How well therapy works: statistics

A network meta-analysis for adult depression alone pooled hundreds of randomised trials. Trials compare a therapy with a waiting list, with usual care, or with another treatment. The answer to 'does it work?' depends on which of these a figure comes from.

These figures come from the original trials and reviews, not from summaries of them. Each figure names the comparison and the measure. Most also give the number of trials or people and the time point.

Most effect sizes here describe how far apart two groups ended up. They are not the share of people who got better. The couple therapy figures are different: they describe change within one group.

Therapy against waiting list, usual care or placebo

The counts below show how large the trial base is. A review of cognitive behavioural therapy (CBT) for depression and anxiety disorders adds two warnings.

Most anxiety trials compared CBT with a waiting list, which makes effects look larger. Only a small share of the trials met the authors' standard for high quality. For panic disorder and social anxiety disorder, effects were smaller when the authors counted only those trials.

• A network meta-analysis comparing eight types of psychotherapy for adult depression with each other and with control conditions pooled 331 randomised trials. (meta-analysis of trials, published 2021, checked 10 Oct 2026) ¹
• The trials in a network meta-analysis of psychotherapies for adult depression included 34,285 patients. (meta-analysis of trials, published 2021, checked 10 Oct 2026) ¹
• A meta-analysis of cognitive behavioural therapy (CBT) for depression and three anxiety disorders pooled 144 randomised trials against control conditions. (meta-analysis of trials, published 2016, checked 10 Oct 2026) ⁴
• In randomised trials of adults with major depression, CBT reduced symptoms more than control conditions, a mix of waiting lists, usual care and pill placebo, by the end of treatment (Hedges' g 0.75). The result pools adults with major depression in 63 comparisons of CBT against control conditions. (meta-analysis of trials, published 2016, checked 10 Oct 2026) ⁴
• More than 80% of the randomised trials of CBT for anxiety disorders in one meta-analysis used a waiting list as the comparison. The few with other comparison groups found much smaller effects. (meta-analysis of trials, published 2016, checked 10 Oct 2026) ⁴
• Only 17.4% of the randomised trials in a meta-analysis of CBT for depression and anxiety disorders met the authors' standard for high quality. (meta-analysis of trials, published 2016, checked 10 Oct 2026) ⁴

By condition

Each review below pooled trials at the end of treatment. Figures from different reviews are not comparable with each other. Most figures here are for CBT or trauma-focused therapies, because those are what these reviews reported separately. That does not show that other approaches work less well.

The CBT anxiety figures compare CBT with a mix of waiting lists, usual care and pill placebo. Against usual care alone, the review found much smaller effects. The high-quality panic disorder figure rests on four trials, all against a waiting list.

For PTSD, the review graded how sure we can be of each result. The borderline personality disorder review included teenagers as well as adults, mostly female. The eating disorder count covers anorexia nervosa, bulimia nervosa, binge-eating disorder and mixed samples.

• In randomised trials of adults with generalised anxiety disorder, CBT reduced symptoms more than control conditions by the end of treatment (Hedges' g 0.80). The result pools adults with generalised anxiety disorder in 31 comparisons of CBT against control conditions. (meta-analysis of trials, published 2016, checked 10 Oct 2026) ⁴
• After adjusting for publication bias, the end-of-treatment effect of CBT against control conditions for generalised anxiety disorder fell to 0.59 (Hedges' g). The result pools adults with generalised anxiety disorder in 31 comparisons of CBT against control conditions. (meta-analysis of trials, published 2016, checked 10 Oct 2026) ⁴
• In randomised trials of adults with panic disorder, CBT reduced symptoms more than control conditions by the end of treatment (Hedges' g 0.81). The result pools adults with panic disorder in 42 comparisons of CBT against control conditions. (meta-analysis of trials, published 2016, checked 10 Oct 2026) ⁴
• Counting only high-quality trials, the end-of-treatment effect of CBT against control conditions for panic disorder fell to 0.61 (Hedges' g). The result pools adults with panic disorder in 4 high-quality trials of CBT against control conditions. (meta-analysis of trials, published 2016, checked 10 Oct 2026) ⁴
• In randomised trials of adults with social anxiety disorder, CBT reduced symptoms more than control conditions by the end of treatment (Hedges' g 0.88). The result pools adults with social anxiety disorder in 48 comparisons of CBT against control conditions. (meta-analysis of trials, published 2016, checked 10 Oct 2026) ⁴
• Counting only high-quality trials, the end-of-treatment effect of CBT against control conditions for social anxiety disorder fell to 0.76 (Hedges' g). The result pools adults with social anxiety disorder in 8 high-quality trials of CBT against control conditions. (meta-analysis of trials, published 2016, checked 10 Oct 2026) ⁴
• A review of psychological therapies for post-traumatic stress disorder (PTSD) in adults included 114 randomised trials. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ⁵
• The randomised trials in a review of psychological therapies for adults with PTSD included 8,171 participants. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ⁵
• Trauma-focused CBT reduced PTSD symptom severity more than a waiting list or usual care, by a standardised mean difference of 1.32 after treatment (moderate-quality evidence). The result pools adults with PTSD in 51 trials (1,380 participants) comparing trauma-focused CBT with a waiting list or treatment as usual. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ⁵
• Eye movement desensitisation and reprocessing (EMDR) reduced PTSD symptom severity more than a waiting list or usual care, by a standardised mean difference of 1.23 after treatment (low-quality evidence). The result pools adults with PTSD in 11 trials (415 participants) comparing EMDR with a waiting list or treatment as usual. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ⁵
• At the end of treatment, psychotherapy reduced the severity of borderline personality disorder symptoms more than treatment as usual, by a standardised mean difference of 0.52 (moderate-quality evidence). The result pools people with borderline personality disorder in 22 trials (1,244 participants) comparing psychotherapy with treatment as usual. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ⁶
• A meta-analysis of individual CBT for eating disorders drew on 42 randomised trials. (meta-analysis of trials, published 2025, checked 10 Oct 2026) ⁷

