapy: the Veterans Administration-Penn study [published erratum appears in Am J Psychiatry 1989 Dec;146(12):1651]

Authors:
  • GWG E Woody
    G E Woody
  • AMA T McLellan
    A T McLellan
  • LLL Luborsky
    L Luborsky
  • COC P O'Brien
    C P O'Brien
  • JBJ Blaine
    J Blaine
  • SFS Fox
    S Fox
  • IHI Herman
    I Herman
  • ABA T Beck
    A T Beck
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Abstract
One hundred ten nonpsychotic opiate addicts were randomly assigned to receive paraprofessional drug counseling alone, counseling plus cognitive-behavioral psychotherapy, or counseling plus supportive- expressive psychotherapy. Patients were classified low-severity, mid- severity, or high-severity on the basis of the number and severity of their psychiatric symptoms. Overall, the addition of professional psychotherapy was associated with greater benefits than was drug counseling alone. Low-severity patients made considerable and approximately equal progress with added psychotherapy or with counseling alone. Mid-severity patients had better outcomes with additional psychotherapy than with counseling alone, but counseling did effect numerous significant improvements. High-severity patients made little progress with counseling alone, but with added psychotherapy made considerable progress and used both prescribed and illicit drugs less often.

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