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

P. Cuijpers, E. Driessen, S.D. Hollon, P. van Oppen, J. Barth, G. Andersson

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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. © 2012 Elsevier Ltd.
Original languageEnglish
Pages (from-to)280-291
JournalClinical psychology review
Issue number4
Publication statusPublished - 2012

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