By approach: head to head

When the trials and reviews below test therapies against each other, the differences are small or not significant. Figures from different reviews are not a ranking.

In the psychodynamic equivalence review, the comparison treatments, mostly CBT, did slightly better. The difference stayed inside the margin the authors set in advance. The review's authors included researchers from both psychodynamic therapy and CBT, to control for researcher allegiance. Equivalent here means inside that margin, not that there was no difference. On psychosocial functioning at follow-up, the review did not find equivalence; there the result leaned towards psychodynamic therapy, but a test for superiority was not significant.

In the review of interpersonal psychotherapy (IPT), the unadjusted difference favoured IPT. The figure adjusted for publication bias favoured the other treatments. Neither was significant.

In an English trial of adolescents, neither CBT nor short-term psychoanalytic psychotherapy did better than a brief psychosocial intervention twelve months after treatment ended. The two therapies did about as well as each other. In a Pennsylvania trial of adults, dynamic psychotherapy was not inferior to cognitive therapy on the clinician-rated measure. On most self-report measures, the trial could not show that.

In Australia, a programme built on social connection, Groups for Health, was not inferior to group CBT for depression in young people at twelve months. Groups for Health is not a conventional psychotherapy.

The CBT review in the list below does not state the time point for its head-to-head figure.

• A meta-analysis of direct comparisons between bona fide psychotherapies for adult depression (therapies meant to be therapeutic, with a clear rationale) pooled 53 randomised trials. (meta-analysis of trials, published 2013, checked 10 Oct 2026) ²
• The head-to-head trials of bona fide psychotherapies for adult depression in one meta-analysis included 3,965 patients. (meta-analysis of trials, published 2013, checked 10 Oct 2026) ²
• Head to head with other psychotherapies, CBT for depression was ahead by a small effect size (Hedges' g) of 0.06. The confidence interval reached down to zero, and the difference was no longer significant in most sensitivity analyses. The result pools adults with depression in 87 studies comparing CBT with other psychotherapies. (meta-analysis of trials, published 2023, checked 10 Oct 2026) ⁸
• Head to head with other psychological treatments at the end of treatment, IPT for depression was ahead by an effect size (Cohen's d) of 0.04, a difference that was not statistically significant. The result pools people with depression in 10 trials comparing IPT with other psychological treatments; the trials included adolescents as well as adults. (meta-analysis of trials, published 2011, checked 10 Oct 2026) ⁹
• After adjusting for publication bias, IPT for depression trailed other psychological treatments at the end of treatment by 0.11 (Cohen's d), a difference that was still not statistically significant. The result pools people with depression in 10 trials comparing IPT with other psychological treatments. (meta-analysis of trials, published 2011, checked 10 Oct 2026) ⁹
• A meta-analysis testing whether psychodynamic therapy is equivalent to treatments of established efficacy pooled randomised trials with 2,751 patients. (meta-analysis of trials, published 2017, checked 10 Oct 2026) ¹⁰
• Before analysing the results, the authors of a psychodynamic therapy equivalence meta-analysis set a margin of 0.25 (Hedges' g). The therapies counted as equivalent only if the confidence interval of the difference lay wholly inside that margin, either way. (meta-analysis of trials, published 2017, checked 10 Oct 2026) ¹⁰
• At the end of treatment, the comparison treatments did slightly better than psychodynamic therapy on target symptoms, by 0.153 (Hedges' g). The difference lay inside the margin the authors had set for equivalence. The result pools adults in 23 randomised trials comparing manual-guided psychodynamic therapy with a treatment of established efficacy, mostly CBT. (meta-analysis of trials, published 2017, checked 10 Oct 2026) ¹⁰
• Head to head, EMDR and trauma-focused CBT showed no evidence of a difference in PTSD symptom severity after treatment (standardised mean difference 0.17, low-quality evidence). The review does not state which way this difference points. The result pools adults with PTSD in 10 trials (387 participants) comparing EMDR with trauma-focused CBT. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ⁵
