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Non-directive supportive therapy for depression: A meta-analytic review.
Pim Cuijpers1, Clara Miguel2, Marketa Ciharova2
1Department of Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands; Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania.
Journal of Affective Disorders
|January 11, 2024
Summary
Non-directive supportive therapy (NDST) is an effective depression treatment, showing moderate effects against control groups. However, its efficacy compared to other therapies may be overestimated when NDST is used as a control.
Area of Science:
- Psychiatry and Behavioral Sciences
- Clinical Psychology
- Evidence-Based Medicine
Background:
- Non-directive supportive therapy (NDST) is a recognized treatment for adult depression.
- A comprehensive meta-analysis integrating recent randomized trials on NDST's effectiveness was lacking.
Purpose of the Study:
- To conduct a meta-analysis of randomized controlled trials (RCTs) evaluating Non-directive supportive therapy (NDST) for adult depression.
- To compare NDST's efficacy against control conditions and other psychotherapies.
Main Methods:
- Systematic search of PubMed, PsycINFO, Embase, and the Cochrane Library for relevant randomized trials.
- Inclusion of 48 RCTs involving 5075 participants.
- Random effects meta-analyses were performed to calculate effect sizes.
Main Results:
- NDST demonstrated a moderate effect size (g=0.53) compared to control conditions, indicating probable effectiveness.
- NDST was found to be less effective than other psychotherapies (g=-0.21).
- This difference was significantly larger in studies where NDST served as the control group, suggesting potential bias.
Conclusions:
- Non-directive supportive therapy is likely an effective treatment for depression.
- The observed smaller effects compared to other therapies might be influenced by NDST's frequent use as a control, potentially as an 'intent-to-fail' intervention.
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