Faith-adapted psychological therapies for depression and anxiety: Systematic review and meta-analysis.
BACKGROUND
Incorporating faith (religious or spiritual) perspectives into psychological treatments has attracted significant interest in recent years. However, previous suggestion that good psychiatric care should include spiritual components has provoked controversy. To try to address ongoing uncertainty in this field we present a systematic review and meta-analysis to assess the efficacy of faith-based adaptations of bona fide psychological therapies for depression or anxiety.


METHODS
A systematic review and meta-analysis of randomised controlled trials were performed.


RESULTS
The literature search yielded 2274 citations of which 16 studies were eligible for inclusion. All studies used cognitive or cognitive behavioural models as the basis for their faith-adapted treatment (F-CBT). We identified statistically significant benefits of using F-CBT. However, quality assessment using the Cochrane risk of bias tool revealed methodological limitations that reduce the apparent strength of these findings.


CONCLUSIONS
Whilst the effect sizes identified here were statistically significant, there were relatively a few relevant RCTs available, and those included were typically small and susceptible to significant biases. Biases associated with researcher or therapist allegiance were identified as a particular concern.


CONCLUSIONS
Despite some suggestion that faith-adapted CBT may out-perform both standard CBT and control conditions (waiting list or "treatment as usual"), the effect sizes identified in this meta-analysis must be considered in the light of the substantial methodological limitations that affect the primary research data. Before firm recommendations about the value of faith-adapted treatments can be made, further large-scale, rigorously performed trials are required.
Hull York Medical School, University of York, Heslington, York YO10 5DD, United Kingdom.
Naomi
N
Anderson
Bradford District Care Trust, New Mill, Victoria Road, Saltaire, West Yorkshire BD18 3LD, United Kingdom; Institute of Health Sciences, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, United Kingdom.
Suzanne
S
Heywood-Everett
Bradford District Care Trust, New Mill, Victoria Road, Saltaire, West Yorkshire BD18 3LD, United Kingdom; Institute of Health Sciences, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, United Kingdom.
Najma
N
Siddiqi
Institute of Health Sciences, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, United Kingdom.
Judy
J
Wright
Department of Health Sciences, University of York, Heslington, York YO10 5DD, United Kingdom.
Jodi
J
Meredith
Hull York Medical School, University of York, Heslington, York YO10 5DD, United Kingdom; Department of Health Sciences, University of York, Heslington, York YO10 5DD, United Kingdom. Electronic address: dean.mcmillan@york.ac.uk.
Dean
D
McMillan
D001007:Anxiety / Q000523:psychology* / Q000628:therapy*; D015982:Bias; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology* / Q000628:therapy*; D029221:Faith Healing; D006801:Humans; D016032:Randomized Controlled Trials as Topic
Anxiety; Cognitive behavioural therapy; Depression; Psychological therapy; Religion; Spirituality