Stuttgart TRANS-OP study

Puschner, B., Kraft, S., & Bauer, S. (2004). Interpersonal problems and outcome in outpatient psychotherapy: Findings from a long-term longitudinal study in Germany. Journal of Personality Assessment, 83(3), 223-234.

Puschner, B., Kraft, S., Kächele, H., & Kordy, H. (2007). Course of improvement during two years in psychoanalytic and psychodynamic outpatient psychotherapy. Psychology and Psychotherapy, 80, 51-68.

Puschner, B., Wolf, M., & Bauer, S. F. (2008). Helping alliance and outcome in psychotherapy: What predicts what in routine outpatient treatment? Psychotherapy Research, 18(2), 167-178.


To assess and predict level and course of symptomatic improvement in psychoanalytic (PA) and psychodynamic psychotherapy (PD).

Material and Methods

In a comprehensive longitudinal study, course of improvement of 116 patients in PA and of 357 patients PD was tracked over a period of two years and analyzed via hierarchical linear models.


At baseline, over 90% of the patients reported considerable psychological, physical, or interpersonal distress. In both forms of treatment, course of improvement was best fitted by a linear model as compared to a logarithmic one. Symptom distress decreased notably within two years, with an especially sharp decline already before the beginning of treatment. No significant differences between forms of treatment as to level or pace of symptom improvement could be observed. Prediction of speed of improvement was poor, with initial symptom distress showing the strongest influence, while initial helping alliance had no predictive value. When comparing patients who finished their treatment within the two-year observation period to those with still ongoing treatments, the former showed quicker symptom improvement.


Implications for psychotherapy provision are pertinent for issues of allocation of ressources.


Dr. Hans Kordy

Center for Psychotherapy Research, University of Heidelberg