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Cited by 34Psychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDigital Mental Health Interventions

Enduring effects of evidence-based psychotherapies in acute depression and anxiety disorders versus treatment as usual at follow-up--a longitudinal meta-analysis

Flückiger, Christoph, Del Re, A.C., Munder, Thomas, Heer, Sara, Wampold, Bruce E.·2014·Clinical Psychology Review
DOI 10.1016/j.cpr.2014.05.001
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Abstract

Objective This meta-analysis examined the enduring efficacy of evidence-based psychotherapies (EBP) in comparison to treatment as usual (TAU) by examining effects from termination to follow-up for acute anxiety and depression in an adult outpatient population. It was hypothesized that EBPs might extend their efficacy at follow-up assessment (Tolin, 2010).Method Longitudinal multilevel meta-analyses were conducted that examined the magnitude of difference between EBP and TAU. Targeted (disorder-specific) outcomes were examined, along with dropout rates at follow-up assessments.Results A total of 15 comparisons (including 30 repeated effect sizes [ES]) were included in this meta-analysis (average of 8.9 month follow-up). Small to moderate ES differences were found to be in favor of EBPs at 0-4 month assessments (Hedges' g=0.40) and up to 12-18 month assessments (g=0.20), indicating no extended efficacy at follow-up. However, the TAU-conditions were heterogeneous, ranging from absence of minimal mental health treatment to legitimate psychotherapeutic interventions provided by trained professionals, the latter of which resulted in smaller ES differences. Furthermore, samples where substance use comorbidities were not actively excluded indicated smaller ES differences. TAU-conditions produced slightly higher dropout rates than EBP-conditions.Conclusion Findings indicate small and no extended superiority of EBP for acute depression and anxiety disorders in comparison to TAU at follow-up assessment. There are a limited number of studies investigating the transportability and lasting efficacy of EBP compared to TAU, especially to TAU with equivalent conditions between treatment groups.

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Authors
Flückiger, C., Del Re, A. C., Munder, T., Heer, S., & Wampold, B. E.
Affiliations
  • University of Zurich (CH)
  • University of Wisconsin System (US)
ORCID
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2014-07
Volume
34
Issue
5
Pages
367-375
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2014.05.001
OpenAlex
W2046007573
Cited by
34
References
75
Citations by year
2026: 2 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 8 · 2017: 2 · 2016: 2 · 2015: 3 · 2014: 1
FWCI
0.40
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Clinical Psychology Review (publishedVersion)
  • PubMed (publishedVersion)
  • Bern Open Repository and Information System (University of Bern) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Funders
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (PZ00P1_136937)
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 › Applied Psychology › Digital Mental Health Interventions
Keywords
evidence-based psychotherapy, usual care, acute depression, anxiety disorders, long-term treatment efficacy, follow-up evaluation, dropout rates, substance use comorbidity, outpatient psychiatric care
MeSH terms
Anxiety Disorders, Depressive Disorder, Follow-Up Studies, Humans, Psychotherapy, Treatment Outcome, Evidence-Based Practice

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