title: Enduring effects of evidence-based psychotherapies in acute depression and anxiety disorders versus treatment as usual at follow-up--a longitudinal meta-analysis.
abstract: OBJECTIVE
  This meta-analysis examined the enduring efficacy of evidence-based psychotherapies (EBP) in comparison to treatment as usual (TAU) by examining effects from termination to follow-up for acute anxiety and depression in an adult outpatient population. It was hypothesized that EBPs might extend their efficacy at follow-up assessment (Tolin, 2010).
  
  
  METHODS
  Longitudinal multilevel meta-analyses were conducted that examined the magnitude of difference between EBP and TAU. Targeted (disorder-specific) outcomes were examined, along with dropout rates at follow-up assessments.
  
  
  RESULTS
  A total of 15 comparisons (including 30 repeated effect sizes [ES]) were included in this meta-analysis (average of 8.9 month follow-up). Small to moderate ES differences were found to be in favor of EBPs at 0-4 month assessments (Hedges' g=0.40) and up to 12-18 month assessments (g=0.20), indicating no extended efficacy at follow-up. However, the TAU-conditions were heterogeneous, ranging from absence of minimal mental health treatment to legitimate psychotherapeutic interventions provided by trained professionals, the latter of which resulted in smaller ES differences. Furthermore, samples where substance use comorbidities were not actively excluded indicated smaller ES differences. TAU-conditions produced slightly higher dropout rates than EBP-conditions.
  
  
  CONCLUSIONS
  Findings indicate small and no extended superiority of EBP for acute depression and anxiety disorders in comparison to TAU at follow-up assessment. There are a limited number of studies investigating the transportability and lasting efficacy of EBP compared to TAU, especially to TAU with equivalent conditions between treatment groups.
authors.affiliation: University of Zürich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Flückiger
authors.affiliation: Center for Innovation to Implementation, VA Palo Alto, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Del Re
authors.affiliation: Psychologische Hochschule Berlin, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Munder
authors.affiliation: University of Zürich, Switzerland.
authors.forename: Sara
authors.initials: S
authors.lastname: Heer
authors.affiliation: University of Wisconsin-Madison, USA; Modum Bad Psychiatric Center, Vikersund, Norway.
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Wampold
mesh_terms: D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D055317:Evidence-Based Practice; D005500:Follow-Up Studies; D006801:Humans; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome
keywords: EBP; Follow-up studies; Longitudinal meta-analysis; Treatment as usual