Effectiveness of cognitive behavioural therapy for anxiety and depression in primary care: a meta-analysis

Twomey, Conal; O’Reilly, Gary; Byrne, Michael

doi:10.1093/fampra/cmu060

Cited by 124Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and Applications

Effectiveness of cognitive behavioural therapy for anxiety and depression in primary care: a meta-analysis

Twomey, Conal, O’Reilly, Gary, Byrne, Michael·2015·Family Practice

DOI 10.1093/fampra/cmu060

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Abstract

BACKGROUND: Cognitive behavioural therapy (CBT) is increasingly being delivered in primary care, in a variety of delivery formats such as guided self-help CBT, telephone-based CBT, computerized CBT and standard, one-to-one CBT. However, the vast majority of research has focused on CBT in specialized services, and no previous meta-analysis has examined CBT's effectiveness across delivery formats in primary care. OBJECTIVE: To determine the effectiveness of multi-modal CBT (i.e. CBT across delivery formats) for symptoms of anxiety and depression, in primary care. METHODS: A meta-analysis of CBT-focused RCTs, for symptoms of anxiety or depression, in primary care. The authors searched four databases. To be included, RCTs had to be set in primary care or have primary care participants. RESULTS: Twenty-nine RCTs were included in three separate meta-analyses. Results showed multi-modal CBT was more effective than no primary care treatment (d =0.59), and primary care treatment-as-usual (TAU) (d = 0.48) for anxiety and depression symptoms. Moreover, multi-modal CBT in addition to primary care TAU was shown to be more effective than primary care TAU for depression symptoms (no comparisons of this kind were available for anxiety) (d = 0.37). CONCLUSIONS: The results from conducted meta-analyses indicate that multi-modal CBT is effective for anxiety and depression symptoms in primary care. Furthermore, based on CBT's economic viability, increasing the provision of CBT in primary care seems justified. Future research should examine if varying levels of qualification among primary care CBT practitioners impacts on the effectiveness of CBT in this setting.

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Multimodal cognitive behavioral therapy has moderate effects in reducing anxiety and depression symptoms in primary care.
“Furthermore, multimodal CBT has shown moderate effects in reducing anxiety and depression symptoms in primary care [23].”
From Evaluation and Future Challenges in a Self-Guided Web-Based Intervention With and Without Chat Support for Depression and Anxiety Symptoms During the COVID-19 Pandemic: Randomized Controlled Trial (2024) · cites this paper as [23]
The introduction and widespread use of SSRI and psychological therapy including CBT meant that well tolerated and effective treatments for depression and anxiety disorders became available in primary care, widening the group of individuals eligible for treatment.
“The introduction and widespread use of selective serotonine uptake inhibitors (SSRI) [22, 23] and psychological therapy including cognitive behavioral therapy (CBT) [24, 25] meant that well tolerated and effective treatments for depression and anxiety disorders became available in primary care, widening the group of individuals eligible for treatment.”
From Trends in psychiatric diagnoses, medications and psychological therapies in a large Swedish region: A population-based study (2020) · cites this paper as [25]

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Authors: Twomey, C., O’Reilly, G., & Byrne, M.
Affiliations: University College Dublin (IE)
Health Service Executive (IE)
ORCID: Twomey, Conal
O’Reilly, Gary
Byrne, Michael
Venue: Family Practice
Publisher: Oxford University Press (OUP)
Published: 2014-09-22
Volume: 32
Issue: 1
Pages: 3-15
ISSN: 0263-2136 (ISSN-L)
1460-2229
DOI: 10.1093/fampra/cmu060
OpenAlex: W1985634563
Cited by: 123
References: 44
Citations by year: 2026: 11 · 2025: 9 · 2024: 8 · 2023: 13 · 2022: 12 · 2021: 15 · 2020: 10 · 2019: 9 · 2018: 15 · 2017: 4 · 2016: 10 · 2015: 7
FWCI: 0.85
Type: journal article
Language: en
Open access: closed
Locations: Family Practice (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: cognitive behavioral therapy, anxiety, depression, primary care, guided self-help, treatment effectiveness, usual care, economic feasibility
MeSH terms: Anxiety, Depression, Humans, Primary Health Care, Models, Statistical, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome

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Effectiveness of cognitive behavioural therapy for anxiety and depression in primary care: a meta-analysis

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