Publication · 2015
A-Tjak, J. G. L., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A. J., & Emmelkamp, P. M. G. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84(1), 30–36. 10.1159/000365764
Access assessed: indexed abstract or official source excerpt
Study context and limitations
- Population
- Mixed clinically relevant mental and physical health problems
- Intervention
- ACT
- Comparison
- Waitlist, psychological placebo, usual care, established CBT
- Outcomes
- Primary symptoms and secondary/process outcomes
- Reported estimate
- Advantages versus several controls; no significant difference against established CBT reported. Not an equivalence design.
- Certainty
- No new formal certainty rating
- Limitations
- Older mixed-population synthesis; retained for conceptual boundary, not latest exhaustive ACT review.
Discussed in: ACT, DBT, MBCT, and REBT.
Background resource · 2025
American Psychological Association (2025). Use of generative AI chatbots and wellness applications for mental health: An APA health advisory. American Psychological Association.
Access assessed: Official advisory and issuing-body publication information
Study context and limitations
- Population
- Consumer-facing general-purpose chatbots and wellness apps
- Outcomes
- Evidence, privacy, safety and oversight recommendations
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Professional guidance rather than intervention efficacy trial
Discussed in: Conversational AI and mental health.
Publication · 2025
Angerer, F., Mennel, V., Grund, S., Mayer, A., Büscher, R., Sander, L. B., Cuijpers, P., Terhorst, Y., Baumeister, H., & Domhardt, M. (2025). Mechanisms of change in digital interventions for depression: A systematic review and meta-analysis of six mediator domains. Journal of Affective Disorders, 368, 615–632. 10.1016/j.jad.2024.09.055
Access assessed: Publisher structured abstract and author institutional bibliographic record; full-text audit unavailable
Study context and limitations
- Population
- Adults with depression
- Intervention
- Digital depression interventions
- Comparison
- Varied randomized treatment comparisons; mediator itself generally not randomized
- Outcomes
- Indirect effects across mediator domains
- Reported estimate
- Associations support candidate mechanisms; causal mechanism not established
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Methodological shortcomings and heterogeneous small domains; same trial pool as C17
Discussed in: How CBT may work.
Background resource · n.d.
Association for Contextual Behavioral Science (n.d.). ACT.
Access assessed: Full professional association page
Study context and limitations
- Certainty
- No new formal certainty rating
- Limitations
- Definition from approach-specific association, not independent efficacy evidence.
Discussed in: ACT, DBT, MBCT, and REBT.
Publication · 2019
Axelsson, E., & Hedman-Lagerlöf, E. (2019). Cognitive behavior therapy for health anxiety: systematic review and meta-analysis of clinical efficacy and health economic outcomes. Expert Review of Pharmacoeconomics & Outcomes Research, 19(6), 663–676. 10.1080/14737167.2019.1703182
Access assessed: Indexed complete PubMed abstract and metadata; full article not appraised.
Study context and limitations
- Population
- Clinical health-anxiety trial samples; diagnostic/recruitment variation.
- Intervention
- CBT.
- Comparison
- Non-CBT controls, differing in intensity.
- Outcomes
- Health anxiety; secondary symptoms, quality of life and economics.
- Reported estimate
- Pooled g = 0.79 (95% CI 0.57–1.01); publication-bias-adjusted estimate 0.62.
- Follow-up
- Benefits mostly maintained 12–18 months in available studies.
- Certainty
- No outcome-specific GRADE rating extracted.
- Limitations
- Mixed comparators; pooled response/remission definitions vary.
Discussed in: CBT for health anxiety.
Publication · 2020
Axelsson, E., Andersson, E., Ljótsson, B., Björkander, D., Hedman-Lagerlöf, M., & Hedman-Lagerlöf, E. (2020). Effect of Internet vs Face-to-Face Cognitive Behavior Therapy for Health Anxiety: A Randomized Noninferiority Clinical Trial. JAMA Psychiatry, 77(9), 915–924. 10.1001/jamapsychiatry.2020.0940
Access assessed: Publisher full text.
Study context and limitations
- Population
- Swedish primary-care adults; highly educated sample; severe clinical risks excluded.
- Intervention
- Twelve-week therapist-guided internet CBT.
- Comparison
- Protocol-matched individual face-to-face CBT.
- Outcomes
- Health Anxiety Inventory (HAI) change.
- Reported estimate
- Met 12-week noninferiority margin of 2.25 HAI points.
- Follow-up
- 6 and 12 months; long-term noninferiority not adequately powered.
- Certainty
- No independent formal rating assigned.
- Limitations
- Therapist guidance retained; not unguided or AI. No follow-up diagnostic interviews.
- Funding and interests
- Karolinska Institutet, Psykiatrifonden and Region Stockholm; book/manual interests disclosed.
Discussed in: CBT for health anxiety.
Background resource · n.d.
Behavioral Tech Institute (n.d.). What is DBT?.
Access assessed: Full treatment-developer training organization page
Study context and limitations
- Intervention
- Four-mode comprehensive outpatient DBT
- Certainty
- No new formal certainty rating
- Limitations
- Useful for treatment structure; training organization interests and not independent outcome evidence.
Discussed in: ACT, DBT, MBCT, and REBT.
Publication · 2026
Borgers, T., Zwiky, E., Klug, M., Enneking, V., Fisch, L., Klein, L., Neutz, L., Leehr, E. J., Opel, N., König, P., Schöniger, K., Küttner, A., Selle, J., Dannlowski, U., & Redlich, R. (2026). Changes in brain function during negative emotion processing following cognitive–behavioural therapy in depressive disorders. The British Journal of Psychiatry, 228(4), 324–331. 10.1192/bjp.2025.71
Access assessed: Publisher full text and PDF result excerpts; selected methods/results inspected
Study context and limitations
- Population
- Depressive disorders and healthy comparison participants
- Intervention
- Approximately 20 naturalistic CBT sessions
- Comparison
- Healthy controls measured twice; no randomized clinical-treatment control
- Outcomes
- Negative-emotion task fMRI and symptoms
- Reported estimate
- Hippocampal activity change associated with treatment response
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Naturalistic design; response subgroups and correlational findings cannot establish causal biomarker or individual prediction
Discussed in: How CBT may work.
Publication · 2026
Bunnell, B. E., Schuler, K. R., Craggs, J. G., Welch, B. M., & Ong, T. (2026). Examining the efficacy of a telehealth-based virtual reality clinic in treating adults with specific phobia: Feasibility randomized controlled trial. JMIR Formative Research, 10, e84670. 10.2196/84670
Access assessed: full text, PMC
Study context and limitations
- Population
- Florida adults with elevated fear of dogs/snakes/spiders; selected exclusions
- Intervention
- Therapist-led shared VR exposure
- Comparison
- Standard telemental-health exposure
- Outcomes
- Feasibility; preliminary clinical symptoms
- Reported estimate
- No significant clinical between-group difference; trial not powered for superiority.
- Follow-up
- Posttreatment after12weekly sessions
- Limitations
- Single site, one therapist, feasibility design.
- Funding and interests
- NIMH R43MH129065; commercial employment/compensation disclosed.
Discussed in: Exposure therapy for specific phobias.
Clinical guidance · 2026
Buysse, D. J., Arnedt, J. T., Buenaver, L., Chang, J. L., Fernandez-Mendoza, J., Patel, S. I., Zhou, E. S., Falck-Ytter, Y., Hyer, S., Kazmi, U., Singh, M., & Wickwire, E. M. (2026). Combination treatment for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 22(1), Article 56. 10.1007/s44470-025-00038-8
Access assessed: Full PMC text and PubMed metadata.
Study context and limitations
- Population
- Adults with chronic insomnia.
- Intervention
- CBT-I with concurrent medication.
- Comparison
- Medication alone; CBT-I alone, separately.
- Outcomes
- Insomnia severity, sleep and daytime outcomes.
- Reported estimate
- Conditional for combination over medication alone; conditional against routine combination over CBT-I alone.
- Follow-up
- Varies; not extracted.
- Certainty
- Published low-certainty evidence for both main recommendations.
- Limitations
- Evidence through June 2025; limited comparative trials.
- Funding and interests
- AASM; pharmaceutical/device/IP interests disclosed.
Discussed in: CBT for insomnia.
Publication · 2025
Campellone, T. R., Flom, M., Montgomery, R. M., Bullard, L., Pirner, M. C., Pavez, A., Morales, M., Harper, D., Oddy, C., O’Connor, T., Daniels, J., Eaneff, S., Forman-Hoffman, V. L., Sackett, C., & Darcy, A. (2025). Safety and user experience of a generative artificial intelligence digital mental health intervention: Exploratory randomized controlled trial. Journal of Medical Internet Research, 27, e67365. 10.2196/67365
Access assessed: Publisher full text; abstract, methods and conflicts inspected
Study context and limitations
- Population
- Adult volunteers in short exploratory study
- Intervention
- Generative version of a conversational intervention
- Comparison
- Rules-based version
- Outcomes
- Relationship, satisfaction, engagement and monitored safety; not a clinical efficacy comparison
- Reported estimate
- Most relationship/experience measures similar
- Follow-up
- 2 weeks
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Developer conflict; short duration and modest sample cannot establish uncommon-event safety
- Funding and interests
- All authors employees of Woebot Health at study conduct
Discussed in: Conversational AI and mental health.
