Cited by 189Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDigital Mental Health InterventionsPsychotherapy Techniques and Applications

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Treatment-as-usual (TAU) is anything but usual: A meta-analysis of CBT versus TAU for anxiety and depression

Watts, Sarah E., Turnell, Adrienne, Kladnitski, Natalie, Newby, Jill M., Andrews, Gavin·2015·Journal of Affective Disorders

DOI 10.1016/j.jad.2014.12.025

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Abstract

Objectives There were three aims of this study, the first was to examine the efficacy of CBT versus treatment-as-usual (TAU) in the treatment of anxiety and depressive disorders, the second was to examine how TAU is defined in TAU control groups for those disorders, and the third was to explore whether the type of TAU condition influences the estimate of effects of CBT.Method A systematic search of Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL was conducted.Results 48 studies of CBT for depressive or anxiety disorders (n=6926) that specified that their control group received TAU were identified. Most (n=45/48) provided an explanation of the TAU group however there was significant heterogeneity amongst TAU conditions. The meta-analysis showed medium effects favoring CBT over TAU for both anxiety (g=0.69, 95% CI 0.47-0.92, p<0.001, n=1318) and depression (g=0.70, 95% CI 0.49-0.90, p<0.001, n=5054), with differential effects observed across TAU conditions.Conclusions CBT is superior to TAU and the size of the effect of CBT compared to TAU depends on the nature of the TAU condition. The term TAU is used in different ways and should be more precisely described. The four key details to be reported can be thought of as "who, what, how many, and any additional treatments?"

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“That is, those studies conducted in the general population yield significant, large effect sizes when comparing the CBT interventions with controls (Cuijpers et al ., 2013; Li et al., 2018; Watts et al ., 2015).”

Authors: Watts, S. E., Turnell, A., Kladnitski, N., Newby, J. M., & Andrews, G.
Affiliations: St Vincent's Hospital Sydney (AU)
Corresponding author: Newby, Jill M.
ORCID: Watts, Sarah E.
Turnell, Adrienne
Newby, Jill M.
Andrews, Gavin
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2015-04
Volume: 175
Pages: 152-167
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/j.jad.2014.12.025
OpenAlex: W2083442609
Cited by: 188
References: 76
Citations by year: 2026: 6 · 2025: 18 · 2024: 12 · 2023: 17 · 2022: 25 · 2021: 25 · 2020: 15 · 2019: 17 · 2018: 23 · 2017: 12 · 2016: 11 · 2015: 7
FWCI: 1.35
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: cognitive behavioral therapy, usual care, anxiety disorders, depressive disorders, treatment efficacy, differential treatment effects
MeSH terms: Anxiety, Anxiety Disorders, Depression, Depressive Disorder, Humans, Thinking, Cognitive Behavioral Therapy

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Treatment-as-usual (TAU) is anything but usual: A meta-analysis of CBT versus TAU for anxiety and depression

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