Brief Psychotherapy for Depression: A Systematic Review and Meta-Analysis
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Objective: Because evidence-based psychotherapies of 12 to 20 sessions can be perceived as too lengthy and time intensive for the treatment of depression in primary care, a number of studies have examined abbreviated psychotherapy protocols. The purpose of this study was to conduct a systematic review and meta-analysis to determine the efficacy of brief psychotherapy (i.e., < 8 sessions) for depression. Methods: We used combined literature searches in PubMed, EMBASE, PsycINFO, and an Internet-accessible database of clinical trials of psychotherapy to conduct two systematic searches: one for existing systematic reviews and another for randomized controlled trials (RCTs). Included studies examined evidence-based psychotherapy(s) of eight or fewer sessions, focused on adults with depression, contained an acceptable control condition, were published in English, and used validated measures of depressive symptoms. Results: We retained 2 systematic reviews and 15 RCTs evaluating cognitive behavioral therapy, problem-solving therapy, and mindfulness-based cognitive therapy. The systematic reviews found brief psychotherapies to be more efficacious than control, with effect sizes ranging from −0.33 to −0.25. Our meta-analysis found six to eight sessions of cognitive behavioral therapy to be more efficacious than control (ES −0.42, 95% CI −0.74 to −0.10, I 2 = 56%). A sensitivity analysis controlled for statistical heterogeneity but showed smaller treatment effects (ES −0.24, 95% CI −0.42 to −0.06, I 2 = 0%). Conclusions: Depression can be efficaciously treated with six to eight sessions of psychotherapy, particularly cognitive behavioral therapy and problem-solving therapy. Access to non-pharmacologic treatments for depression could be improved by training healthcare providers to deliver brief psychotherapies.
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Two meta-analyses looking at brief (8 or fewer sessions) CBT, MBCT, and PST noted significant efficacy in symptom reduction.
“while 2 other meta-analyses looking at brief (8 or fewer sessions) of CBT, MBCT, and PST noted significant efficacy in symptom reduction.82,83”
From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [83]
The Results report a significant reduction in depressive symptoms in the meta-analysis of six to eight CBT sessions. The Results also report a positive finding for eight-session MBCT, but that finding came from a single study, not a meta-analysis. For PST, one reviewed analysis found a significant effect when PST and CBT were combined, while another found a statistically nonsignificant effect for PST alone. (LLM, conf=0.87)
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- Authors
- Nieuwsma, J. A., Trivedi, R. B., McDuffie, J., Kronish, I., Benjamin, D., & Williams, J. W.
- Affiliations
- Duke Medical Center (US)
- University of Washington (US)
- Columbia University Irving Medical Center (US)
- Carolina Behavioral Care, Durham
- Corresponding author
- Nieuwsma, Jason A.
- Venue
- The International Journal of Psychiatry in Medicine
- Publisher
- SAGE Publications
- Published
- 2012-02
- Volume
- 43
- Issue
- 2
- Pages
- 129-151
- ISSN
- 0033-278X (ISSN-L)
- 0091-2174
- 1541-3527
- PMC
- PMC3668561
- OpenAlex
- W2024404741
- Semantic Scholar
- 2bbe1afe64443147ab60967c82297adabc9695f8
- Cited by
- 135
- References
- 51
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 12 · 2023: 9 · 2022: 8 · 2021: 13 · 2020: 17 · 2019: 16 · 2018: 8 · 2017: 8 · 2016: 8 · 2015: 7 · 2014: 7 · 2013: 6 · 2012: 1
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- The International Journal of Psychiatry in Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- National Heart, Lung, and Blood Institute (K23HL098359)
- 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
- depression, brief psychotherapy, cognitive behavioral therapy, problem-solving therapy, mindfulness-based cognitive therapy, treatment efficacy, primary care, non-pharmacological treatment, health professions education
- MeSH terms
- Adult, Depression, Depressive Disorder, Humans, Psychotherapy, Brief, Treatment Outcome
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