Publication · 2025
Carey, M., Kerr-Gaffney, J., Strawbridge, R., Hieronymus, F., McCutcheon, R. A., Young, A. H., & Jauhar, S. (2025). Are cognitive behavioural therapy, cognitive therapy, and behavioural activation for depression effective in primary care? A systematic review and meta-analysis. Journal of Affective Disorders, 382, 215–226. 10.1016/j.jad.2025.04.070
Access assessed: PubMed abstract, metadata and disclosures
Study context and limitations
- Population
- Primary-care depression; age-specific eligibility not extracted
- Intervention
- CBT, cognitive therapy, behavioural activation pooled
- Comparison
- Inactive controls; active therapies, medication or exercise
- Outcomes
- Depressive symptoms
- Reported estimate
- Inactive controls: g=0.44; active comparators: g=−0.06, not statistically significant; CIs not extracted
- Certainty
- No outcome-level formal certainty extracted
- Limitations
- Therapy classes pooled; high bias; lack of significant superiority is not equivalence.
- Funding and interests
- Study funding not extracted; multiple authors disclosed pharmaceutical/digital-resource interests.
Discussed in: CBT for depression.
Publication · 2016
Cherkin, D. C., Sherman, K. J., Balderson, B. H., Cook, A. J., Anderson, M. L., Hawkes, R. J., Hansen, K. E., & Turner, J. A. (2016). Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA, 315(12), 1240–1249. 10.1001/jama.2016.2323
Access assessed: Full PMC text, including abstract, outcomes and funding sections.
Study context and limitations
- Population
- Adults aged 20–70 with nonspecific chronic low back pain.
- Intervention
- Eight weekly two-hour group CBT sessions.
- Comparison
- MBSR groups and usual care separately.
- Outcomes
- At least 30% improvement in function and pain bothersomeness.
- Reported estimate
- 26-week functional improvement: CBT 57.7%, usual care 44.1%; RR 1.31 (95% CI 1.01–1.69). No significant CBT–MBSR difference.
- Follow-up
- 52 weeks.
- Certainty
- No independent formal rating assigned.
- Limitations
- Single healthcare system, generally educated sample; group delivery.
- Funding and interests
- NIH NCCIH R01AT006226; no sponsor role; no conflicts reported.
Discussed in: CBT for chronic pain.
Publication · 2025
Cowansage, K. P., Milligan, T., Morgan, M. A., Boyd, C., Bellanti, D. M., Nair, R., Shank, L. M., Smolenski, D., Evatt, D. P., & Kelber, M. S. (2025). Treatments for adjustment disorder: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Research, 353, 116739. 10.1016/j.psychres.2025.116739
Access assessed: Indexed abstract and primary author-institution publication record
Study context and limitations
- Population
- Adult adjustment disorder
- Intervention
- Psychological and other interventions including CBT/iCBT
- Outcomes
- Adjustment-related symptoms
- Reported estimate
- Abstract reports possible CBT/iCBT benefits; no pooled estimate extracted
- Certainty
- No new formal certainty rating
- Limitations
- Abstract insufficient to appraise individual pooled comparisons or assign certainty.
- Funding and interests
- No known competing interests reported in indexed statement; funding not extracted
Discussed in: CBT for adjustment disorder.
Publication · 2014
Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23. 10.1016/j.brat.2014.04.006
Access assessed: PubMed abstract and bibliographic record; primary published-paper excerpts
Study context and limitations
- Population
- Anxiety disorders; clinical translation of learning research
- Intervention
- Exposure through an inhibitory-learning framework
- Comparison
- Conceptual contrasts with habituation and belief-disconfirmation models
- Outcomes
- Learning, return of fear, clinical translation
- Reported estimate
- No new clinical pooled effect extracted
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Mechanistic model does not prove that all optimization strategies improve all clinical outcomes
Discussed in: How CBT may work.
Publication · 2023
Cuijpers, P., Miguel, C., Harrer, M., Plessen, C. Y., Ciharova, M., Ebert, D., & Karyotaki, E. (2023). Cognitive behavior therapy vs. control conditions, other psychotherapies, pharmacotherapies and combined treatment for depression: A comprehensive meta-analysis including 409 trials with 52,702 patients. World Psychiatry, 22(1), 105–115. 10.1002/wps.21069
Access assessed: full text, publisher
Study context and limitations
- Population
- Mixed-age depression populations; adult-only inference requires subsets.
- Intervention
- CBT across delivery formats
- Comparison
- Inactive controls; other psychotherapies; medication; combined treatment
- Outcomes
- Depression symptoms
- Reported estimate
- Versus pooled controls: g=0.79, 95% CI 0.70–0.89
- Follow-up
- Benefits versus controls through 6–12 months; longer-term estimate uncertain
- Certainty
- No formal certainty label extracted
- Limitations
- Pooled control effect is not a universal recovery rate.
Discussed in: CBT for depression.
Publication · 2018
David, D., Cotet, C., Matu, S., Mogoase, C., & Stefan, S. (2018). 50 years of rational-emotive and cognitive-behavioral therapy: A systematic review and meta-analysis. Journal of Clinical Psychology, 74(3), 304–318. 10.1002/jclp.22514
Access assessed: Publisher indexed abstract and author-institution bibliographic record
Study context and limitations
- Population
- Mixed REBT literature
- Intervention
- REBT
- Comparison
- Varied interventions/controls
- Outcomes
- Clinical outcomes and irrational beliefs
- Reported estimate
- Between-group posttest d=0.58 for outcomes in mixed comparisons; not used as diagnosis-specific ranking
- Certainty
- No new formal certainty rating
- Limitations
- Heterogeneous corpus; mechanism conclusions cannot be inferred from symptom effects alone.
Discussed in: ACT, DBT, MBCT, and REBT.
Publication · 2024
de Ponti, N., Matbouriahi, M., Franco, P., Harrer, M., Miguel, C., Papola, D., Sicimoğlu, A., Cuijpers, P., & Karyotaki, E. (2024). The efficacy of psychotherapy for social anxiety disorder, a systematic review and meta-analysis. Journal of Anxiety Disorders, 104, 102881. 10.1016/j.janxdis.2024.102881
Access assessed: publisher indexed abstract/results table/discussion; publisher and repository direct403
Study context and limitations
- Population
- Adults with SAD
- Intervention
- Psychotherapies, predominantly CBT
- Comparison
- Control conditions
- Outcomes
- Posttreatment social-anxiety symptoms
- Reported estimate
- g0.88,95%CI0.76–1.00
- Limitations
- Broad prediction intervals; effects differ under publication-bias models.
Discussed in: CBT for social anxiety.
Publication · 2025
Domhardt, M., Mennel, V., Angerer, F., Grund, S., Mayer, A., Büscher, R., Sander, L. B., Cuijpers, P., Terhorst, Y., & Baumeister, H. (2025). Processes of change in digital interventions for depression: A meta-analytic review of cognitive and behavioral mediators. Behaviour Research and Therapy, 189, 104735. 10.1016/j.brat.2025.104735
Access assessed: Author institutional abstract and verified bibliographic record
Study context and limitations
- Population
- Adults with depression
- Intervention
- Digital depression interventions
- Comparison
- Varied randomized comparisons
- Outcomes
- Cognitive/behavioural indirect effects
- Reported estimate
- Pooled indirect effects for broad cognitive and behavioural domains; specific dysfunctional-attitude/interpretation-bias results not significant
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Mediation evidence requires timing and confounding checks; overlaps C16
Discussed in: How CBT may work.
Clinical guidance · 2021
Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., Sateia, M. J., Troxel, W. M., Zhou, E. S., Kazmi, U., Heald, J. L., & Martin, J. L. (2021). Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 17(2), 255–262. 10.5664/jcsm.8986
Access assessed: Full PMC text.
Study context and limitations
- Population
- Adults with chronic insomnia, with or without comorbidity.
- Intervention
- Multicomponent CBT-I, usually trained professional delivery.
- Comparison
- Controls varied in underlying review.
- Outcomes
- Remission, response and sleep continuity/quality.
- Reported estimate
- Strong recommendation for multicomponent CBT-I; conditional against sleep hygiene alone.
- Certainty
- Published moderate quality for multicomponent CBT-I, primarily limited by imprecision.
- Limitations
- Clinical delivery context; adaptations may be necessary.
- Funding and interests
- AASM; disclosures managed through guideline process.
Discussed in: What is CBT?; CBT for insomnia.
