The efficacy of systemic therapy on adults with depressive disorders

Members of AFT’s Research Advisory Group have conducted a meta-analysis on the efficacy of systemic therapy on adults with depressive disorders (in cooperation with Prof Martin Pinquart, University of Marburg, Germany). The meta-analysis is based on 30 randomized controlled trials (RCTs) conducted in 12 different countries and was publish online in the journal Psychotherapy Research in May 2024. 

The findings show that the efficacy of systemic interventions is equal to other therapeutic modalities, and that clients who received systemic therapy systemic interventions showed on average larger improvements in depressive symptoms compared to clients in no-treatment control groups. The meta-analytical review further suggests that it would be beneficial to provide more client patients with depression with access to systemic therapy, especially in cases where relational factors play a key role in the onset of depression, and where modalities focussed on the individual are not able to address the impact of system members sustaining or perturbing recovery.

The full paper can be accessed here: Efficacy of systemic therapy on adults with depressive disorders: A meta-analysis  

Objective

This meta-analysis evaluates the efficacy of systemic therapy approaches on adult clients with depressive disorders.

Methods

The illness-specific systematic review updates a previous meta-analysis on the efficacy of systemic therapy on psychiatric disorders in adulthood. It integrates the results of 30 randomized controlled trials (RCTs) comparing systemic psychotherapy for depression with an untreated control group or alternative treatments. Studies were identified through systematic searches in relevant electronic databases and cross-referencing. A random-effects model calculated weighted mean effect sizes for each type of comparison (alternative treatments, control group with no alternative treatment/waiting list) on two outcomes (depressive symptoms change, drop-out rates).

Results

On average, systemic interventions show larger improvements in depressive symptoms compared to no-treatment controls at post-test (g = 1.09) and follow-up (g = 1.23). Changes do not significantly differ when comparing systemic interventions with alternative treatments (post-test g = 0.25; follow-up g = 0.09). Results also vary, in part, by participant age, publication year, and active control condition.

Conclusion

This meta-analysis indicates the potential benefits of systemic interventions for adult patients with depression. Future randomized clinical trials in this area should enhance study quality and include relational and other relevant outcome measures.

Clinical or methodological significance:

The result of the meta-analysis enhances the evidence base on systemic therapy for depression. It provides valuable implications for both therapists working with clients who are experiencing depressive symptoms and for researchers’ continued examination of systemically oriented psychotherapy approaches for depression. With an international dataset, the conclusions hold global implications for mental health service providers and individuals with depression.