Comparison of brief dynamic and cognitive-behavioural therapies in avoidant personality disorder

Background There is a paucity of controlled trials examining the effectiveness of individual psychotherapy in personality disorders, especially in patients with cluster C disorders.

Aims To compare the effectiveness of brief dynamic therapy and cognitive-behavioural therapy as out-patient treatment for people with avoidant personality disorder.

Method Patients who met the criteria for avoidant personality disorder (n=62) were randomly assigned to 20 weekly sessions of either brief dynamic therapy (n=23) or cognitive-behavioural therapy (n=21), or they were assigned to the waiting-list control group (n=18). After the waiting period, patients in the control group were randomly assigned to one of the two therapies.

Results Patients who received cognitive-behavioural therapy showed significantly more improvements on a number of measures in comparison with those who had brief dynamic psychotherapy or were in the waiting-list control group. Results were maintained at follow-up.

Conclusions Cognitive-behavioural therapy is more effective than waiting-list control and brief dynamic therapy. Brief dynamic therapy was no better than the waiting-list control condition.

Declaration of interest None. Funding detailed in Acknowledgements.