The efficacy of non-directive supportive therapy for adult depression: A meta-analysis

Cuijpers, Pim; Driessen, Ellen; Hollon, Steven D; van Oppen, Patricia; Barth, Jürgen; Andersson, Gerhard (2012). The efficacy of non-directive supportive therapy for adult depression: A meta-analysis. Clinical psychology review, 32(4), pp. 280-291. New York, N.Y.: Elsevier Science 10.1016/j.cpr.2012.01.003

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The effects of non-directive supportive therapy (NDST) for adult depression have been examined in a considerable number of studies, but no meta-analysis of these studies has been conducted. We selected 31 studies on NDST from a comprehensive database of trials, examining psychotherapies for adult depression, and conducted meta-analyses in which NDST was compared with control groups, other psychotherapies and pharmacotherapy. We found that NDST is effective in the treatment of depression in adults (g=0.58; 95% CI: 0.45-0.72). NDST was less effective than other psychological treatments (differential effect size g=-0.20; 95% CI: -0.32 to -0.08, p<0.01), but these differences were no longer present after controlling for researcher allegiance. We estimated that extra-therapeutic factors (those processes operating in waiting-list and care-as-usual controls) were responsible for 33.3% of the overall improvement, non-specific factors (the effects of NDST compared with control groups) for 49.6%, and specific factors (the effects of NDST compared with other therapies) for 17.1%. NDST has a considerable effect on symptoms of depression. Most of the effect of therapy for adult depression is realized by non-specific factors, and our results suggest that the contribution of specific effects is limited at best.

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