This paper should give solace to those who practice and/or research short-term or time-limited psychodynamic therapy.
While most of the studies included in this analysis provided equal number of sessions for cognitive-behavior and psychodynamic therapies, in some of them, the number of sessions was greater for those receiving psychodynamic therapy. Even in shorter term treatment models, psychodynamic therapy may require more sessions than cognitive-behavior therapy.
In the US, billing codes and reimbursement for the different types of psychotherapy are the same. However, health insurances may limit the total number of sessions of psychotherapy that they pay for per year. Therefore, access to longer-term psychodynamic psychotherapy continues to be a problem for many patients.
In this analysis, only clinical trials that used manual-guided psychotherapy were included. Of course, in clinical practice, manual-guided psychotherapy is not commonly used, especially not for psychodynamic therapy. In my opinion, adoption of manual-guided psychotherapy can be a major advance in the quality of psychotherapy training and practice.
The clinicians providing psychotherapy, both psychodynamic and cognitive-behavior therapy, in clinical trials may have different levels of expertise than clinicians in general. Therefore, all psychotherapy studies have more difficulty generalizing to routine clinical practice than studies in psychopharmacology.
While overall the treatments were equally efficacious, it is possible (and probably likely) that one type of treatment may be more efficacious than another for some patients with some conditions. This is what future research should focus on.
In the meanwhile, when one treatment modality is not helpful, it is probably clinically wise to consider a different modality.