How to improve outcomes of psychological treatment of depression: Lessons from "next-level" meta-analytic research.

Abstract

Depression is a major public health challenge. Psychotherapy is one of the most important first-line treatments with good outcomes, although there is also room for improvement. In this article, I describe how outcomes can be further improved, based on innovative meta-analytic research. I first describe this innovative approach: a living systematic review of all randomized trials on psychological treatments, regardless of age, target group, or comparator, which provides an overview of everything that can be known about the field from randomized trials. In the second part, I present a brief overview of the research questions that have been answered by this work. Several therapies have been found to be effective, and they are effective in different age and target groups. They are as effective as antidepressants at the short term but more effective at the longer term. In the third part of this article, I describe some recommendations for the field. One important finding is that therapies are effective but not for everyone. More research on sequential treatments and on those who do not respond to a therapy is very much needed. Another important finding is that none of the new therapies that have been introduced over the past 50 years are more effective than previous treatments. It is important, therefore, not to embrace new therapies too easily but to focus on other innovations that will result in better outcomes, such as increased frequency of sessions, feedback to patients, and better matching the needs of patients to the expertise of therapists. (PsycInfo Database Record (c) 2024 APA, all rights reserved).