Abstract
Laboratory studies of empirically supported treatments (ESTs) for mental health problems achieve much higher rates of clinical improvement than has been observed following treatment in the community. This discrepancy is likely to due to limited reliance on ESTs by therapists outside of academia. Concerns about the generalizability of ESTs to patients in the community, who may have comorbid problems, likely limit rates of adoption. The present study examined the impact of ESTs delivered in the real-world for 1,256 adults who received services through an employee assistance program specializing in the delivery of ESTs. Rates of anxiety and depression decreased significantly, following treatment with an EST, and 898 (71.5%) patients demonstrated reliable improvement. Even among patients comorbid for depression and anxiety at baseline, over half reported reliable improvement in both disorders. Findings suggest ESTs can be effectively delivered outside of academic RCTs. However, additional research is needed to understand and overcome barriers to disseminating ESTs to the broader community.
Highlights
Specialty section: This article was submitted to Psychology for Clinical Settings, a section of the journal Frontiers in Psychology
Cognitive behavioral therapy (CBT), cognitive therapy (CT), and interpersonal psychotherapy have all demonstrated efficacy in the treatment of moderate or severe depression, with evidence suggesting that cognitive behavioral therapy (CBT) and CT may be as efficacious as antidepressant medication (Shapiro et al, 1994; Gloaguen et al, 1998; DeRubeis et al, 2005)
Findings presented here demonstrate that empirically supported treatments (ESTs) can be efficacious under real-world conditions and deliver results that are comparable to those observed in randomized controlled trials (RCTs) (e.g., Hofmann et al, 2012)
Summary
18 years or older, who started individual therapy between July 1, 2018 and May 31, 2019, were included in the present study. We were looking for providers who used ESTs as defined by Chambless and Hollon (1998) and Tolin et al (2015), used validated measures to assess treatment progress and outcomes, and practiced short-term therapy in contrast to treatments of indeterminate length. Those therapists who passed the rigorous clinical vetting interview were invited to join the network. To better assess the impact of treatment on patients with psychological comorbidity, rates of reliable improvement and recovery are reported separately for patients who started in the clinical range on both the PHQ9 and GAD-7
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