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We estimated the hazard ratio (HR) of subsequent psychological treatment over several years following the initial psychological intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This naturalistic register follow\u2010up study in Finland included patients receiving therapist\u2010guided iCBT (2013\u20132021,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930,934) or \u226420\u2010session psychotherapy (2018\u20132021,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093348), and matched population controls (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200992,846). Their long\u2010term psychotherapy data (\u2264200 sessions\/3\u2009years, requiring prior treatment) were obtained from the Social Insurance Institution. We used Cox proportional hazard regression, adjusting for age, sex, first purchase of psychotropic drugs and onset of the first psychiatric diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Given the adjustments, the hazard of subsequent long\u2010term psychotherapy was fourfold after iCBT (HR\u2009=\u20094.08; 95% CI 3.81\u20134.37) and nearly ninefold after \u226420\u2010session psychotherapy (HR\u2009=\u20098.94; CI 7.79\u201310.26), compared to those without these prior treatments. Prior \u226420\u2010session psychotherapy was associated with reduced hazard of entering subsequent iCBT (HR .12, CI .09\u2013.16), while prior long\u2010term psychotherapy was not (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.087). Prior iCBT was associated with a lower hazard of subsequent \u226420\u2010session psychotherapy (HR\u2009=\u2009.41, CI\u2009=\u2009.35\u2013.47), while prior long\u2010term psychotherapy was not (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.332).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mapping the succession of psychological treatments added knowledge and revealed surprises. For example, patients receiving therapist\u2010guided iCBT were less likely to access subsequent face\u2010to\u2010face psychotherapy than those initially treated face\u2010to\u2010face. While past services are used as a convenience indicator for future services, future research on successive psychological treatments should continue to disentangle clinical need from service systems effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bjc.70036","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T07:35:12Z","timestamp":1767684912000},"page":"451-469","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapy after therapy: Entry rates into subsequent psychological treatment among patients receiving therapist\u2010guided internet\u2010delivered or face\u2010to\u2010face psychotherapy"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6047-4550","authenticated-orcid":false,"given":"A.","family":"Plattonen","sequence":"first","affiliation":[{"name":"Department of Psychology Faculty of Medicine, University of Helsinki  Helsinki Finland"},{"name":"Department of Psychiatry Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Myll\u00e4ri","sequence":"additional","affiliation":[{"name":"Department of Psychology Faculty of Medicine, University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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