• A trial randomly assigned 470 adolescents aged 11 to 17 with major depressive disorder at 15 NHS child and adolescent mental health clinics in England to CBT, short-term psychoanalytic psychotherapy or a brief psychosocial intervention. (randomised trial, 2010-2013 data, checked 10 Oct 2026) ¹¹
• A noninferiority trial randomly assigned 237 adult outpatients with major depressive disorder at a community mental health centre in Pennsylvania to sixteen sessions of short-term dynamic psychotherapy or cognitive therapy. (randomised trial, 2010-2014 data, checked 10 Oct 2026) ¹²
• In a community mental health centre in Pennsylvania, adults with major depressive disorder improved slightly more on a clinician-rated depression scale with cognitive therapy than with dynamic psychotherapy. By the end of sixteen sessions the difference was 0.11 (Cohen's d), which was not statistically significant. By the trial's test, dynamic therapy was not inferior on that measure. On most patient-rated measures of symptoms, functioning and quality of life, the trial could not show that it was not inferior. The trial randomised 237 adult outpatients with major depressive disorder at a community mental health centre in pennsylvania. (randomised trial, 2010-2014 data, checked 10 Oct 2026) ¹²
• A noninferiority trial enrolled 174 people aged 15 to 25 in Southeast Queensland with loneliness and clinically significant depression symptoms. It compared five group sessions of Groups for Health, a programme built on social connection, with five sessions of group CBT. (randomised trial, 2018-2019 data, checked 10 Oct 2026) ¹³

By approach: how much evidence each has

Some approaches have far more trials than others. Fewer trials means less tested, not less effective.

This section shows IPT and dialectical behaviour therapy (DBT) against control groups. The DBT figure rests on few trials. Psychodynamic therapy appears in the head-to-head section above. We did not include a pooled figure for family therapy or for humanistic and experiential therapies. This says nothing about whether these approaches work.

• At the end of treatment, interpersonal psychotherapy (IPT) for depression did better than control groups by an effect size (Cohen's d) of 0.63. The control groups were a mix of usual care, waiting lists, pill placebo and other conditions. The result pools people with depression in 16 trials comparing IPT with a control group; the trials included adolescents as well as adults. (meta-analysis of trials, published 2011, checked 10 Oct 2026) ⁹
• Dialectical behaviour therapy (DBT) reduced the severity of borderline personality disorder symptoms more than treatment as usual at the end of treatment (standardised mean difference 0.60, low-quality evidence). The result pools people with borderline personality disorder in 3 trials (149 participants) comparing DBT with treatment as usual. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ⁶

Couple therapy: before-and-after figures

The two figures below compare couples with themselves, before and after, not with a control group. That is weaker evidence than a comparison between groups. Do not set them beside the figures above.

• Couples in couple therapy gained in relationship satisfaction between the start and end of therapy, by a within-group effect size (Hedges' g) of 1.12. This before-and-after figure has no comparison group. The review's abstract does not give the number of studies or couples behind this figure. The review's samples were all opposite-sex couples. (meta-analysis of studies, published 2020, checked 10 Oct 2026) ¹⁴
• Couples on a waiting list in studies of couple therapy did not improve significantly in relationship satisfaction while they waited (within-group Hedges' g 0.12). The review's abstract does not give the number of studies or couples behind this figure. (meta-analysis of studies, published 2020, checked 10 Oct 2026) ¹⁴

How long the benefits last

Fewer trials follow people up after therapy ends. In the depression network meta-analysis, about a year means twelve months after randomisation, give or take six. The year runs from the start of the trial, not from the end of therapy.

Two trials in South Asia followed people for a year. In the Pakistan trial, maternal depression was a secondary outcome; the main outcomes were the infants' weight and height.

