The clinical effectiveness of cognitive behaviour therapy: outcome for a large sample of adults treated in routine practice
Abstract
There is increasing interest in questions about how far the demonstrated efficacy of psychological therapies in research trials can be translated into clinical effectiveness in routine practice. This paper summarises outcome data from several hundred patients treated with CBT in routine clinical practice in a National Health Service psychology service, and compares their outcomes with some of the published research. Although the data have flaws common in ordinary clinical practice (no untreated controls, missing data, uncontrolled pharmacotherapy, etc.), the analyses suggest that CBT in this context is an effective treatment, albeit with probably not quite such good results as it achieves in research trials. Using clinical significance statistics on standardised measures, about half of the sample reliably improved over a course of therapy, including about a third who recovered to normal range.
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Reliable change results were consistent with effectiveness studies showing about 50% reliable change on depression measures and 15%-30% on anxiety measures.
“Results on reliable change in the current study also were consistent with effectiveness studies that have shown reliable change of approximately 50% on depression measures and 15% to 30% on anxiety measures (e.g., McEvoy & Nathan, 2007; Westbrook & Kirk, 2005).”
From An Integrated, Acceptance-Based Behavioral Approach for Depression With Social Anxiety: Preliminary Results (2014) · cites this paper as Westbrook & Kirk, 2005
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“Results on reliable change in the current study also were consistent with effectiveness studies that have shown reliable change of approximately 50% on depression measures and 15% to 30% on anxiety measures (e.g., McEvoy & Nathan, 2007; Westbrook & Kirk, 2005).”
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- Authors
- Westbrook, D., & Kirk, J.
- Affiliations
- Warneford Hospital (GB)
- Corresponding author
- Westbrook, David
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2005-10
- Volume
- 43
- Issue
- 10
- Pages
- 1243-1261
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2009742487
- Cited by
- 183
- References
- 29
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 4 · 2022: 8 · 2021: 1 · 2020: 5 · 2019: 7 · 2018: 12 · 2017: 3 · 2016: 10 · 2015: 9 · 2014: 17 · 2013: 12 · 2012: 18
- FWCI
- 6.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy, clinical effectiveness, routine clinical practice, treatment outcomes, adults
- MeSH terms
- Adolescent, Adult, Aged, Anxiety Disorders, Depressive Disorder, England, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Severity of Illness Index, State Medicine, Cognitive Behavioral Therapy, Treatment Outcome, Outcome Assessment, Health Care, Benchmarking
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