Publication · 2024
Errors in network meta-analysis. (2024). JAMA Psychiatry, 81(3), 320. 10.1001/jamapsychiatry.2023.5480
Access assessed: full correction notice
Study context and limitations
- Limitations
- Correction notice, not independent efficacy evidence
Discussed in: CBT for generalized anxiety.
Publication · 2015
Fairburn, C. G., Bailey-Straebler, S., Basden, S., Doll, H. A., Jones, R., Murphy, R., O’Connor, M. E., & Cooper, Z. (2015). A transdiagnostic comparison of enhanced cognitive behaviour therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders. Behaviour Research and Therapy, 70, 64–71. 10.1016/j.brat.2015.04.010
Access assessed: Indexed PubMed abstract and primary PMC abstract; direct PMC blocked
Study context and limitations
- Population
- Specialist eating-disorder outpatients; BMI>17.5 and<40
- Intervention
- CBT-E,20 sessions/20weeks
- Comparison
- Interpersonal psychotherapy
- Outcomes
- Eating-disorder remission by study definition
- Reported estimate
- Posttreatment65.5% versus33.3%; follow-up69.4% versus49.0%; denominators/definition must be retained before reusing percentages publicly
- Follow-up
- 60-week closed follow-up after treatment
- Certainty
- No new formal certainty rating
- Limitations
- Excludes markedly underweight sample; older specialist trial; complete therapy rather than a journaling component.
Discussed in: CBT for eating disorders.
Publication · 2024
Furukawa, Y., Sakata, M., Yamamoto, R., Nakajima, S., Kikuchi, S., Inoue, M., Ito, M., Noma, H., Takashina, H. N., Funada, S., Ostinelli, E. G., Furukawa, T. A., Efthimiou, O., & Perlis, M. (2024). Components and Delivery Formats of Cognitive Behavioral Therapy for Chronic Insomnia in Adults: A Systematic Review and Component Network Meta-Analysis. JAMA Psychiatry, 81(4), 357–365. 10.1001/jamapsychiatry.2023.5060
Access assessed: Full PMC text.
Study context and limitations
- Population
- Adults with and without comorbid conditions.
- Intervention
- CBT-I components and formats.
- Comparison
- Treatment networks; modelled incremental component associations.
- Outcomes
- Post-treatment remission primarily.
- Reported estimate
- Cognitive restructuring, third-wave elements, sleep restriction and stimulus control associated with remission.
- Certainty
- Published component evidence moderate to low; comparison-specific certainty varies.
- Limitations
- Associations do not isolate randomized component effects; review overlap not counted as new participants.
Discussed in: CBT for insomnia.
Publication · 2015
Gilbody, S., Littlewood, E., Hewitt, C., Brierley, G., Tharmanathan, P., Araya, R., Barkham, M., Bower, P., Cooper, C., Gask, L., Kessler, D., Lester, H., Lovell, K., Parry, G., Richards, D. A., Andersen, P., Brabyn, S., Knowles, S., Shepherd, C., … White, D. (2015). Computerised cognitive behaviour therapy (cCBT) as treatment for depression in primary care (REEACT trial): Large scale pragmatic randomised controlled trial. BMJ, 351, h5627. 10.1136/bmj.h5627
Access assessed: Publisher indexed abstract and PDF extracts; direct full text returned 403
Study context and limitations
- Population
- Adults in UK primary care with depression
- Intervention
- Beating the Blues or MoodGYM plus usual care with support
- Comparison
- Usual GP care
- Outcomes
- Depressive symptoms
- Reported estimate
- Neither program superior to usual care in the reported pragmatic comparison
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Specific programs and delivery context; engagement matters; not evidence that all iCBT is ineffective
Discussed in: Digital CBT, journaling, and mental health apps.
Publication · 2026
Gong, B., Yao, N., Xie, H., Huang, C., Kishimoto, T., Berenbaum, H., & Mu, W. (2026). Efficacy, user engagement, and acceptability of cognitive behavioral therapy–oriented psychological chatbots for adults with depressive and/or anxiety symptoms: Systematic review and meta-analysis of randomized controlled trials. Journal of Medical Internet Research, 28, e82677. 10.2196/82677
Access assessed: Final publisher full text; Results/GRADE and author record inspected
Study context and limitations
- Population
- Adults with depressive/anxiety symptoms; bot architectures varied
- Intervention
- CBT-oriented conversational interventions
- Comparison
- Mixed controls
- Outcomes
- Symptoms, follow-up and engagement
- Reported estimate
- Depression postintervention g −0.55 (95% CI −0.70 to −0.40); prediction interval −1.23 to 0.13
- Follow-up
- Fewer trials at follow-up
- Certainty
- Published GRADE: low for postintervention depression/anxiety and follow-up depression; very low for follow-up anxiety
- Limitations
- Mixed bot types; cannot treat as pure generative-AI evidence
Discussed in: Conversational AI and mental health.
Publication · 2025
Hall, M., Luo, A., Bhullar, N., Moses, K., & Wootton, B. M. (2025). Cognitive behaviour therapy for social anxiety disorder: A systematic review and meta-analysis investigating different treatment formats. Australian Psychologist, 60(1), 1–14. 10.1080/00050067.2024.2356804
Access assessed: publisher indexed abstract/discussion excerpts; direct403; issue metadata corroborated by UTS repository
Study context and limitations
- Population
- Adults with diagnosed SAD
- Intervention
- Individual, group, remote disorder-specific CBT
- Comparison
- Waitlist controls in all included studies
- Outcomes
- SAD symptoms
- Reported estimate
- Remote g0.90(0.74–1.06);individual g0.95(0.66–1.23);group g0.71(0.49–0.94)
- Limitations
- No significant modality difference does not establish equivalence.
- Funding and interests
- Authors report unfunded; no potential COI reported.
Discussed in: CBT for social anxiety.
Publication · 2024
Hautzinger, M., & A2 BipoLife Consortium (2024). Adjuvant psychotherapies to prevent relapse in bipolar disorder: A randomized clinical trial. JAMA Psychiatry, 81(9), 855–862. 10.1001/jamapsychiatry.2024.1310
Access assessed: Indexed publisher/PMC full-text methods and results passages
Study context and limitations
- Population
- Euthymic bipolarI/II,ages18–50,German clinics
- Intervention
- Structured CBT group(SEKT) alongside psychiatric care
- Comparison
- Supportive emotion-focused group(FEST) alongside psychiatric care
- Outcomes
- Time to new affective episode
- Reported estimate
- No simple adjusted superiority of structured CBT; unadjusted and adjusted results differ
- Follow-up
- 18months including intervention
- Certainty
- No new formal certainty rating
- Limitations
- Baseline imbalances,adjustment and bipolar subtype influence interpretation; no non-treatment group.
Discussed in: Psychological treatment for bipolar disorder.
Publication · 2023
Hedman-Lagerlöf, E., Carlbring, P., Svärdman, F., Riper, H., Cuijpers, P., & Andersson, G. (2023). Therapist-supported Internet-based cognitive behaviour therapy yields similar effects as face-to-face therapy for psychiatric and somatic disorders: An updated systematic review and meta-analysis. World Psychiatry, 22(2), 305–314. 10.1002/wps.21088
Access assessed: Publisher full text; selected methods and results inspected
Study context and limitations
- Population
- Adults across 16 psychiatric and somatic conditions
- Intervention
- Therapist-supported internet CBT
- Comparison
- Full-length face-to-face CBT
- Outcomes
- Primary symptom outcome at posttreatment
- Reported estimate
- Pooled g 0.02 (95% CI −0.09 to 0.14)
- Follow-up
- Primary synthesis posttreatment
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Few trials per condition; PubMed update and English publications only; pooled similarity does not prove every program equivalent
Discussed in: Digital CBT, journaling, and mental health apps.
Publication · 2025
Heinz, M. V., Mackin, D. M., Trudeau, B. M., Bhattacharya, S., Wang, Y., Banta, H. A., Jewett, A. D., Salzhauer, A. J., Griffin, T. Z., & Jacobson, N. C. (2025). Randomized trial of a generative AI chatbot for mental health treatment. NEJM AI, 2(4), AIoa2400802. 10.1056/AIoa2400802
Access assessed: Publisher indexed abstract; direct publisher full page returned 403; no full-text safety extraction
Study context and limitations
- Population
- Adults screened with clinically significant MDD/GAD symptoms or high feeding/eating-disorder risk
- Intervention
- 4-week Therabot access
- Comparison
- Waitlist; not psychotherapy
- Outcomes
- Screening symptom scores; engagement and alliance
- Reported estimate
- Greater symptom reductions than waitlist reported; no clinician-equivalence result
- Follow-up
- 4 and 8 weeks
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Short follow-up; selected sample; developer-led; waitlist comparison
- Funding and interests
- Dartmouth College
Discussed in: Conversational AI and mental health.