• In a network meta-analysis of psychotherapies for adult depression, 90 trials reported whether patients had responded about a year after randomisation. (meta-analysis of trials, published 2021, checked 10 Oct 2026) ¹
• At the latest follow-up each trial reported, the comparison treatments again did slightly better than psychodynamic therapy on target symptoms, by 0.049 (Hedges' g). This difference also lay inside the authors' margin for equivalence. The result pools adults in 16 randomised trials comparing manual-guided psychodynamic therapy with a treatment of established efficacy, mostly CBT, that reported a follow-up. (meta-analysis of trials, published 2017, checked 10 Oct 2026) ¹⁰
• At twelve months' follow-up, 27% of mothers in rural Rawalpindi with perinatal depression whose community health workers delivered a CBT-based programme met the criteria for major depression. (randomised trial published 2008, year not stated, checked 10 Oct 2026) ¹⁵
• At twelve months' follow-up, 59% of mothers in rural Rawalpindi with perinatal depression visited by untrained health workers met the criteria for major depression. (randomised trial published 2008, year not stated, checked 10 Oct 2026) ¹⁵
• In Goa, adults with moderately severe to severe depression got the Healthy Activity Programme from lay counsellors or enhanced usual care alone. Twelve months after randomisation, those who got the programme were more likely to be in remission (adjusted prevalence ratio 1.36). The programme itself lasted two to three months, so the twelve months run from the start of the trial, not from the end of therapy. The result covers 493 primary care attendees in goa aged 18 to 65 with moderately severe to severe depression. (randomised trial published 2017, year not stated, checked 10 Oct 2026) ¹⁶

Therapy, medication, or both

Most of these figures compare effects; one compares how many people dropped out. All but the IPT figures come from one network meta-analysis, counted in the first bullet. Most of its trials enrolled people with moderate to severe depression.

The IPT figures come from a separate review. They do not tell you how other single approaches compare with medication. That review found too few combination trials to draw firm conclusions.

• A network meta-analysis of psychotherapy, antidepressant medication and their combination for adult depression pooled 101 randomised trials. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ³
• Pooling all types of psychotherapy and of antidepressant medication, psychotherapy alone and medication alone showed no significant difference in response at the end of treatment (relative risk 0.99). Response meant symptoms falling by at least half. The result pools adults with depression, mostly moderate to severe, in 101 randomised trials of psychotherapy, medication or both. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ³
• At the end of treatment, psychotherapy combined with medication was more likely to bring a response than psychotherapy alone (relative risk 1.27). The result pools adults with depression, mostly moderate to severe, in 101 randomised trials of psychotherapy, medication or both. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ³
• At the end of treatment, psychotherapy combined with medication was more likely to bring a response than medication alone (relative risk 1.25). The result pools adults with depression, mostly moderate to severe, in 101 randomised trials of psychotherapy, medication or both. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ³
• Psychotherapy alone was more acceptable than medication alone (relative risk for acceptability 1.17, where above one favours psychotherapy). Acceptability here means people staying in rather than leaving the study for any reason during acute-phase treatment. The result pools adults with depression, mostly moderate to severe, in 101 randomised trials of psychotherapy, medication or both. (meta-analysis of trials, published 2020, checked 10 Oct 2026) ³
• At the end of treatment, antidepressant medication and IPT for depression did not differ significantly (Cohen's d 0.12, favouring medication). The result pools people with depression in 10 trials comparing IPT with medication. (meta-analysis of trials, published 2011, checked 10 Oct 2026) ⁹
• With one outlying study left out, antidepressant medication did better than IPT for depression at the end of treatment, by an effect size (Cohen's d) of 0.19. The result pools people with depression in the 10 trials comparing IPT with medication, leaving out one outlying study. (meta-analysis of trials, published 2011, checked 10 Oct 2026) ⁹

Trials outside North America, Europe and Australia

One review of trials of psychotherapy for adult depression counted how many took place in non-Western countries. Its non-Western group includes eight high-income countries, so it is not only low- and middle-income countries.

The review found large average effects there, against control conditions that were mostly usual care, with very high variation between trials. Its authors note that the comparison groups were often weak, since in some places no care was available. They also note that many of the trials were of low quality.

Several trials below trained lay health workers or community workers to deliver brief therapy. In the Harare trial, which randomised clinics rather than people, depression symptoms were a secondary outcome; the main outcome was a questionnaire on common mental disorder symptoms. In the Pakistan trial, maternal depression was also a secondary outcome.

In the Chilean trial, recovered means a low score on the clinician-rated Hamilton depression scale. That programme also gave medication to women with severe depression, so its result is not therapy alone. In the Jordanian refugee camp, the follow-up came three months after treatment ended. The programme reduced depression but not anxiety. Both Jordanian figures are between-group effect sizes, as the trial reports them.

