Establishing Specificity in Psychotherapy: A Meta-Analysis of Structural Equivalence of Placebo Controls.

Baskin, Thomas W.; Tierney, Sandy; Minami, Takuya; Wampold, Bruce E.

doi:10.1037/0022-006x.71.6.973

Cited by 315 publications

(299 citation statements)

References 43 publications

(53 reference statements)

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“…However, a close look at Table 1 indicates that the CBT ES generated in TADS is not characteristic of most CBT or psychotherapy effects on youth depression; 20 of the 23 other CBT programs in the table showed larger ES than the TADS version of CBT, and the mean ES value across the non-TADS CBT programs in the table was 0.48, markedly higher than the −0.07 ES associated with the TADS CBT intervention. What is not clear from the available data is whether this picture results from a low-potency version of CBT in TADS, from the unusual and challenging comparison of CBT with a medication placebo condition in TADS (see Baskin et al, 2003), from a combination of the two, or from other factors not identified. A concern raised by some (e.g., Jensen, 2003;Weisz, 2004) about the evidence on youth treatment research in general is that so many of the trials have compared active treatment with passive control conditions, including no treatment and waitlist.…”

Section: Discussionmentioning

confidence: 99%

Effects of psychotherapy for depression in children and adolescents: A meta-analysis.

Weisz¹,

McCarty²,

Valeri³

2006

Psychological Bulletin

767

650

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Serious sequelae of youth depression, plus recent concerns over medication safety, prompt growing interest in the effects of youth psychotherapy. In previous meta-analyses, effect sizes (ESs) have averaged .99, well above conventional standards for a large effect and well above mean ES for other conditions. The authors applied rigorous analytic methods to the largest study sample to date and found a mean ES of .34, not superior but significantly inferior to mean ES for other conditions. Cognitive treatments (e.g., cognitive-behavioral therapy) fared no better than noncognitive approaches. Effects showed both generality (anxiety was reduced) and specificity (externalizing problems were not), plus short-but not long-term holding power. Youth depression treatments appear to produce effects that are significant but modest in their strength, breadth, and durability. Keywords depression; children; adolescents; psychotherapy; meta-analysis Depression in children and adolescents (herein referred to collectively as youths) is a significant, persistent, and recurrent public health problem that undermines social and school functioning, generates severe family stress, and prompts significant use of mental health services (Angold et al., 1998;Clarke, DeBar, & Lewinsohn, 2003). Youth depression is also linked to increased risk of other psychiatric disorders (Angold & Costello, 1993) as well as drug use and suicide (Gould et al., 1998;Rohde, Lewinsohn, & Seeley, 1991), which is the third most common cause of death among adolescents (Arias, MacDorman, Strobino, & Guyer, 2003). Relapse rates have been reported at 12% within 1 year and 33% within 4 years (Lewinsohn, Clarke, Seeley, & Rohde, 1994), and by the age of 18 years, some 20% of youths will have met criteria for a diagnosis of major depressive disorder at least once (Birmaher et al., 1996). Prospective longitudinal research has shown substantial continuity of youth depression into adulthood, with impaired functioning in work, social, and family life, and markedly elevated risk of adult suicide attempts and completed suicide (see, e.g., Costello et al., 2002;Weissman et al., 1999). The extent, impact, and long-term sequelae of youth depression underscore the need for effective treatment. A primary purpose of the current article was to assess the effects of the most extensively tested genre of youth depression treatment: psychotherapy. In this article, we seek to answer the six questions listed below. What Is the Overall Effect of Psychotherapy on Youth Depression?The need to examine psychotherapy effects is underscored not only by evidence on the extent, impact, and sequelae of youth depression but also by recent debate over medication risks. Selective serotonin reuptake inhibitors (SSRIs) have become a widely used treatment for depressed youths (Safer, 1997; Treatment for Adolescents with Depression Study [TADS] Team, 2004;Weisz & Jensen, 1999), but concerns over possible risks, including suicidal ideation and suicide attempts (Vitiello & Swedo, 2004;Whittington...