Publication · 2024
Himle, J. A., Grogan-Kaylor, A., Hiller, M. A., Mannella, K. A., Norman, L. J., Abelson, J. L., Prout, A., Shunnarah, A. A., Becker, H. C., Russman Block, S. R., Taylor, S. F., & Fitzgerald, K. D. (2024). Exposure and response prevention versus stress management training for adults and adolescents with obsessive compulsive disorder: A randomized clinical trial. Behaviour Research and Therapy, 172, 104458. 10.1016/j.brat.2023.104458
Access assessed: PubMed abstract and metadata; PMC full-text access blocked by challenge.
Study context and limitations
- Population
- Adolescents 12–18 and adults 24–46; pooled outcomes are not adult-only.
- Intervention
- Twelve weekly ERP sessions.
- Comparison
- Stress management training: active treatment.
- Outcomes
- OCD severity, response and remission.
- Reported estimate
- ERP superior in pooled age sample; adult-specific effect not extracted.
- Follow-up
- Post-treatment; later follow-up not extracted.
- Certainty
- No formal rating assigned.
- Limitations
- Age bands omit younger and older adults; no detected age interaction is not equivalence.
- Funding and interests
- Funding not extracted; authors declare no competing interests.
Discussed in: OCD and exposure and response prevention.
Publication · 2024
Hoppen, T. H., Meiser-Stedman, R., Kip, A., Birkeland, M. S., & Morina, N. (2024). The efficacy of psychological interventions for adult post-traumatic stress disorder following exposure to single versus multiple traumatic events: a meta-analysis of randomised controlled trials. The Lancet Psychiatry, 11(2), 112–122. 10.1016/S2215-0366(23)00373-5
Access assessed: Indexed complete PubMed abstract and bibliographic record; full article not appraised.
Study context and limitations
- Population
- Adult trial samples with predominantly diagnosed PTSD.
- Intervention
- Psychological interventions, including trauma-focused CBT.
- Comparison
- Passive and active controls separately.
- Outcomes
- PTSD symptoms.
- Reported estimate
- Benefits versus controls; no detected efficacy difference between single- and multiple-trauma trial groups.
- Certainty
- Do not convert review-level abstract wording into an outcome-specific GRADE rating.
- Limitations
- Trauma-history moderator is not randomized; multiple trauma is not equivalent to complex PTSD.
- Funding and interests
- None reported in abstract.
Discussed in: CBT and trauma-focused treatments for PTSD.
Publication · 2026
Jelinek, L., Wille, L., Scheunemann, J., Tegtmeier, L., Zapf, H., Miegel, F., Schuurmans, L., Schultz, J., Gallinat, J., & Yassari, A. H. (2026). Concentrated Exposure Therapy vs Internet-Based Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: A Randomized Clinical Trial. JAMA Network Open, 9(10), e2639281. 10.1001/jamanetworkopen.2026.39281
Access assessed: Publisher full text.
Study context and limitations
- Population
- German single-centre adults aged 18–72; acute suicidality and several severe conditions excluded.
- Intervention
- Preparatory sessions and four concentrated days of therapist-led ERP.
- Comparison
- Eight-week unguided OCD-specific iCBT; both could use usual care.
- Outcomes
- Yale–Brown Obsessive Compulsive Scale (Y-BOCS).
- Reported estimate
- Three months: adjusted difference −5.61 points (95% CI −7.83 to −3.39), favouring concentrated ERP.
- Follow-up
- 3 months.
- Certainty
- Single RCT; no formal rating assigned.
- Limitations
- Human support, dose and schedule differ simultaneously; short follow-up.
- Funding and interests
- Peter Möhrle Foundation; professional affiliations and outside-work interests disclosed.
Discussed in: OCD and exposure and response prevention.
Publication · 2025
Jung, H. W., Jang, K. W., Nam, S., Kim, A., Lee, J., Ahn, M. E., Lee, S.-K., Kim, Y. J., Shin, J.-K., & Roh, D. (2025). Digital cognitive behavioral therapy for panic disorder and agoraphobia: A meta-analytic review of clinical components to maximize efficacy. Journal of Clinical Medicine, 14(5), 1771. 10.3390/jcm14051771
Access assessed: full text, PMC
Study context and limitations
- Intervention
- Digital CBT including guided programs
- Comparison
- Passive versus active separately
- Limitations
- Database search Aug15,2022; retrospectively registered protocol; cross-trial moderators noncausal.
- Funding and interests
- Korean public research/development grants; authors declare no COI.
Discussed in: CBT for panic and agoraphobia.
Publication · 2026
Juszczyk-Kalina, A., Farchione, T. J., Williams, A. L., & Holas, P. (2026). Effectiveness and mechanisms of internet-delivered transdiagnostic CBT for students with adjustment disorder: The role of cognitive inflexibility, self-compassion, and mindfulness. Cognitive Behaviour Therapy, 1–24, advance online publication. 10.1080/16506073.2026.2720139
Access assessed: PubMed abstract and metadata
Study context and limitations
- Population
- University students meeting ICD-11 AjD criteria
- Intervention
- Six-week iCBT Unified Protocol
- Comparison
- Internet progressive muscle relaxation and waitlist
- Outcomes
- AjD symptoms, academic adjustment, candidate mediators
- Reported estimate
- Both active interventions improved AjD versus waitlist; CBT academic-adjustment improvement reported; comparative effect estimates not supplied in abstract
- Follow-up
- One month after treatment
- Certainty
- No new formal certainty rating
- Limitations
- Abstract only; brief follow-up; mediation not a randomized manipulation of mediator.
Discussed in: CBT for adjustment disorder.
Publication · 2021
Karyotaki, E., Efthimiou, O., Miguel, C., Maas genannt Bermpohl, F., Furukawa, T. A., Cuijpers, P., & Individual Patient Data Meta-Analyses for Depression (IPDMA-DE) Collaboration (2021). Internet-based cognitive behavioral therapy for depression: A systematic review and individual patient data network meta-analysis. JAMA Psychiatry, 78(4), 361–371. 10.1001/jamapsychiatry.2020.4364
Access assessed: Publisher full text; selected methods, results, funding and correction inspected
Study context and limitations
- Population
- Adults with depressive symptoms
- Intervention
- Guided or unguided structured internet CBT
- Comparison
- Other iCBT format, treatment as usual, waiting list
- Outcomes
- PHQ-9 depressive symptoms
- Reported estimate
- Guided vs unguided posttreatment MD −0.8 PHQ-9 points (95% CI −1.4 to −0.2)
- Follow-up
- No evidence of guided–unguided difference at 6 or 12 months
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Heterogeneity; guidance benefit varied by baseline severity; smartphone-only interventions excluded
- Funding and interests
- ZonMw and Swiss National Science Foundation support disclosed
Discussed in: Digital CBT, journaling, and mental health apps.
Clinical guidance · 2014
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry, 14(Suppl. 1), S1. 10.1186/1471-244X-14-S1-S1
Access assessed: full text, PMC; initial challenge resolved on final recheck
Study context and limitations
- Population
- Adults; separate special-population sections
- Intervention
- Psychotherapy and pharmacotherapy guidance
- Certainty
- Authors’ consensus evidence ratings, not newly assigned GRADE
- Limitations
- Evidence searches1980–2012; historical Canadian context, not current comprehensive update
Discussed in: CBT for generalized anxiety; Exposure therapy for specific phobias.
Publication · 2007
Kazdin, A. E. (2007). Mediators and mechanisms of change in psychotherapy research. Annual Review of Clinical Psychology, 3, 1–27. 10.1146/annurev.clinpsy.3.022806.091432
Access assessed: PubMed abstract and bibliographic record
Study context and limitations
- Population
- Psychotherapy research methodology
- Outcomes
- Requirements for mechanism evidence
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Foundational framework, not current efficacy estimate
Discussed in: How CBT may work.
Clinical guidance · 2023
Keramatian, K., Chithra, N. K., & Yatham, L. N. (2023). The CANMAT and ISBD guidelines for the treatment of bipolar disorder: Summary and a 2023 update of evidence. Focus, 21(4), 344–353. 10.1176/appi.focus.20230009
Access assessed: Full text
Study context and limitations
- Population
- Bipolar disorder across the lifespan; relevant adult psychosocial recommendations
- Intervention
- Adjunctive psychological treatments within bipolar care
- Outcomes
- Guideline hierarchy
- Reported estimate
- CBT listed as second-line adjunct for acute bipolar depression and maintenance; no quantitative effect extracted
- Certainty
- No new formal certainty rating
- Limitations
- Summary of guideline recommendations; hierarchy incorporates safety and clinical factors, not efficacy alone.
Discussed in: Psychological treatment for bipolar disorder.