• Of the randomised trials of psychotherapy for adult depression in one meta-analysis, 32 took place in non-Western countries. (meta-analysis of trials, published 2018, checked 10 Oct 2026) ¹⁷
• At the end of treatment, psychotherapy for adult depression in non-Western countries did better than control conditions, mostly usual care, by an effect size (Hedges' g) of 1.10, with wide variation between trials. The result pools adults with depression in 32 randomised trials in non-Western countries. (meta-analysis of trials, published 2018, checked 10 Oct 2026) ¹⁷
• After adjusting for publication bias, the end-of-treatment effect of psychotherapy for adult depression in non-Western trials fell to 0.73 (Hedges' g). The result pools adults with depression in 32 randomised trials in non-Western countries. (meta-analysis of trials, published 2018, checked 10 Oct 2026) ¹⁷
• Adult clinic attenders in Harare with common mental disorder symptoms could take up the Friendship Bench. Six months after enrolment, 13.7% of those offered it scored at or above the depression cut-off on the Patient Health Questionnaire. The programme offers six sessions of problem-solving therapy from trained lay health workers, plus an optional peer support group. (randomised trial, 2014-2015 data, checked 10 Oct 2026) ¹⁸
• Other adult clinic attenders in Harare with common mental disorder symptoms had standard care plus education and support. Six months after enrolment, 49.9% of them scored at or above the depression cut-off on the Patient Health Questionnaire. (randomised trial, 2014-2015 data, checked 10 Oct 2026) ¹⁸
• At six months' follow-up, 23% of mothers in rural Rawalpindi with perinatal depression whose community health workers delivered a CBT-based programme met the criteria for major depression. (randomised trial published 2008, year not stated, checked 10 Oct 2026) ¹⁵
• At six months' follow-up, 53% of mothers in rural Rawalpindi with perinatal depression visited by untrained health workers met the criteria for major depression. (randomised trial published 2008, year not stated, checked 10 Oct 2026) ¹⁵
• Six months after randomisation, 70% of low-income women with major depression in Santiago primary care given a stepped-care programme (group psychoeducation, structured follow-up, and medication for severe depression) had recovered. (randomised trial published 2003, year not stated, checked 10 Oct 2026) ¹⁹
• Six months after randomisation, 30% of low-income women with major depression in Santiago primary care given usual care had recovered. (randomised trial published 2003, year not stated, checked 10 Oct 2026) ¹⁹
• Adult Syrian refugees in Azraq camp who got Group Problem Management Plus from lay helpers had a larger fall in depression scores than those on enhanced usual care (between-group effect size 0.40). This was three months after treatment ended. The trial randomised 410 adult Syrian refugees in Azraq camp with psychological distress and impaired functioning. (randomised trial, 2019-2020 data, checked 10 Oct 2026) ²⁰
• Three months after treatment ended, adult Syrian refugees in Azraq camp who got Group Problem Management Plus showed no difference in anxiety scores from those on enhanced usual care (between-group effect size -0.03). The trial does not say which way this very small difference points. The trial randomised 410 adult Syrian refugees in Azraq camp with psychological distress and impaired functioning. (randomised trial, 2019-2020 data, checked 10 Oct 2026) ²⁰

How to read these figures

An effect size is not the share of people who got better. Most effect sizes here show how far apart two groups ended up, in standard units.

The comparison matters. Against a waiting list, therapy looks larger than against usual care or another active treatment.

A within-group figure compares people with themselves before and after. A between-group figure compares a treated group with a control group, and is stronger evidence.

Reviews use different signs for the direction of an effect. We give the size and, where the source states it, say in words which way it points. Where the source reports that a difference was not significant, we say so.

Trial quality and publication bias can both inflate effects. For several results we also show the review's figure adjusted for publication bias or limited to high-quality trials.

In one review of depression trials, most took place in Western countries. Results may not carry over to every country or service.

In trials against waiting lists or usual care, most therapies on this page did better than the comparison. For adult depression, which most head-to-head figures here cover, the main therapies mostly did about equally well when tested against each other. For PTSD, EMDR and trauma-focused CBT showed no evidence of a difference. For other conditions, the head-to-head evidence on this page is thinner.

You can search the TherapyRoute directory for a therapist near you or online, and read our guide on how to find the right therapist. If you are in distress right now, see our helplines and suicide hotlines worldwide.

Cite this page: TherapyRoute. How well therapy works: statistics. https://www.therapyroute.com/article/how-well-therapy-works-statistics-by-therapyroute. Last updated 10 October 2026.

Clinically reviewed by Enzo Sinisi, clinical psychologist, on 11 October 2026.

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