Benchmarks for psychotherapy efficacy in adult major depression.

Abstract

This study estimates pretreatment-posttreatment effect size benchmarks for the treatment of major depression in adults that may be useful in evaluating psychotherapy effectiveness in clinical practice. Treatment efficacy benchmarks for major depression were derived for 3 different types of outcome measures: the Hamilton Rating Scale for Depression (M. A. Hamilton, 1960A. Hamilton, , 1967, the Beck Depression Inventory (A. T. Beck, 1978;A. T. Beck & R. A. Steer, 1987), and an aggregation of low reactivity-low specificity measures. These benchmarks were further refined for 3 conditions: treatment completers, intent-to-treat samples, and natural history (wait-list) conditions. The study confirmed significant effects of outcome measure reactivity and specificity on the pretreatment-posttreatment effect sizes. The authors provide practical guidance in using these benchmarks to assess treatment effectiveness in clinical settings.

Recovery From Depressive Symptoms Over the Course of Physical Therapy: A Prospective Cohort Study of Individuals With Work-Related Orthopaedic Injuries and Symptoms of Depression

“…Previous research suggests that, when individuals suffering from major depressive disorders act as wait-list controls for depression intervention studies, they experience a natural reduction in the severity of depressive symptoms, benchmarking this nontreatment-related reduction at 10% to 15% 47 (Cohen d effect size = 0.37). 38 In the present study, patients were included in the study sample if they showed at least minimal levels of depressive symptoms (BDI of 14 or greater). Comparing the mean pretreatment level of depressive symptoms among participants in our sample (22.0) to a previously established major depressive disorder cut score of 22 46 suggests that approximately half of participants had lower levels of depressive symptoms than [ research report ] those with major depression.…”

Effectiveness of routine psychotherapy: Method matters

“…Minami and colleagues Minami, Wampold, Serlin, Kircher, & Brown, 2007) provided a more general and formal method of developing benchmarks for routine practice, and applied that method to studies of adult MDD. Their method includes at least three major advances beyond other methods of benchmarking.…”

“…However, there are several possible limitations to be considered. For instance, it could be argued that even the most formal method of benchmarking change (Minami et al, 2007) is not a comprehensive method. After all, the amount of change observed is only one portion of the relevant information about the outcome of treatments.…”

“…Clinically, overall or general distress may adequately capture many clients' reported concerns, but for some target problems, a general distress factor may not be directly related to success or failure in therapy (for example, when a client reports low distress except for in a specific area, like disordered eating). For these reasons, it is necessary to consider multiple types of client problems in treatment, and adapt the Minami et al (2007) method to separate benchmarks for distinct problem types.…”

“…Finally, the Minami et al (2007) method also incorporates a natural recovery benchmark, developed by creating a benchmark based on the waitlist control condition from the same RCTs. Using the same range-null hypotheses tests, they suggest that change in routine treatment should be greater than 0.2 d higher than the waitlist benchmark, and that if this is true, the routine treatment can be considered more effective than no-treatment.…”