A just published paper in the Journal of Clinical Psychology by Smith and Hewit (2024) proclaims the equivalence of psychodynamic and cognitive behavioural therapy for depressive disorder in adults. At face value it supports the Dodo verdict – that all psychotherapies are equal and it is the common factors between them that makes a difference. But the authors appear to be operating in a parallel universe:
- It is impossible to discern from the 10 studies considered what proportion of people in each condition were recovered in the sense that they considered themselves back to their old selves and the duration of such a return.
- Only 4 of the 10 studies used independent blind-raters.
- Patients had 22-25 treatment sessions, this impossible to provide in routine practice, but this is not even mentioned
- Only the results on completers could be furnished, no intention to treat analysis.
- Only 4 of the 10 studies assessed treatment adherence.
- The authors observe ‘ The HRSD was the most commonly used measure of depressive symptoms across included studies. However, research suggests that the HRSD’s total score is multidimensional, that its factor structure is not invariant across different populations, and that its conceptualization of depression is several decades out of date (see Bagby et al., 2004 for review). Hence, future research would likely profit from using a more psychometrically sound assessor‐rated measure of depression’
- 75% of the population was female, no report of social class. 4 studies did not report ethnicity.
Real-world avoidance is it seems ripe
Dr Mike Scott