Effectiveness and Outcome Prediction of Outpatient Cognitive Behavioral Therapy

Background: Investigations regarding the effectiveness of outpatient psychotherapy for various psychological disorders treated in naturalistic settings are rare. The present study investigates several psychological predictors of outpatient cognitive behavioral therapy in a largely un-selected patient sample treated by trainees in psychotherapy under supervision. Patients and Methods: In this prospective study, 73 patients with diverse diagnoses according to the International Classification of Diseases 10 (ICD-10) were examined before and after treatment. Effect sizes (Cohen's d) were used to assess the treatment outcome. To predict treatment outcome, the strategy of multiple outcome criteria was used, calculating a load score and an outcome score from several outcome measures. Sociodemographic and psychological predictor variables were tested in a mixed-model analysis. Results: Pre-post analyses showed high effect sizes between d = 0.98 and d = 1.43. The severity of the psychological problems at treatment start, an anxiety disorder and a lower level of education were found to be significant treatment outcome predictors. Other variables were not correlated with outcome. Conclusions: Cognitive behavioral therapy in a clinical outpatient setting carried out by psychologists in psychotherapy training under supervision can be very effective overall. Patients with anxiety disorders draw the least benefit whereas patients with adaptation and personality disorders benefit the most. Questions arising from the different results are discussed and some suggestions for future research are made.