The efficacy of non-directive supportive therapy for adult depression: a meta-analysis

Clin Psychol Rev. 2012 Jun;32(4):280-91. doi: 10.1016/j.cpr.2012.01.003. Epub 2012 Feb 8.


The effects of non-directive supportive therapy (NDST) for adult depression have been examined in a considerable number of studies, but no meta-analysis of these studies has been conducted. We selected 31 studies on NDST from a comprehensive database of trials, examining psychotherapies for adult depression, and conducted meta-analyses in which NDST was compared with control groups, other psychotherapies and pharmacotherapy. We found that NDST is effective in the treatment of depression in adults (g=0.58; 95% CI: 0.45-0.72). NDST was less effective than other psychological treatments (differential effect size g=-0.20; 95% CI: -0.32 to -0.08, p<0.01), but these differences were no longer present after controlling for researcher allegiance. We estimated that extra-therapeutic factors (those processes operating in waiting-list and care-as-usual controls) were responsible for 33.3% of the overall improvement, non-specific factors (the effects of NDST compared with control groups) for 49.6%, and specific factors (the effects of NDST compared with other therapies) for 17.1%. NDST has a considerable effect on symptoms of depression. Most of the effect of therapy for adult depression is realized by non-specific factors, and our results suggest that the contribution of specific effects is limited at best.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Adult
  • Control Groups
  • Depression / therapy*
  • Depressive Disorder / therapy*
  • Humans
  • Male
  • Person-Centered Psychotherapy / statistics & numerical data*
  • Psychotherapy / methods*