Publication · 2024
Komischke-Konnerup, K. B., Zachariae, R., Boelen, P. A., Marello, M. M., & O’Connor, M. (2024). Grief-focused cognitive behavioral therapies for prolonged grief symptoms: A systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 92(4), 236–248. 10.1037/ccp0000884
Access assessed: indexed abstract or official source excerpt
Study context and limitations
- Population
- Bereaved adults; prolonged grief symptoms
- Intervention
- Grief-focused CBTs
- Comparison
- Various comparators; not a universal active-treatment comparison
- Outcomes
- Grief symptoms
- Reported estimate
- Postintervention g=0.65 (95% CI 0.49–0.81); follow-up g=0.90 (0.37–1.43), latter based on 7 studies
- Follow-up
- Follow-up pooled across 7 studies; duration not extracted
- Certainty
- Authors used GRADE; exact ratings not extracted
- Limitations
- Authors identify inconsistency and indirectness; overlapping trials with later reviews possible.
- Funding and interests
- Authors report no conflicts in repository manuscript; funding not extracted
Discussed in: CBT for prolonged grief.
Publication · 2025
König, P., Zwiky, E., Küttner, A., Uhlig, M., & Redlich, R. (2025). Brain functional effects of cognitive behavioral therapy for depression: A systematic review of task-based fMRI studies. Journal of Affective Disorders, 368, 872–887. 10.1016/j.jad.2024.09.084
Access assessed: PubMed structured abstract; publisher full text returned 403
Study context and limitations
- Population
- Patients with current depressive disorders receiving CBT
- Intervention
- CBT
- Comparison
- Before/after and control designs varied
- Outcomes
- Task-related regional brain activity; relation to remission
- Reported estimate
- Limbic/reward/cortical changes reported, with heterogeneous cortical results
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Task and analytic differences; small heterogeneous observational imaging literature; cannot validate an app
Discussed in: How CBT may work.
Publication · 2026
Kuta, B., Novak, L., Zidkova, R., Furstova, J., Malinakova, K., De Winter, A., & Husek, V. (2026). Effectiveness of a fully automated mobile therapeutic versus a general chatbot in reducing depression and anxiety and improving well-being: Feasibility randomized controlled trial. JMIR Mental Health, 13, e82642. 10.2196/82642
Access assessed: Publisher full text; abstract, participant flow, analysis and editorial notice inspected
Study context and limitations
- Population
- English-speaking nonclinical, nontreatment-seeking adults
- Intervention
- Solution-focused ChatMind chatbot
- Comparison
- ChatGPT and assessment-only
- Outcomes
- PHQ-9, GAD-7, ODSIS, WHO-5
- Reported estimate
- PHQ-9 improved vs assessment-only; no structured-chatbot superiority over ChatGPT
- Follow-up
- 3 weeks
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Small pilot; high attrition; limited power; psychiatric treatment excluded; editorial registration notice
- Funding and interests
- DigiWELL/IGA support; first author employed by app owner/developer
Discussed in: Conversational AI and mental health.
Publication · 2016
Kuyken, W., Warren, F. C., Taylor, R. S., Whalley, B., Crane, C., Bondolfi, G., Hayes, R., Huijbers, M., Ma, H., Schweizer, S., Segal, Z., Speckens, A., Teasdale, J. D., Van Heeringen, K., Williams, M., Byford, S., Byng, R., & Dalgleish, T. (2016). Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: An individual patient data meta-analysis from randomized trials. JAMA Psychiatry, 73(6), 565–574. 10.1001/jamapsychiatry.2016.0076
Access assessed: Indexed publisher full-text passages and abstract; direct PMC blocked
Study context and limitations
- Population
- Adults with recurrent depression in full/partial remission
- Intervention
- Manualized MBCT
- Comparison
- Non-MBCT including usual care and active treatments
- Outcomes
- Depressive relapse
- Reported estimate
- HR0.69 (95%CI0.58–0.82) for pooled non-MBCT comparison; does not establish superiority to each active treatment
- Follow-up
- 60 weeks
- Certainty
- No new formal certainty rating
- Limitations
- Older specific relapse-prevention population, not generic mindfulness app evidence.
- Funding and interests
- Some authors disclose MBCT teaching/royalty interests; full funding not extracted
Discussed in: ACT, DBT, MBCT, and REBT.
Publication · 2026
Lai, L., Liu, Y., Axelsson, E., Tyrer, P., Li, Y., Lu, Y., Shi, C., & Ren, Z. (2026). The comparative effectiveness of psychological interventions for health anxiety: systematic review and a network meta-analysis of randomised controlled trials. The British Journal of Psychiatry, FirstView, 1–10. 10.1192/bjp.2026.10647
Access assessed: Publisher abstract, PubMed abstract and metadata; full article not assessed.
Study context and limitations
- Population
- Adults with substantial health anxiety.
- Intervention
- Psychological interventions and coded components.
- Comparison
- Network comparisons; many reported effects against waitlist.
- Outcomes
- Health anxiety.
- Reported estimate
- CBT and several related approaches superior to waitlist; component associations include ERP and cognitive restructuring.
- Certainty
- No formal rating extracted.
- Limitations
- Indirect comparisons and component associations do not establish a best intervention.
Discussed in: CBT for health anxiety.
Publication · 2024
Li, Y., & Zhang, L. (2024). Efficacy of Cognitive Behavioral Therapy Combined with Pharmacotherapy Versus Pharmacotherapy Alone in Adult ADHD: A Systematic Review and Meta-Analysis. Journal of Attention Disorders, 28(3), 279–292. 10.1177/10870547231214969
Access assessed: PubMed abstract and metadata.
Study context and limitations
- Population
- Adults with ADHD receiving medication.
- Intervention
- CBT plus medication.
- Comparison
- Medication alone.
- Outcomes
- ADHD symptoms.
- Reported estimate
- Additional benefit post-treatment and at 3 months; difference not statistically detected at 6 or 9 months.
- Follow-up
- Up to 9 months in available comparisons.
- Certainty
- No formal rating extracted.
- Limitations
- Small evidence base; absent long-term significance is not proof of equivalence.
- Funding and interests
- Funding not extracted; authors declare no competing interests.
Discussed in: CBT for adult ADHD.
Publication · 2024
Linardon, J., Torous, J., Firth, J., Cuijpers, P., Messer, M., & Fuller-Tyszkiewicz, M. (2024). Current evidence on the efficacy of mental health smartphone apps for symptoms of depression and anxiety. A meta-analysis of 176 randomized controlled trials. World Psychiatry, 23(1), 139–149. 10.1002/wps.21183
Access assessed: Publisher full text; results, comparators, dropout and limitations inspected
Study context and limitations
- Population
- Mixed adult symptom-selected and unselected samples
- Intervention
- Mental-health smartphone apps
- Comparison
- Mixed controls; active-treatment comparisons separately reported
- Outcomes
- Depression and generalized-anxiety symptoms
- Reported estimate
- Depression g 0.28; generalized anxiety g 0.26; active-comparator superiority not established
- Follow-up
- Most endpoints within 12 weeks; longer-term maintenance uncertain
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Heterogeneity; small condition-specific evidence bases; pooled features are observational moderators
Discussed in: Digital CBT, journaling, and mental health apps.
Publication · 2023
Liu, C.-I., Hua, M.-H., Lu, M.-L., & Goh, K. K. (2023). Effectiveness of cognitive behavioural-based interventions for adults with attention-deficit/hyperactivity disorder extends beyond core symptoms: A meta-analysis of randomized controlled trials. Psychology and Psychotherapy: Theory, Research and Practice, 96(3), 543–559. 10.1111/papt.12455
Access assessed: PubMed abstract and metadata.
Study context and limitations
- Population
- Adults with ADHD.
- Intervention
- Cognitive behavioural interventions.
- Comparison
- Active treatment, usual care and waitlist; not interchangeable.
- Outcomes
- Core symptoms, emotional symptoms, self-esteem and quality of life.
- Reported estimate
- Authors report benefits beyond core symptoms; effect intervals not available in accessed abstract.
- Certainty
- No formal outcome-specific rating extracted.
- Limitations
- Comparator and outcome heterogeneity; overlapping trials with other reviews.
Discussed in: CBT for adult ADHD.
Publication · 2018
Lopez, P. L., Torrente, F. M., Ciapponi, A., Lischinsky, A. G., Cetkovich-Bakmas, M., Rojas, J. I., Romano, M., & Manes, F. F. (2018). Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database of Systematic Reviews, 2018(3), CD010840. 10.1002/14651858.CD010840.pub2
Access assessed: Cochrane public summary and complete abstract.
Study context and limitations
- Population
- Adults aged 18–65.
- Intervention
- CBT-based interventions, alone or adjunctive.
- Comparison
- Waitlist, supportive therapy and medication alone separately.
- Outcomes
- ADHD ratings; secondary mood outcomes.
- Reported estimate
- Self-report: waitlist SMD −0.84 (95% CI −1.18 to −0.50); supportive therapy −0.16 (−0.52 to 0.19).
- Certainty
- Published very low to moderate, depending on outcome/comparator.
