Treating treatment non-responders: A meta-analysis of randomized controlled psychotherapy trials
Abstract
Background Non-responsiveness to treatment occurs in approximately one third of patients. Randomized clinical trials of psychotherapy options for these patients are scarce and systematic knowledge about whether psychotherapy is a viable option is lacking. Objectives This meta-analysis aimed to 1) determine the amount of evidence available for treatment non-response using psychotherapy relative to pharmacological procedures; 2) systematically review randomized controlled psychotherapy trials (RCTs) used to treat non-responders; and 3) examine whether some psychotherapies are more efficacious than others. Data sources Online databases were systematically examined and references of relevant systematic reviews were hand-searched. Study eligibility criteria RCTs that administered a psychotherapy new to non-responders were considered. All Mood and Anxiety Disorders were considered. No limitations were made with respect to type of treatment. Review method A meta-analytic review of the psychotherapy RCTs for treatment non-responders. Results Results showed that psychotherapy was successful in treating treatment non-responders with a medium to large effect size. Between-group comparisons did not reveal significant differences in treatment effects for any of the assessed disorder or treatment types. Effects were maintained at follow-up. Conclusions Psychotherapy is a viable treatment option for treatment non-responders. More attention to this group of patients is needed and more research with better quality studies is warranted. Recommendations are discussed.
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- Authors
- Gloster, A. T., Rinner, M. T. B., Ioannou, M., Villanueva, J., Block, V. J., Ferrari, G., Benoy, C., Bader, K., & Karekla, M.
- Affiliations
- University of Basel (CH)
- University of Cyprus (CY)
- Corresponding author
- Gloster, Andrew T.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2020-02
- Volume
- 75
- Pages
- 101810
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2995527320
- Cited by
- 53
- References
- 19
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 14 · 2023: 6 · 2022: 8 · 2021: 4 · 2020: 3
- FWCI
- 0.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- edoc (University of Basel) (acceptedVersion)
- Funders
- Swiss National Science Foundation (PP00P1_163716/1)
- 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 Disorders
- Keywords
- treatment non-responders, psychotherapy, mood disorders, anxiety disorders, pharmacotherapy, treatment-resistant depression, psychotherapy efficacy, psychotherapy versus pharmacotherapy
- MeSH terms
- Anxiety Disorders, Humans, Psychotherapy, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care, Depressive Disorder, Treatment-Resistant
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