The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 36, 17-31

University of Pennsylvania and Beck Institute for Cognitive Therapy and Research, USA.
Clinical Psychology Review (Impact Factor: 7.18). 02/2006; 26(1):17-31. DOI: 10.1016/j.cpr.2005.07.003
Source: PubMed


This review summarizes the current meta-analysis literature on treatment outcomes of CBT for a wide range of psychiatric disorders. A search of the literature resulted in a total of 16 methodologically rigorous meta-analyses. Our review focuses on effect sizes that contrast outcomes for CBT with outcomes for various control groups for each disorder, which provides an overview of the effectiveness of cognitive therapy as quantified by meta-analysis. Large effect sizes were found for CBT for unipolar depression, generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, posttraumatic stress disorder, and childhood depressive and anxiety disorders. Effect sizes for CBT of marital distress, anger, childhood somatic disorders, and chronic pain were in the moderate range. CBT was somewhat superior to antidepressants in the treatment of adult depression. CBT was equally effective as behavior therapy in the treatment of adult depression and obsessive-compulsive disorder. Large uncontrolled effect sizes were found for bulimia nervosa and schizophrenia. The 16 meta-analyses we reviewed support the efficacy of CBT for many disorders. While limitations of the meta-analytic approach need to be considered in interpreting the results of this review, our findings are consistent with other review methodologies that also provide support for the efficacy CBT.

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    • "OVK and PRP are based on several psychological theories and principles, namely Cognitive Behavioral Therapy (CBT) (Beck 1976), the ABC model (Ellis 1962), and the hopelessness theory of depression (Hankin et al. 2001). CBT-based intervention and prevention programs have been found to effectively reduce and prevent depressive symptoms in adolescents (for a review see Butler et al. 2006). In OVK therefore, adolescents learn that their thoughts influence their feelings and their behavior. "
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    ABSTRACT: The longitudinal effectiveness of a universal, adolescent school-based depression prevention program Op Volle Kracht (OVK) was evaluated by means of a cluster randomized controlled trial with intervention and control condition (school as usual). OVK was based on the Penn Resiliency Program (PRP) (Gillham et al. Psychological Science, 6, 343-351, 1995). Depressive symptoms were assessed with the Child Depression Inventory (Kovacs 2001). In total, 1341 adolescents participated, Mage = 13.91, SD = 0.55, 47.3 % girls, 83.1 % Dutch ethnicity; intervention group n = 655, four schools; control group n = 735, five schools. Intent-to-treat analyses revealed that OVK did not prevent depressive symptoms, β = -0.01, SE = 0.05, p = .829, Cohen's d = 0.02, and the prevalence of an elevated level of depressive symptoms was not different between groups at 1 year follow-up, OR = 1.00, 95 % CI = 0.60-1.65, p = .992, NNT = 188. Latent Growth Curve Modeling over the 2 year follow-up period showed that OVK did not predict differences in depressive symptoms immediately following intervention, intercept: β = 0.02, p = .642, or changes in depressive symptoms, slope: β = -0.01, p = .919. No moderation by gender or baseline depressive symptoms was found. To conclude, OVK was not effective in preventing depressive symptoms across the 2 year follow-up. The implications of these findings are discussed.
    Journal of Abnormal Child Psychology 09/2015; DOI:10.1007/s10802-015-0080-1 · 3.09 Impact Factor
    • "While cognitive behaviour therapy (CBT) has been demonstrated as an efficacious treatment for mild to moderate depression in a large number of studies (e.g. Butler et al. 2006), the empirical foundation of the supposed mechanisms of change in CBT is less solid (Clark et al. 1999; Roth & Fonagy , 2005; Wampold , 2010). A central assumption of CBT is that since people respond to cognitive representations of the environment rather than to the environment itself , cognitive distortions are central to the place between two equal persons . "
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    ABSTRACT: Six clients in cognitive behaviour therapy (CBT) or metacognitive therapy (MCT) were interviewed about their experiences of therapy with a focus on helpful elements. Clients in both CBT and MCT mentioned the positive and informal relationship with the therapist as helpful. However, while clients in both therapies emphasized insight into the causes of depression and modification of negative maintenance patterns as helpful, the understanding of depression and the remedies for the condition differed. Clients in CBT focused on previous negative experiences as the cause of present maintenance patterns and mentioned changing negative thought patterns as helpful. Clients in MCT stated that the realization that rumination was their key problem and that they could choose not to engage in negative thinking had been crucial. Furthermore, clients in CBT tended to describe increased personal strength and self-confidence as the main gain from therapy, whereas MCT clients mentioned improved ways of coping with thoughts or problems. The importance attributed by the clients to technical factors differs from previous qualitative studies conducted across various therapeutic approaches, which have typically concluded that common therapeutic factors are more important than specific factors. It does, however, correspond with conclusions from other qualitative studies focusing explicitly on CBT.
    The Cognitive Behaviour Therapist 09/2015; 8:e22. DOI:10.1017/S1754470X15000574
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    • "reduction ≥ 29%) and PD (Cohen's d ≥ 0.49; avg. reduction ≥ 32%) for both TD-CBT and DS-CBT are consistent with the magnitude of clinical change reported in meta-analyses of the broader transdiagnostic and disorder-specific treatment literature (Butler et al., 2006; McEvoy et al., 2009; Andrews et al., 2010; Reinholt & Krogh, 2014). These improvements were also reflected in significantly reduced proportions of participants meeting diagnostic criteria for MDD (reduction ≥ 86%), GAD (reduction ≥ 62%), SAD (reduction ≥ 41%), but not PD (reduction ≥ 11%), at 3-month follow-up when participants again completed a diagnostic interview. "
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    ABSTRACT: Disorder-specific cognitive behavior therapy (DS-CBT) is effective at treating major depressive disorder (MDD) while transdiagnostic CBT (TD-CBT) addresses both principal and comorbid disorders by targeting underlying and common symptoms. The relative benefits of these two models of therapy have not been determined. Participants with MDD (n=290) were randomly allocated to receive an internet delivered TD-CBT or DS-CBT intervention delivered in either clinician-guided (CG-CBT) or self-guided (SG-CBT) formats. Large reductions in symptoms of MDD (Cohen's d≥1.44; avg. reduction≥45%) and moderate-to-large reductions in symptoms of comorbid generalised anxiety disorder (Cohen's d≥1.08; avg. reduction≥43%), social anxiety disorder (Cohen's d≥0.65; avg. reduction≥29%) and panic disorder (Cohen's d≥0.45; avg. reduction≥31%) were found. No marked or consistent differences were observed across the four conditions, highlighting the efficacy of different forms of CBT at treating MDD and comorbid disorders.
    Journal of anxiety disorders 08/2015; 35. DOI:10.1016/j.janxdis.2015.08.002 · 2.68 Impact Factor
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