- Limitations
- Search through June 2017; limited long-term evidence.
Discussed in: CBT for adult ADHD.
Publication · 2024
Mayer, S. F., Corcoran, C., Kennedy, L., Leucht, S., & Bighelli, I. (2024). Cognitive behavioural therapy added to standard care for first-episode and recent-onset psychosis. Cochrane Database of Systematic Reviews(3), CD015331. 10.1002/14651858.CD015331.pub2
Access assessed: Official Cochrane abstract and plain-language summary
Study context and limitations
- Population
- First-episode/recent-onset psychosis; average age 24, not exclusively adult eligibility
- Intervention
- CBT added to standard care
- Comparison
- Standard care/control conditions as defined in review
- Outcomes
- Overall symptoms, functioning, relapse
- Reported estimate
- Overall symptoms SMD −0.27 (95% CI −0.47 to −0.08), 20 RCTs n=1508. Functioning SMD −0.23 (−0.42 to −0.05), 18 RCTs n=1241. Relapse RR 0.82 (0.57–1.18), 7 RCTs n=693.
- Follow-up
- Combined timepoints mainly up to one year; search 6 March 2022
- Certainty
- Published GRADE: overall symptoms low; functioning moderate; relapse low
- Limitations
- Heterogeneity and imprecision; early-illness population; summary not full review.
- Funding and interests
- Studies mainly public funding; some industry funding
Discussed in: CBT for psychosis.
Publication · 2026
McFadyen, J., Habicht, J., Dina, L.-M., Harper, R., Hauser, T. U., & Rollwage, M. (2026). Increasing engagement with cognitive-behavioral therapy (CBT) using generative AI: A randomized controlled trial (RCT). Communications Medicine, 6(1), 129. 10.1038/s43856-025-01321-8
Access assessed: PubMed and publisher indexed abstract/results excerpts; direct publisher page redirected to inaccessible cookie service
Study context and limitations
- Population
- Self-guided adult sample
- Intervention
- GenAI-enabled CBT app
- Comparison
- Digital CBT workbooks
- Outcomes
- Usage, PHQ-9, GAD-7, adverse events
- Reported estimate
- Higher usage; no overall anxiety/depression symptom superiority
- Follow-up
- 6 weeks
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Unblinded; postrandomization exclusions; exploratory feature-users analysis is not randomized feature assignment
- Funding and interests
- Authors affiliated with developer Limbic; full funding declaration not extracted
Discussed in: Conversational AI and mental health.
Publication · 2021
Miklowitz, D. J., Efthimiou, O., Furukawa, T. A., Scott, J., McLaren, R., Geddes, J. R., & Cipriani, A. (2021). Adjunctive psychotherapy for bipolar disorder: A systematic review and component network meta-analysis. JAMA Psychiatry, 78(2), 141–150. 10.1001/jamapsychiatry.2020.2993
Access assessed: Indexed publisher methods/results and PubMed metadata
Study context and limitations
- Population
- Bipolar I/II/unspecified;36adult trials and3adolescent
- Intervention
- Adjunctive manualized psychotherapy
- Comparison
- Supportive therapy,usual care and other controls
- Outcomes
- Recurrence and mood symptoms
- Reported estimate
- Adjunctive psychotherapy benefits in some comparisons; component model associations not randomized component effects
- Certainty
- No new formal certainty rating
- Limitations
- Network/component assumptions and population heterogeneity.
- Funding and interests
- Several investigators led included trials; author research/royalty interests disclosed
Discussed in: Psychological treatment for bipolar disorder.
Publication · 2025
Moore, J., Grabb, D., Agnew, W., Klyman, K., Chancellor, S., Ong, D. C., & Haber, N. (2025). Expressing stigma and inappropriate responses prevents LLMs from safely replacing mental health providers. Proceedings of the 2025 ACM Conference on Fairness, Accountability, and Transparency, 599–627. 10.1145/3715275.3732039
Access assessed: Published conference paper PDF on author institution website; experimental scope inspected
Study context and limitations
- Population
- Model outputs to constructed clinical scenarios, not patients
- Intervention
- Several 2025-era LLMs under therapy-like instructions
- Comparison
- Clinical standards and model/scenario conditions
- Outcomes
- Stigma and appropriateness of responses
- Reported estimate
- Stigma and inappropriate responses demonstrated in tested conditions
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Model/version specific; simulations do not estimate real-world harm incidence
Discussed in: Conversational AI and mental health.
Clinical guidance · 2017
National Institute for Health and Care Excellence (2017). Eating disorders: Recognition and treatment (NG69).
Access assessed: Official indexed recommendation passages; direct page returned 403
Study context and limitations
- Population
- Adults and young people; recommendations distinguished by age and diagnosis
- Intervention
- CBT-ED and other specified care pathways
- Outcomes
- Clinical recommendations, not a pooled effect estimate
- Certainty
- No new formal certainty rating
- Limitations
- Direct guideline unavailable in this session. Recommendation text indexed; do not imply complete guideline appraisal.
Discussed in: CBT for eating disorders.
Clinical guidance · 2014
National Institute for Health and Care Excellence (2014b). Psychosis and schizophrenia in adults: Prevention and management (CG178).
Access assessed: indexed abstract or official source excerpt
Study context and limitations
- Population
- Adults with psychosis or schizophrenia
- Intervention
- Individual CBT within specialist care
- Outcomes
- Treatment and delivery recommendations
- Certainty
- No new formal certainty rating
- Limitations
- Indexed official recommendation passages; full direct guideline appraisal not performed.
Discussed in: CBT for psychosis.
Clinical guidance · 2014
National Institute for Health and Care Excellence (2014a). Bipolar disorder: Assessment and management (CG185).
Access assessed: indexed abstract or official source excerpt
Study context and limitations
- Population
- Bipolar disorder with age-specific recommendations
- Intervention
- Structured bipolar-specific psychological intervention within care
- Outcomes
- Clinical recommendations
- Certainty
- No new formal certainty rating
- Limitations
- Official indexed passages; full independent guideline appraisal not performed.
Discussed in: Psychological treatment for bipolar disorder.
Clinical guidance · 2024
National Institute for Health and Care Excellence (2024). 2024 exceptional surveillance of eating disorders: Recognition and treatment (NICE guideline NG69).
Access assessed: Official indexed surveillance text and NCBI bibliographic record
Study context and limitations
- Population
- Longstanding anorexia surveillance focus
- Outcomes
- Decision whether to update guideline
- Reported estimate
- Decision not to update; acknowledged subgroup evidence gap
- Certainty
- No new formal certainty rating
- Limitations
- Surveillance decision is not a new efficacy meta-analysis.
Discussed in: CBT for eating disorders.
Clinical guidance · 2022
National Institute for Health and Care Excellence (2022). Depression in adults: Treatment and management. NICE guideline NG222.
Access assessed: official indexed recommendation excerpts; direct HTML 403
Study context and limitations
- Population
- Adults; separate pathways for severity, chronicity and response
- Intervention
- Guided self-help, CBT, behavioural activation and other care options
- Certainty
- Guideline recommendation; no outcome-level GRADE extracted
- Limitations
- Recommendations are context-specific, not product endorsements.
Discussed in: CBT for depression.
Clinical guidance · 2011
National Institute for Health and Care Excellence (2011). Generalised anxiety disorder and panic disorder in adults: Management. NICE clinical guideline CG113.
Access assessed: official indexed public-information/recommendation excerpts; direct403
Study context and limitations
- Population
- Adults
- Intervention
- Stepped care; structured CBT
- Limitations
- Direct recommendation page inaccessible; updated-version status not fully checked on issuing overview.
Discussed in: CBT for generalized anxiety; CBT for panic and agoraphobia.
Clinical guidance · 2013
National Institute for Health and Care Excellence (2013). Social anxiety disorder: Recognition, assessment and treatment. NICE clinical guideline CG159.
Access assessed: official indexed public-information and recommendation excerpts; direct403
Study context and limitations
- Population
- Adults; separate youth guidance
- Intervention
- Disorder-specific individual CBT; supported self-help when appropriate
- Limitations
- Guideline context and preferences matter; not a head-to-head efficacy calculation.
Discussed in: CBT for social anxiety.
Clinical guidance · 2005
National Institute for Health and Care Excellence (2005). Obsessive-compulsive disorder and body dysmorphic disorder: treatment. NICE clinical guideline CG31.
Access assessed: Official indexed recommendation excerpts; direct HTML and PDF fetches returned HTTP 403. Full guideline and evidence reviews not assessed.
Study context and limitations
- Population
- Adults with OCD; guideline also covers BDD and youth, kept separate here.
- Intervention
- CBT including ERP; low intensity can include structured self-help with therapist contact.
- Comparison
- Recommendation, not a new comparison.
- Outcomes
- Functional impairment informs care intensity.
- Reported estimate
- Mild impairment or preference: consider lower-intensity CBT including ERP (up to 10 therapist hours).
