Citation: Westen, D., & Morrison, K. (2001). A multidimensional meta-analysis of treatments for depression, panic, and generalized anxiety disorder: an empirical examination of the status of empirically supported therapies. Journal of Consulting and Clinical Psychology, 69(6), 875-899.
This meta-analysis draws a distinction between initial response and sustained efficacy and attempts to determine the sustained efficacy of evidence-based treatments. This is particularly useful in their examination of GAD, for which a sizable percentage of clients experience significant improvements even before seeing a therapist for the first time. The analysis included five controlled studies of GAD which generally excluded comorbid conditions and had high completion rates. » Read the rest of this entry «
Borkovec, Newman, Pincus, and Lytle here cite prior reviews of outcome research as having well established CBT as an effective treatment for GAD with low drop-out rates and treatment gains that “routinely maintained or increased at long-term follow-up.” Regardless of this, CBT still fails to produce highly functional states in a large percentage of clients.
This five-year study was designed to explore potential avenues for increasing the efficacy of CBT by extending its duration, measuring the efficacy of two components—cognitive therapy (CT) and applied relaxation and self-control desensitization (SCD)—of the CBT therapy being used, and by measuring interpersonal factors contributing to the success of failure of the treatment.
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The Canadian Psychiatric Association (CPA) here cites a number of meta-analyses which it recognizes as having “clearly demonstrated” the efficacy of cognitive-behavioral therapy (CBT) in alleviating anxiety symptoms. According to these Guidelines, the effectiveness of CBT in the treatment of anxiety symptoms in general is on par with that of antidepressant drug treatment. This appears to be the case in both individual and group therapy settings. For Generalized Anxiety Disorder (GAD) specifically, CBT is more effective than either placebo psychological treatment or no treatment at all.
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Citing a relative scarcity of research on the efficacy of CBT for GAD as compared to pharmacotherapy, Kristin Mitte conducted a meta-analysis of 65 controlled studies using a random-effects model to produce results that could be generalized beyond the selected studies. A “trim-and-fill analysis” was also conducted to correct for publication bias, several additional sensitivity analyses were performed to ensure the robustness of the selected studies, and methodological differences were controlled for. Studies utilizing new techniques in CBT such as mindfulness practices and interpersonal interventions were excluded due to insufficient research.
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