Predicting who benefits most from cognitive-behavioral therapy for anxiety and depression

J Clin Psychol. 2014 Oct;70(10):924-32. doi: 10.1002/jclp.22099. Epub 2014 Apr 19.


Objectives: We examined core features of patient suitability for cognitive-behavioral therapy (CBT) and their ability to predict CBT outcomes.

Method: A sample of 256 outpatients diagnosed with depression and anxiety disorders were assessed using the Suitability for Short-Term Cognitive Therapy (SSCT) scale. Therapists rated patients' symptom severity using the Clinical Global Impression scale before and after therapy.

Results: A factor analysis of the SSCT scale yielded 2 factors: (a) Capacity for Participation in CBT Process and (b) Attitudes Relevant to the CBT Process. A multiple regression analysis revealed that only Capacity for Participation in CBT Process uniquely predicted improvement at termination.

Conclusions: These findings highlight the importance of assessing the suitability of CBT for individual patients. Specifically, patients with greater capacity to identify and articulate thoughts and feelings and to share them in a nondefensive, focused way benefit most from CBT.

Keywords: anxiety; cognitive-behavioral therapy; depression; factor analysis; suitability.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Depressive Disorder / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Severity of Illness Index
  • Young Adult