Treatment-as-usual (TAU) is anything but usual: A meta-analysis of CBT versus TAU for anxiety and depression

Abstract Objectives There were three aims of this study, the first was to examine the efficacy of CBT versus treatment-as-usual (TAU) in the treatment of anxiety and depressive disorders, the second was to examine how TAU is defined in TAU control groups for those disorders, and the third was to explore whether the type of TAU condition influences the estimate of effects of CBT. Method A systematic search of Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL was conducted. Results 48 studies of CBT for depressive or anxiety disorders ( n =6926) that specified that their control group received TAU were identified. Most ( n =45/48) provided an explanation of the TAU group however there was significant heterogeneity amongst TAU conditions. The meta-analysis showed medium effects favoring CBT over TAU for both anxiety ( g =0.69, 95% CI 0.47–0.92, p