Effectiveness of Psychotherapy: Synthesis of a “Meta-Analytic Research Domain” Across World Regions and 12 Mental Health Problems

Mathias Harrer*, Clara Miguel, Wouter van Ballegooijen, Marketa Ciharova, Constantin Yves Plessen, Paula Kuper, Antonia A. Sprenger, Claudia Buntrock, Davide Papola, Ioana A. Cristea, Nino de Ponti, Đorđe Bašić, Darin Pauley, Ellen Driessen, Soledad Quero, Jorge Grimaldos, Sara Fernández Buendía, Cristina Botella, Jessica L. Hamblen, Paula P. SchnurrSadie E. Larsen, Rory A. Pfund, Emma Motrico, Irene Gómez-Gómez, Kim Setkowski, Minoo Matbouriahi, Yingying Wang, Josine Rawee, Heleen Riper, Annemieke van Straten, Marit Sijbrandij, Stefan Leucht, Toshi A. Furukawa, Eirini Karyotaki, Pim Cuijpers

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

The scientific output generated in psychology has surged in recent decades, including the number of studies investigating psychological treatments. To keep track of all this evidence, we developed the “Metapsy” meta-analytic research domain: a comprehensive system of open databases and tailored software that allows for rapid evidence generation. We leverage this novel infrastructure to summarize the effect of psychological treatment across 12 mental health problems and trace back the global expansion of psychotherapy research over the past 50 years. Including 1,029 studies with 85,952 patients, our results indicate small to moderate average benefits in treating psychosis (g = 0.32), suicidal ideation (g = 0.34), borderline personality disorder (g = 0.46), and prolonged grief (g = 0.49). In contrast, psychological interventions have large average effects on depression (g = 0.73), problem gambling (g = 0.80), panic (g = 0.83), generalized anxiety (g = 0.86), social anxiety (g = 0.95), obsessive–compulsive (g = 1.18), posttraumatic stress disorder (g = 1.18), and phobias (g = 1.25). Most available evidence (83.4%–86.1%) comes from high-income and Western countries, but their dominance is declining. We found no indication that psychotherapy is less effective in low- and middle-income countries (g = 0.38–2.41) or non-Western cultures (g = 0.74–2.20). We discuss ways to further enhance psychotherapy’s public health impact, as well as how the meta-analytic research domain concept may be extended to other types of psychological research in the future.

Original languageEnglish
Pages (from-to)600-667
Number of pages68
JournalPsychological bulletin
Volume151
Issue number5
DOIs
Publication statusPublished - May 2025

Bibliographical note

Publisher Copyright:
© 2025 American Psychological Association

Funding

Mathias Harrer reports to be a part-time employee of Get. On Institut/HelloBetter, a company that aims to implement digital psychological interventions into routine care. Ellen Driessen has received grants from the American Psychoanalytic Association, the Dutch Psychoanalytic Funds, and the Dutch Research Council. Stefan Leucht has received honoraria as a consultant/advisor and/or for lectures from Angelini B\u00F6hringer Ingelheim, Geodon and Richter, Janssen, Johnson & Johnson, Lundbeck, and LTS Lohmann. Toshi A. Furukawa reports personal fees from Boehringer-Ingelheim, Daiichi Sankyo, DT Axis, Micron, Shionogi, SONY, and UpToDate, and a grant from DT Axis and Shionogi, outside the submitted work. Davide Papola was funded by the Horizon-MSCA-2021-PF-01 research program of the European Union under Grant Agreement No. 101061648. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the article; and decision to submit the article for publication. This research was funded in whole, or in part, by the Horizon Europe Framework Programme (Grant 101061648). For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission.

FundersFunder number
H. Lundbeck A/S
Angelini Böhringer Ingelheim
Nederlandse Organisatie voor Wetenschappelijk Onderzoek
American Psychoanalytic Association
HORIZON EUROPE Framework Programme
Dutch Psychoanalytic Funds
UpToDate
Shionogi
European Commission101061648

    Keywords

    • mental disorders
    • meta-analysis
    • meta-analytic research domain
    • psychotherapy
    • systematic reviews

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