The Utility of Psychotherapy: Meaningful Treatments for Depression and Anxiety

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Bhandari, Nishant
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Major Depressive Disorder (MAD) and Generalized Anxiety Disorder (GAD) correlate with earlier mortality rates; those affected die up to eight years earlier than populations without either affective condition (Pratt et al., 2016). There is an increasing need for interventions as trillions of global dollars are lost yearly due to mental health complications (Chisholm et al., 2016). This review evaluates the quality of evidence generated by research to inform treatments for anxiety and depression, and the outcomes of clinical guidelines informed by this research. Most outcome studies and clinical guidelines selected for this review are from 2014 onwards, or as close as possible, in an effort to combat the potential six-year half-life of psychological data (Neimeyer et al., 2014). Findings are aggregated as being MDD specific, GAD specific, MDD-GAD comorbidity specific, or as supporting MDD-GAD relevant themes. Adjusted effect size estimates of psychotherapy suggest psychotherapy is "probably effective" when defined as better than no treatment at all (Cuijpers et al., 2016a, p.245 and p.254). Still, practitioners and researchers should interpret effects cautiously, given the absence of many high-quality studies. Psychotherapy is not responsible for 86% of the variation in outcome studies (see Table 9.1 in Wampold, 2015). In the 14% outcome-influence of psychotherapy, research quality obstructs a conclusive answer to the question of how well outcome measures support current clinical recommendations for treating depression and anxiety. Even if current recommendations are high-quality, and this literature review simply reflects outcomes from practitioners failing to adopt guidelines, improving research quality needs to be a priority in future MDD and GAD studies.
anxiety, depression, gad, mdd, psychotherapy, counselling, medication, treatment, pharmacology, outcome, efficacy, comorbidity, effect size, clinical guidelines, cognitive behavioural therapy
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