- Certainty
- Recommendation wording only; original evidence certainty not extracted.
Discussed in: What is CBT?; OCD and exposure and response prevention.
Clinical guidance · 2018
National Institute for Health and Care Excellence (2018). Attention deficit hyperactivity disorder: diagnosis and management. NICE guideline NG87.
Access assessed: Official indexed recommendations, including adult section 1.5.15–1.5.18; direct fetch HTTP 403. Evidence reviews not appraised.
Study context and limitations
- Population
- Adults; youth recommendations treated separately.
- Intervention
- ADHD-focused structured psychological intervention with regular follow-up; may include CBT.
- Comparison
- Recommendation; not a new trial.
- Outcomes
- Symptoms and impairment in a holistic care plan.
- Reported estimate
- Consider nonpharmacological care when medication is declined, difficult to adhere to, ineffective or intolerable; also for residual impairment despite benefit.
- Certainty
- Original evidence certainty not extracted.
- Limitations
- Clinical assessment and support context; not endorsement of consumer habit apps.
Discussed in: CBT for adult ADHD.
Clinical guidance · 2021
National Institute for Health and Care Excellence (2021). Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. NICE guideline NG193.
Access assessed: Official indexed recommendations. Full evidence review not assessed.
Study context and limitations
- Population
- People aged 16 and over; adult synthesis does not infer youth outcomes.
- Intervention
- ACT or CBT for pain delivered by appropriately trained healthcare professionals.
- Comparison
- Recommendation, not a new trial.
- Outcomes
- Management of chronic primary pain.
- Reported estimate
- Recommendation 1.2.3: consider ACT or CBT for chronic primary pain.
- Certainty
- Underlying outcome-specific certainty not extracted.
- Limitations
- Recommendation is specifically for chronic primary pain; not every cause of chronic pain.
Discussed in: CBT for chronic pain.
Background resource · 2024
National Institute of Mental Health (2024). Psychotherapies.
Access assessed: Full institutional information page
Study context and limitations
- Certainty
- No new formal certainty rating
- Limitations
- Educational overview, not a treatment-effect systematic review.
Discussed in: What is CBT?.
Publication · 2022
Odgers, K., Kershaw, K. A., Li, S. H., & Graham, B. M. (2022). The relative efficacy and efficiency of single- and multi-session exposure therapies for specific phobia: A meta-analysis. Behaviour Research and Therapy, 159, 104203. 10.1016/j.brat.2022.104203
Access assessed: PubMed abstract and metadata; indexed publisher excerpt
Study context and limitations
- Population
- Clinical specific-phobia samples; age-specific subset not extracted
- Intervention
- Single/multi-session in-vivo exposure
- Comparison
- Primarily pre/post changes compared across formats
- Outcomes
- Approach behaviour; reported fear
- Reported estimate
- No significant pooled format differences reported; no numeric effect extracted.
- Follow-up
- Posttreatment and follow-up
- Limitations
- Pre/post synthesis does not equal randomized head-to-head proof of equivalence.
Discussed in: Exposure therapy for specific phobias.
Publication · 2025
Ostinelli, E. G., Schulze, M., Zangani, C., Farhat, L. C., Tomlinson, A., Del Giovane, C., Chamberlain, S. R., Philipsen, A., Young, S., Cowen, P. J., Bilbow, A., Cipriani, A., & Cortese, S. (2025). Comparative efficacy and acceptability of pharmacological, psychological, and neurostimulatory interventions for ADHD in adults: a systematic review and component network meta-analysis. The Lancet Psychiatry, 12(1), 32–43. 10.1016/S2215-0366(24)00360-2
Access assessed: Indexed PubMed abstract/record and indexed methodological passages; publisher/repository fetches inaccessible. No full-text appraisal.
Study context and limitations
- Population
- Adults with diagnosed ADHD.
- Intervention
- Medication, psychological and neurostimulatory treatments.
- Comparison
- Placebo/component networks; not a direct CBT–medication head-to-head estimate.
- Outcomes
- Core symptoms at about 12 weeks, separated by rater.
- Reported estimate
- CBT clinician-rated SMD −0.76 (95% CI −1.26 to −0.26); benefit not consistently detected in self-ratings.
- Follow-up
- Longer-term data sparse.
- Certainty
- No formal overall grade assigned here.
- Limitations
- Search through 2023-09-06; no universal treatment ranking.
- Funding and interests
- UK NIHR; pharmaceutical/manual/programme interests disclosed.
Discussed in: CBT for adult ADHD.
Publication · 2024
Papola, D., Miguel, C., Mazzaglia, M., Franco, P., Tedeschi, F., Romero, S. A., Patel, A. R., Ostuzzi, G., Gastaldon, C., Karyotaki, E., Harrer, M., Purgato, M., Sijbrandij, M., Patel, V., Furukawa, T. A., Cuijpers, P., & Barbui, C. (2024). Psychotherapies for generalized anxiety disorder in adults: A systematic review and network meta-analysis of randomized clinical trials. JAMA Psychiatry, 81(3), 250–259. 10.1001/jamapsychiatry.2023.3971
Access assessed: corrected full text, publisher
Study context and limitations
- Population
- Adults with GAD
- Intervention
- CBT and other psychotherapies
- Comparison
- TAU and waitlist; active-treatment network
- Outcomes
- GAD symptoms; discontinuation
- Reported estimate
- CBT vs TAU:SMD−0.74,95%CI−1.09 to−0.38
- Follow-up
- Follow-up analysis3–12 months after treatment
- Certainty
- Published CINeMA moderate for CBT vsTAU; not high
- Funding and interests
- EU Horizon MSCA; some authors disclosed digital-health employment/patents or other interests.
Discussed in: CBT for generalized anxiety.
Publication · 2023
Papola, D., Ostuzzi, G., Tedeschi, F., Gastaldon, C., Purgato, M., Del Giovane, C., Pompoli, A., Pauley, D., Karyotaki, E., Sijbrandij, M., Furukawa, T. A., Cuijpers, P., & Barbui, C. (2023). CBT treatment delivery formats for panic disorder: A systematic review and network meta-analysis of randomised controlled trials. Psychological Medicine, 53(3), 614–624. 10.1017/S0033291722003683
Access assessed: full text, PMC
Study context and limitations
- Population
- Adults with panic disorder with/without agoraphobia
- Intervention
- CBT by group, individual, guided/unguided self-help
- Comparison
- TAU and other formats
- Outcomes
- Panic symptoms and all-cause discontinuation
- Reported estimate
- Guided self-help vsTAU:SMD−0.42,95%CI−0.77 to−0.07
- Limitations
- Absence of significant format differences is not proof of equivalence.
- Funding and interests
- No specific grant; one author disclosed outside interests.
Discussed in: CBT for panic and agoraphobia.
Publication · 2026
Perlis, R. H., Gunning, F. M., Uslu, A. A., Santillana, M., Baum, M. A., Druckman, J. N., Ognyanova, K., & Lazer, D. (2026b). Generative AI use and depressive symptoms among US adults. JAMA Network Open, 9(1), e2554820. 10.1001/jamanetworkopen.2025.54820
Access assessed: Publisher full text; abstract, methods, Results and correction note inspected
Study context and limitations
- Population
- US adults; nonprobability online survey
- Intervention
- Self-reported general AI exposure, not assigned treatment
- Comparison
- Use-frequency categories
- Outcomes
- PHQ-9 symptoms
- Reported estimate
- Daily-or-more use associated with moderate-or-greater symptoms OR 1.29 (95% CI 1.15–1.46)
- Follow-up
- Cross-sectional April–May 2025 survey
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Confounding and reverse causation; no therapy efficacy or causal harm inference
Discussed in: Conversational AI and mental health.
Publication · 2026
Perlis, R. H., Gunning, F. M., Uslu, A., Santillana, M., Baum, M. A., Druckman, J. N., Ognyanova, K., & Lazer, D. (2026a). Emulated trial of artificial intelligence use and subsequent depressive outcomes in a survey of US adults. BMJ Mental Health, 29(1), e302609. 10.1136/bmjment-2026-302609
Access assessed: Publisher indexed PDF abstract and author institutional abstract; direct publisher full text returned 403
Study context and limitations
- Population
- US adult internet survey cohort
- Intervention
- Self-reported frequent general AI use
- Comparison
- Low/no use using target-trial emulation
- Outcomes
- Follow-up PHQ-9
- Reported estimate
- Weighted MD −0.18 (95% CI −0.94 to 0.59); no significant association
- Follow-up
- Survey waves June 2024–January 2025
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Observational emulation is not actual randomization; cannot exclude vulnerable-subgroup harm
Discussed in: Conversational AI and mental health.
Review methods · n.d.
PRISMA (n.d.). PRISMA 2020 statement.
Access assessed: Official reporting-guideline page
Study context and limitations
- Certainty
- No new formal certainty rating
- Limitations
- Reporting guidance is not a certificate of review quality or proof all methods were performed.
