Beyond the Constraints of an RCT: Naturalistic treatment outcomes for anxiety-related disorders
Open accessAbstract
Despite considerable data from randomized controlled trials supporting use of behavioral therapies for anxiety disorders and anxiety-related disorders, there is a relative scarcity of data demonstrating that such findings are generalizable to patients in nonresearch settings, and a lack of standardized repeated outcome measurement in such settings. Using one of the largest examinations of naturalistic outcomes of behavioral therapies in treatment-seeking patients (N = 489), we examined the clinical characteristics and treatment outcomes of patients seeking treatment for anxiety and anxiety-related disorders in the past 3 years. Patients seeking treatment at a clinic specializing in cognitive-behavioral therapy (CBT) completed self-report questionnaires via an electronic data capture system and diagnostic interview at baseline, and were reassessed at mid- and posttreatment. Patients with anxiety and related disorders were assessed for changes in symptom severity and secondary outcomes (impairment/functioning, quality of life, and depression) over the course of therapy. Patients showed clinically significant and statistically reliable improvement in anxiety symptom severity scores over treatment (p < .001), after controlling for number of sessions received. Patients also showed significant improvement in depression, quality of life, and functioning (p values ≤ .001). We also found significant improvement in disorder-specific symptoms, including obsessive-compulsive disorder, posttraumatic stress disorder, generalized anxiety disorder, and social anxiety disorder (p values ≤ .001). Importance of, and ways to facilitate, integration of more routine assessment of a broader range of symptoms via online assessment systems and methods to better determine the effectiveness of CBT in naturalistic clinics are discussed.
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The sample's pretreatment worry scores were comparable to those in RCTs and naturalistic settings.
“Our sample consisted of patients with pretreatment worry scores comparable to such scores in RCTs [40] and in naturalistic settings [91].”
From Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting (2023) · cites this paper as [91]
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- Authors
- Asnaani, A., Benhamou, K., Kaczkurkin, A. N., Turk-Karan, E., & Foa, E. B.
- Affiliations
- University of Utah (US)
- University of Pennsylvania (US)
- Corresponding author
- Asnaani, Anu
- Venue
- Behavior Therapy
- Publisher
- Elsevier BV
- Published
- 2020-05
- Volume
- 51
- Issue
- 3
- Pages
- 434-446
- ISSN
- 0005-7894 (ISSN-L)
- PMC
- PMC8246650
- OpenAlex
- W2966684978
- Cited by
- 32
- References
- 54
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 5 · 2023: 6 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 1
- FWCI
- 4.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behavior Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Pennsylvania
- 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 › Applied Psychology › Digital Mental Health Interventions
- Keywords
- anxiety disorders, cognitive behavioral therapy, treatment-seeking patients, symptom severity, depression, quality of life, functioning, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, social anxiety disorder, online assessment, routine outcome measurement
- MeSH terms
- Anxiety, Anxiety Disorders, Humans, Quality of Life, Cognitive Behavioral Therapy, Treatment Outcome
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