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ViewAttendees 3

Symposia

Treatment - CBT

Making a Research Contribution Using Data Collected in Routine Practice

2 - (SYM 55) Effectiveness, Efficiency, and Acceptability of Cognitive Behavior Therapy in Private Practice

Sunday, November 23, 2025
12:37 PM - 12:56 PM CST
Location: Celestin G, Level 3
Keywords: CBT, Assessment, Research Methods
Recommended Readings: Persons, J. B. (2001). Conducting effectiveness studies in the context of evidence-based clinical practice. Clinical Psychology: Science and Practice, 8, 168-172.,   Van Swearingen, Kristen M., and John E. Lothes. “Symptom Reduction in DBT-Informed Partial Hospital, Intensive Outpatient, and Step-down Programs: Mindfulness Matters.” Psychotherapy Research 32, no. 5 (July 4, 2022): 640–51. https://doi.org/10.1080/10503307.2021.2001602.,   Neacsiu, A. D., S. L. Rizvi, and M. M. Linehan. “Dialectical Behavior Therapy Skills Use as a Mediator and Outcome of Treatment for Borderline Personality Disorder.” Behaviour Research and Therapy 48, no. 9 (February 24, 2015): 832–39. https://doi.org/10.1016/j.brat.2010.05.017.,   ,  
Abstract Body

The "treatment prevalence paradox" refers to the puzzling observation that, despite increased availability of treatments for depression, the prevalence of depression in the general population has remained largely unchanged. One proposed explanation is that the effectiveness of treatments demonstrated in randomized controlled trials (RCTs) may not fully translate to “real-world” clinical practice. While several studies have examined how outcomes from RCTs compare to those in routine care settings, limited research has focused specifically on psychotherapy outcomes in private practice settings. This gap is significant given that over one-third of individuals who receive mental health care do so through private practice. Understanding the degree to which RCT findings align with treatment outcomes in private practice is essential for identifying potential barriers to effectiveness, optimizing treatment delivery, and ensuring that evidence-based interventions remain both applicable and accessible in diverse clinical contexts.

The goal of this presentation is to discuss a study that compares findings from RCTs of Cognitive Behavioral Therapy (CBT) for depression to outcomes observed in a private practice clinic. This study will investigate how the effectiveness (Aim 1), efficiency (Aim 2), and acceptability (Aim 3) of CBT for depression in this private practice setting compares to results from RCTs of CBT for depression. We hypothesize that effect sizes observed in this private practice sample will be comparable to effect sizes from RCTs and other clinical practice settings (Aim 1). We expect that the time (number of sessions) to achieve reliable change in this private practice sample will be comparable to time to achieve reliable change observed in RCTs, and that treatment duration (total number of sessions) in this private practice sample will be longer than in the RCTs (Aim 2). Finally, we hypothesize that patient dropout rates in this private practice sample will be comparable to other clinical settings but higher than the RCTs.

To address our aims, the study leverages a robust dataset of routine outcomes monitoring collected over the course of over 40 years from approximately 1500 clients. This study is pre-registered, and data analyses are underway. By the end of this presentation, attendees will gain insight into how CBT for depression performs in private practice compared to RCTs, highlighting implications for real-world treatment effectiveness, efficiency, and acceptability.