The Efficacy of Systemic Therapy With Adult Patients: A Meta‐Content Analysis of 38 Randomized Controlled Trials

Abstract

Systemic therapy is a widely used psychotherapy approach. Yet there exist few systematic reviews on its efficacy. A meta-content analysis was performed to analyze the efficacy of systemic therapy for the treatment of mental disorders in adulthood. All randomized (or matched) controlled trials (RCT) evaluating systemic/systems oriented therapy in various settings (family, couple, individual, group, multifamily group therapy) with adult index patients suffering from mental disorders were identified by database searches and cross-references in other reviews. Inclusion criteria were: index patient diagnosed with a DSM or ICD listed mental disorder, trial published in any language up to the end of 2008. The RCTs were content analyzed according to their research methodology, interventions applied, and results. Thirty-eight trials published in English, German, Spanish, and Chinese were identified, 34 of them showing systemic therapy to be efficacious for the treatment of mood disorders, eating disorders, substance use disorders, mental and social factors related to medical conditions and physical disorders, and schizophrenia. Systemic therapy may also be efficacious for anxiety disorders. Results were stable across follow-up periods of up to 5 years. There is a sound evidence-base for the efficacy of systemic therapy for adult index patients with mental disorders in at least five diagnostic groups.

The State of the Art in Family Therapy Research: What Works? How it Works?

“…Considering that measurement is the main method for determining family therapy's effectiveness and processes, during the past three decades we have witnessed an exponential increase in the number of empirical studies and meta-analyses with good methodology regarding the systemic family interventions (Carr, 2009a;Larner, 2004;Shadish & Baldwin 2003;Sprenkle, 2012;Von Sydow, Beher, Schweitzer, & Retzlaff, 2010). Most recently, the importance of practice-based research and qualitative studies for evaluating the effectiveness of such interventions in general, and in family therapy in particular, has been debated (Larner, 2004;Popay, 2000, Sprenkle, 2012.…”

“…Von Sydow et al, 2010 To analyze the systemic therapy effectiveness in the treatment of mental disorders in adults.…”

“…More recently, Von Sydow et al (2010) analyzed the content of 38 empirical essays about the effectiveness of systemic therapy (family therapy, couple therapy, group therapy, for example) with adults, concluding that 34 of these studies attested the effectiveness of such interventions, mainly in the treatment of mood disorders, eating disorders, drug abuse problems, mental and social issues associated to medical conditions and physical problems, and schizophrenia. In this study, the authors also concluded that (i) systemic therapy has no adverse effects; (ii) with certain disorders systemic therapy needs to be combined with other psychotherapeutic or pharmacological forms of intervention; (iii) the number of drop-outs in this practice is lower than in other forms of psychotherapy; (iv) the most efficient interventions involved guidance to strengths/resources and positive reframing.…”

The Quality of Depressive Experience as a Prognostic Factor in Eating Disorders

“…It is not surprising that interest in family interventions in eating disorders has increased over the past 5 years. A recent metanalysis of RCT studies has shown that systemic family therapy appears efficacious for the treatment of adult eating disorders (von Sydow et al, 2010). Family interventions are the current first-line treatment for adolescent anorexia nervosa and promising for adolescent bulimia nervosa (Le Grange and Eisler 2009;Lock 2011).…”

Social Work and Family Therapy: Interdisciplinary Roots of Family Intervention

“…From 2008 to 2011, thirtyeight RCT studies of family intervention dealing with adult patients were identified in the international literature (Sydow et al 2010). At the same time, forty-seven RCT studies of child and adolescent externalizing behavior (ADHD, conduct disorders, substance abuse) , and thirty-eight RCT studies of child and adolescent internalizing and other behaviors (mood disorders, anxiety disor-ders, eating disorders, suicidality, etc.)…”