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Cited by 84Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and ApplicationsPsychological Treatments and Assessments

The Effects of Waiting for Treatment: A Meta‐Analysis of Waitlist Control Groups in Randomized Controlled Trials for Social Anxiety Disorder

Steinert, Christiane, Stadter, Katja, Stark, Rudolf, Leichsenring, Falk·2017·Clinical Psychology & Psychotherapy
DOI 10.1002/cpp.2032
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Abstract

Social anxiety disorder (SAD) is a highly prevalent mental disorder. However, little is known about how SAD changes in subjects who do not receive treatment. Waitlist control groups (WLCGs) are frequently included in randomized controlled trials (RCTs) on the treatment of mental disorders. Data from WLCGs are of value as they provide information on the untreated short‐term course of a disorder and may serve as disorder‐specific norms of change (benchmarks) against which treatment outcomes of SAD can be compared. Thus, we performed a meta‐analysis focusing on the effects occurring in WLCGs of RCTs for SAD. Our study was conducted along the PRISMA guidelines. Thirty RCTs (total n = 2460) comprising 30 WLCGs and 47 treatment groups were included. Mean waiting time was 10.6 weeks. The pooled effect of waiting on SAD measures was g = 0.128 (95% CI: 0.057–0.199). Effects regarding other forms of anxiety, depression and functioning were of similarly small size. In contrast, change in the treatment groups was large, both within ( g = 0.887) and between groups ( g = 0.860). Our results show that for SAD, changes occurring in WLCGs of RCTs are small. The findings may serve as benchmarks in pilot studies of a new treatment or as an additional comparison in studies comparing two active treatments. For psychotherapy research in general, the small effect sizes found in WLCGs confirm that testing a treatment against a waiting list is not a very strict test. Further research on WLCGs in specific mental disorders is required, for example examining the expectancies of patients randomized to waiting. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message: In clinical practice, patients suffering from a mental disorder often have to wait for treatment. By analyzing data from waitlist control groups we can gain estimates of symptom change that occur during waiting. It could be seen that waiting for treatment only results in a negligible effect. Thus, in the short‐term (i.e., 10.6 weeks) time is no healer in social anxiety disorder. Our results are similar to previous meta‐analyses on the effects of waiting in other disorders, e.g., depression and posttraumatic stress disorder.

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Authors
Steinert, C., Stadter, K., Stark, R., & Leichsenring, F.
Affiliations
Justus-Liebig-Universität Gießen (DE)
Corresponding author
Steinert, Christiane
ORCID
Venue
Clinical Psychology & Psychotherapy
Publisher
Wiley
Published
2016-07-22
Volume
24
Issue
3
Pages
649-660
ISSN
  • 1063-3995 (ISSN-L)
  • 1099-0879
DOI
10.1002/cpp.2032
OpenAlex
W2481273697
Cited by
83
References
76
Citations by year
2026: 14 · 2025: 5 · 2024: 8 · 2023: 14 · 2022: 9 · 2021: 8 · 2020: 9 · 2019: 6 · 2018: 5 · 2017: 4 · 2016: 1
FWCI
0.70
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Psychology & Psychotherapy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords
social anxiety disorder, waitlist control, waiting time, treatment effects, psychotherapy research, depression, functioning
MeSH terms
Phobia, Social, Humans, Psychotherapy, Waiting Lists, Randomized Controlled Trials as Topic, Treatment Outcome, Control Groups

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