Study: Cognitive Behavioral Therapy helps treat depression–especially among women–but benefits are declining steadily

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CBT

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Researchers have found that CBT is rough­ly half as effec­tive in treat­ing depres­sion as it used to be (The Guardian):

“Every­body loves cog­ni­tive behav­iour­al ther­a­py. It’s the no-non­sense, quick and rel­a­tive­ly cheap approach to men­tal suffering…So it was unset­tling to learn, from a paper in the jour­nal Psy­cho­log­i­cal Bul­letin, that it seems to be get­ting less effec­tive over time. After analysing 70 stud­ies con­duct­ed between 1977 and 2014, researchers Tom Johnsen and Odd­geir Fri­borg con­clud­ed that CBT is rough­ly half as effec­tive in treat­ing depres­sion as it used to be.

What’s going on? One the­o­ry is that, as any ther­a­py grows more pop­u­lar, the pro­por­tion of inex­pe­ri­enced or incom­pe­tent ther­a­pists grows big­ger. But the paper rais­es a more intrigu­ing idea: the place­bo effect. The ear­ly pub­lic­i­ty around CBT made it seem a mir­a­cle cure, so maybe it func­tioned like one for a while. These days, by con­trast, the chances are you know some­one who’s tried CBT and didn’t mirac­u­lous­ly become per­fect­ly hap­py for ever. Our expec­ta­tions have become more real­is­tic, so effec­tive­ness has fall­en, too.”

Study: The Effects of Cog­ni­tive Behav­ioral Ther­a­py as an Anti-Depres­sive Treat­ment is Falling: A Meta-Analy­sis (Psy­cho­log­i­cal Bulletin)

  • Abstract: A meta-analy­sis exam­in­ing tem­po­ral changes (time trends) in the effects of cog­ni­tive behav­ioral ther­a­py (CBT) as a treat­ment for unipo­lar depres­sion was con­duct­ed. A com­pre­hen­sive search of psy­chother­a­py tri­als yield­ed 70 eli­gi­ble stud­ies from 1977 to 2014. Effect sizes (ES) were quan­ti­fied …Rates of remis­sion were also reg­is­tered. The pub­li­ca­tion year of each study was examined…Subgroup analy­ses revealed that women prof­it­ed more from ther­a­py than did men (p .05). Expe­ri­enced psy­chol­o­gists (g  1.55) achieved bet­ter results (p .01) than less expe­ri­enced stu­dent ther­a­pists (g  0.98). The metare­gres­sions exam­in­ing the tem­po­ral trends indi­cat­ed that the effects of CBT have declined lin­ear­ly and steadi­ly since its intro­duc­tion, as mea­sured by patients’ self-reports (the BDI, p .001), clin­i­cians’ rat­ings (the HRSD, p .01) and rates of remis­sion (p .01)…Thus, mod­ern CBT clin­i­cal tri­als seem­ing­ly pro­vid­ed less relief from depres­sive symp­toms as com­pared with the sem­i­nal tri­als. Poten­tial caus­es and pos­si­ble impli­ca­tions for future stud­ies are discussed.

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