The Effectiveness of Psychotherapy for Depression in Private Practice: Benchmarking and Trajectories of Change

The efficacy and effectiveness of psychotherapy for depression are well established in many clinical settings. Nonetheless, its effectiveness in private practice, perhaps the most common clinical setting, has yet to be examined. Likewise, the trajectories of change in depressive symptoms observed during psychotherapy for depression in private practice have yet to be studied. The present study harnessed a large practice-research group of private practitioners to address these important omissions in the literature. The sample of clients with depression (N = 2,268) included in the study displayed medium-to-large and large-sized reductions in depressive symptoms following treatment (depending on baseline severity). These effects were benchmarked against those synthesized from randomized controlled trials (RCTs), a comparable benchmark study, and the course of untreated depression. The outcomes exhibited by the private practice clients were found to be superior to no treatment, equivalent to those reported in other naturalistic clinical settings, and nonequivalent to those exhibited by experimental groups in RCTs. Furthermore, the analysis of trajectories of change indicated that higher session frequency early on in treatment led to better outcomes. Overall, these findings attest to the effectiveness of psychotherapy for depression delivered in private practice. Additionally, they provide clinically useful findings underscoring the importance of higher session frequency in the early phase of psychotherapy. Public Significance Statement Findings from the present study support the effectiveness of psychotherapy for depression delivered in private practice. Moreover, they underscore the importance of higher session frequency in the early phase of treatment.