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

Objectives: We investigated how patients' psychological capacities to engage in psychotherapy predict changes in work ability in short- and long-term psychotherapy.

Methods: A cohort study of 326 patients, aged 20-46 years and suffering from mood and anxiety disorders, treated by short-term solution-focused, short-term psychodynamic, or long-term psychodynamic psychotherapy, followed-up for 5 years. The Suitability for Psychotherapy Scale, assessed at baseline, was the predictor. Outcomes were assessed at baseline and at six follow-up occasions using the Work Ability Index as the primary indicator.

Results: Patients with good pretreatment psychological suitability for psychotherapy, good reflective ability in particular, improved more than patients with poor suitability in short-term psychodynamic psychotherapy. Comparisons between therapy groups showed poorer suitability to predict more improvement in solution-focused and in long-term psychodynamic psychotherapy than in short-term psychodynamic psychotherapy.

Conclusion: Patients' psychological suitability for psychotherapy has a different impact on work ability in different therapy modalities and durations.