title: The efficacy of non-directive supportive therapy for adult depression: a meta-analysis.
abstract: 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.
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands. p.cuijpers@psy.vu.nl
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
authors.forename: Ellen
authors.initials: E
authors.lastname: Driessen
authors.forename: Steven D
authors.initials: SD
authors.lastname: Hollon
authors.forename: Patricia
authors.initials: P
authors.lastname: van Oppen
authors.forename: Jürgen
authors.initials: J
authors.lastname: Barth
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
mesh_terms: D000328:Adult; D035061:Control Groups; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy*; D006801:Humans; D008297:Male; D009629:Person-Centered Psychotherapy / Q000706:statistics & numerical data*; D011613:Psychotherapy / Q000379:methods*