Evaluating the Cost Effectiveness of ISTDP: A Quasi Experimental Study

Importance: Psychiatric and psychological disorders result in excess health care service use and costs. Brief psychotherapy methods may be effective across a broad range of mental disorders and could therefore result in healthcare cost reduction.

Objective: To evaluate whether or not cases treated with Intensive Short-term Dynamic Psychotherapy (ISTDP) facilitate healthcare cost reduction, whether any observed reduction is greater than that of a control group and whether any such gains would be maintained in follow up.

Design: A quasi-experimental design was employed in which pre and post healthcare cost and usage data were extracted for all ISTDP treated cases from 1999 to 2008 and compared to parallel measures of a control group of cases referred but never treated.

Setting: Treatments were provided at an urban University based psychotherapy service.

Participants: All cases from the province of Nova Scotia treated within the research time frame were included. 890 patients were included with a very broad range of psychiatric disorders including anxiety, mood, somatoform, personality and psychotic disorders. 192 referred but never see cases served as non randomized controls.

Intervention(s): ISTDP is an emotionally focused form of brief psychotherapy which has supportive, cognitive, experiential and primarily psychodynamic elements. In this setting the average length of treatment was 7.3 sessions and cost an estimated $500 dollars per treatment course.

Inclusion criteria

• All patients referred for ISTDP treatment

Exclusion criteria

• Patients not referred for ISTDP treatment