This effectiveness study examined the course of treatment longitudinally and outcomes associated with psychodynamic psychotherapy for a sample of 1,050 people undertaking this treatment in a community setting, over the course of 4 years, at 3-month intervals, using the Outcome Questionnaire (OQ)-45.2. The authors used multilevel modeling to look at the nature of change over time and at potentially meaningful moderating variables. Results show a robust general improvement, though a more moderate one than described in recent meta-analyses including primarily prospective studies. The treatment was followed by broad improvements, over time, with a general trend and few notable interaction effects. The treatment involved little deterioration, particularly in the first year. Subgroup analysis suggested that (a) clients with more initial symptom severity showed greater improvement and a unique course of recovery with (b) clients who stayed over a year constituting a potentially unique subgroup. (Contains 4 figures and 5 tables.)