Thomä H
Psyche (Stuttg). 1994 Apr;48(4):287-323.
In early 1993 Germany's health care insurance system decided to exclude high-frequency analytic therapy involving four to five sessions weekly from the list of medical treatment covered by the health insurance provisions. In the present journal the controversy about the frequency and duration of analytic therapy and the efficacy of high-frequency, long-term analytic treatment as opposed to low-frequency psychotherapy has been reflected in the form of a critical commentary (Kaiser, 9/1993) and a review article (Trimborn, 11/1993). Thomä rejects the assumption that high frequency and long duration are invariably necessary conditions for success, advocating greater flexibility in making frequency and duration dependent on the actual changes achieved in the patient's condition by ongoing therapy. The author calls for the employment of differential, "adaptive" indication criteria, his main criticisms being levelled at the form of psychoanalytic training that fails to school young analysts in the selection of the procedures best suited to individual patients. As it is a generally accepted fact that psychic changes take time, the author concludes that successful therapy is not a matter of frequency but a function of extension over time, thus making duration of therapy the operative factor.
1993年初，德国医疗保险系统决定将每周进行四至五次的高频分析疗法排除在医疗保险条款所涵盖的医疗治疗清单之外。在本期刊中，关于分析疗法的频率和时长以及高频、长期分析治疗与低频心理治疗疗效的争议，已通过一篇批判性评论（凯泽，1993年9月）和一篇综述文章（特林伯恩，1993年11月）的形式得到体现。托马反对那种认为高频和长时间是成功的必然必要条件的假设，主张在使频率和时长取决于持续治疗在患者病情中实际取得的变化方面要有更大的灵活性。作者呼吁采用差异化的“适应性”适应症标准，他主要批评的是精神分析培训的形式，这种形式未能让年轻分析师学会选择最适合个体患者的治疗程序。由于心理变化需要时间是一个普遍公认的事实，作者得出结论，成功的治疗不是频率的问题，而是随时间延长的结果，因此使治疗时长成为起作用的因素。