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Section: Discussionmentioning

confidence: 99%

Effects of psychotherapy for depression in children and adolescents: A meta-analysis.

Weisz¹,

McCarty²,

Valeri³

2006

Psychological Bulletin

767

650

View full text Add to dashboard Cite

show abstract

“…As mentioned above, for example, notably high pill placebo response rates are routinely found in depression-outcome research, averaging 30% to 40% and up to 70% (85). In a recent study (86), the authors concluded that outcome differences between putative active psychotherapies and placebo control conditions are neglible when the placebo condition is designed to be "structurally equivalent" (for example, matched on number and duration of therapy sessions and similar therapist training ) to the putative active treatment-which well illustrates the problem posed by placebo response.…”

Section: What Are the Causal Change Mechanisms Of Efficacious Psycholmentioning

confidence: 88%

“…(The above-mentioned Baskin and others [86] study addresses the question.) Two related questions are as follows:…”

Section: What Are the Causal Change Mechanisms Of Efficacious Psycholmentioning

confidence: 98%

The Value of Neuroscience Strategies to Accelerate Progress in Psychological Treatment Research

Moras¹

2006

Can J Psychiatry

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Highlights • Many psychological treatments meet prevailing scientific efficacy standards for various problems. However, like medications, psychological treatments with demonstrated efficacy are also typically associated with suboptimal efficacy and efficiency (for example, rates of remission and sustained recovery). • Extant neuroscience findings, theories, and technologies point to innovations available to researchers investigating psychological treatments that could spur the development of more powerful psychological interventions.

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“…Reviews of the controlled-trial psychotherapy research literature show that systematic matching is not a customary practice (Baskin, Tierney, Minami, & Wampold, 2003;Critelli & Neumann, 1984;Horvath, 1988;Stevens et al, 2000). Rather than precisely controlling for the common factors across psychotherapies, researchers typically use waiting lists, educationally focused groups, dissimilar comparative treatments, and treatment as usual for this purpose.…”

Section: Designing a Control For A Behavioral Group Therapymentioning

confidence: 99%

“…For example, defining structural equivalence by including the same number of sessions and treatment modality (e.g. group therapy, pharmacotherapy), Baskin et al (2003) found smaller effect size differences when active treatments were compared to structurally equivalent controls and larger effect size differences when controls were structurally inequivalent. Baskin and colleagues' focus on requiring equivalent modalities in their definition may explain why earlier studies (Bowers & Clum, 1988;Stevens et al, 2000) were unable to detect meaningful group differences.…”

Section: Designing a Control For A Behavioral Group Therapymentioning

confidence: 99%

Designing a Control for a Behavioral Group Therapy

Safer

Hugo²

2006

Behavior Therapy

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To evaluate whether the specific techniques of a newly developed behavioral therapy exceed the effects of its common factors (e.g. therapeutic alliance), an ideal comparison control must omit the unique ingredients of the active treatment while possessing the common factors in equal measure. Reviews of the controlled-trial psychotherapy research literature show that such systematic matching is not a common practice. Addressing this gap between theory and practice, we delineate seven steps for designing a credible control for a recently developed behavioral therapy adapted for Binge Eating Disorder-Dialectical Behavior Therapy (DBT). Our detailed description of matching the common factors to the extent possible and specifically measuring these offers a useful research design template for investigators of controlled behavioral treatment trials.

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Establishing Specificity in Psychotherapy: A Meta-Analysis of Structural Equivalence of Placebo Controls.

Cited by 315 publications

References 43 publications

Effects of psychotherapy for depression in children and adolescents: A meta-analysis.

Effects of psychotherapy for depression in children and adolescents: A meta-analysis.

The Value of Neuroscience Strategies to Accelerate Progress in Psychological Treatment Research

Designing a Control for a Behavioral Group Therapy

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