Publication · 2022
Rabasco, A., McKay, D., Smits, J. A., Powers, M. B., Meuret, A. E., & McGrath, P. B. (2022). Psychosocial treatment for panic disorder: An umbrella review of systematic reviews and meta-analyses. Journal of Anxiety Disorders, 86, 102528. 10.1016/j.janxdis.2022.102528
Access assessed: PubMed abstract and metadata
Study context and limitations
- Population
- Mainly adults with panic disorder
- Intervention
- Psychosocial treatments, mostly CBT
- Comparison
- Various controls
- Limitations
- Underlying trials overlap; abstract-only appraisal.
Discussed in: CBT for panic and agoraphobia.
Publication · 2021
Reid, J. E., Laws, K. R., Drummond, L., Vismara, M., Grancini, B., Mpavaenda, D., & Fineberg, N. A. (2021). Cognitive behavioural therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: A systematic review and meta-analysis of randomised controlled trials. Comprehensive Psychiatry, 106, 152223. 10.1016/j.comppsych.2021.152223
Access assessed: PubMed abstract and bibliographic record.
Study context and limitations
- Population
- Mixed age: 1,483 adults and 537 young people.
- Intervention
- CBT with ERP.
- Comparison
- Psychological placebo and other active psychotherapies separately.
- Outcomes
- OCD symptoms.
- Reported estimate
- Other active psychotherapies: g = −0.05 (95% CI −0.27 to 0.16; 8 studies).
- Certainty
- No outcome-specific GRADE rating extracted.
- Limitations
- Mixed ages and heterogeneous comparators; allegiance moderator is observational.
Discussed in: OCD and exposure and response prevention.
Publication · 2016
Richards, D. A., Ekers, D., McMillan, D., Taylor, R. S., Byford, S., Warren, F. C., Barrett, B., Farrand, P. A., Gilbody, S., Kuyken, W., O’Mahen, H., Watkins, E. R., Wright, K. A., Hollon, S. D., Reed, N., Rhodes, S., Fletcher, E., & Finning, K. (2016). Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): A randomised, controlled, non-inferiority trial. The Lancet, 388(10047), 871–880. 10.1016/S0140-6736(16)31140-0
Access assessed: published full-text PDF, institutional repository
Study context and limitations
- Population
- UK adults with major depression; several high-risk groups excluded
- Intervention
- BA with trained/supervised junior workers
- Comparison
- CBT with psychological therapists
- Outcomes
- PHQ-9 at12 months
- Reported estimate
- Mean difference0.1 points, 95%CI −1.3 to1.5; noninferiority margin1.9
- Follow-up
- 6,12,18 months after randomization
- Certainty
- Single noninferiority RCT; no new GRADE
- Limitations
- Structured therapist treatment, not unsupervised habit prompts
- Funding and interests
- UK National Institute for Health Research
Discussed in: CBT for depression.
Publication · 2025
Rosner, R., Rau, J., Kersting, A., Rief, W., Steil, R., Rummel, A.-M., Vogel, A., & Comtesse, H. (2025). Grief-specific cognitive behavioral therapy vs present-centered therapy: A randomized clinical trial. JAMA Psychiatry, 82(2), 109–117. 10.1001/jamapsychiatry.2024.3409
Access assessed: Full text
Study context and limitations
- Population
- German university outpatient clinics, adults with PGD
- Intervention
- Grief-specific CBT
- Comparison
- Present-centered therapy matched in session length/number
- Outcomes
- Blinded grief severity
- Reported estimate
- Between-group d=0.31 (95% CI 0.03–0.57) posttreatment; d=0.28 (−0.02–0.57) at 12 months after randomization
- Follow-up
- 12 months after randomization
- Certainty
- No new formal certainty rating
- Limitations
- Primary follow-up interval crosses no difference; within-group effect is not a randomized treatment effect.
- Funding and interests
- German Research Foundation; several authors disclose training/royalty interests
Discussed in: CBT for prolonged grief.
Publication · 2023
Rosser, B. A., Fisher, E., Janjua, S., Eccleston, C., Keogh, E., & Duggan, G. (2023). Psychological therapies delivered remotely for the management of chronic pain (excluding headache) in adults. Cochrane Database of Systematic Reviews, 2023(8), CD013863. 10.1002/14651858.CD013863.pub2
Access assessed: Cochrane public summary and complete abstract.
Study context and limitations
- Population
- Adults with chronic pain, excluding headache.
- Intervention
- Remote psychological care; no more than 30% clinician contact.
- Comparison
- Usual care, primarily internet CBT comparisons.
- Outcomes
- Pain intensity, disability and quality of life.
- Reported estimate
- CBT vs usual care pain: end treatment SMD −0.28 (95% CI −0.39 to −0.16); follow-up −0.04 (−0.17 to 0.09).
- Follow-up
- 3–12 months.
- Certainty
- Published moderate certainty for these pain comparisons.
- Limitations
- Mostly web programmes; only one smartphone intervention.
- Funding and interests
- Public/charitable sources for all but one trial, according to summary.
Discussed in: CBT for chronic pain.
Publication · 2022
Schnurr, P. P., Chard, K. M., Ruzek, J. I., Chow, B. K., Resick, P. A., Foa, E. B., Marx, B. P., Friedman, M. J., Bovin, M. J., Caudle, K. L., Castillo, D., Curry, K. T., Hollifield, M., Huang, G. D., Chee, C. L., Astin, M. C., Dickstein, B., Renner, K., Clancy, C. P., Collie, C., Maieritsch, K., Bailey, S., Thompson, K., Messina, M., Franklin, L., Lindley, S., Kattar, K., Luedtke, B., Romesser, J., McQuaid, J., Sylvers, P., Varkovitzky, R., Davis, L., MacVicar, D., & Shih, M.-C. (2022). Comparison of Prolonged Exposure vs Cognitive Processing Therapy for Treatment of Posttraumatic Stress Disorder Among US Veterans: A Randomized Clinical Trial. JAMA Network Open, 5(1), e2136921. 10.1001/jamanetworkopen.2021.36921
Access assessed: Publisher full text.
Study context and limitations
- Population
- U.S. veterans; 79.7% men.
- Intervention
- 10–14 individual PE sessions.
- Comparison
- 10–14 individual CPT sessions: active treatment.
- Outcomes
- Clinician-Administered PTSD Scale for DSM-5 (CAPS-5).
- Reported estimate
- PE–CPT symptom-improvement difference 2.42 points (95% CI 0.53–4.31), SMD 0.17; below prespecified clinical-importance threshold 0.25.
- Follow-up
- Post-treatment, 3 and 6 months.
- Certainty
- No independent formal rating assigned.
- Limitations
- Veteran and predominantly male population; completion differs.
- Funding and interests
- VA Cooperative Studies Program; funder involved in conduct; manual royalties/outside interests disclosed.
Discussed in: CBT and trauma-focused treatments for PTSD.
Publication · 2017
Schramm, E., Kriston, L., Zobel, I., Bailer, J., Wambach, K., Backenstrass, M., Klein, J. P., Schoepf, D., Schnell, K., Gumz, A., Bausch, P., Fangmeier, T., Meister, R., Berger, M., Hautzinger, M., & Härter, M. (2017). Effect of disorder-specific vs nonspecific psychotherapy for chronic depression: A randomized clinical trial. JAMA Psychiatry, 74(3), 233–242. 10.1001/jamapsychiatry.2016.3880
Access assessed: full text, publisher
Study context and limitations
- Population
- Medication-free adults with early-onset chronic depression
- Intervention
- CBASP, acute and continuation sessions
- Comparison
- Supportive psychotherapy
- Outcomes
- HRSD-24
- Reported estimate
- 20-week adjusted difference−2.51, 95%CI −4.16 to−0.86
- Follow-up
- 20-week acute;48-week continuation endpoint
- Certainty
- Single RCT; no new GRADE
- Limitations
- Specialized protocol, selected population;48-week endpoint is not untreated follow-up
- Funding and interests
- German Research Foundation; some authors disclosed CBASP-related royalties/honoraria
Discussed in: CBT for depression.
Review methods · 2024
Schünemann, H. J., Higgins, J. P. T., Vist, G. E., Glasziou, P., Akl, E. A., Skoetz, N., & Guyatt, G. H. (2024). Chapter 14: Completing Summary of findings tables and grading the certainty of the evidence. In J. P. T. Higgins, J. Thomas, J. Chandler, M. Cumpston, T. Li, M. J. Page, & V. A. Welch (Eds.), Cochrane handbook for systematic reviews of interventions (Version 6.5). Cochrane.
Access assessed: Official handbook chapter
Study context and limitations
- Certainty
- No new formal certainty rating
- Limitations
- Chapter last updated August2023, cited within handbookversion6.5(2024). No new formal GRADE assessment undertaken here.
Discussed in: What is CBT?.
Review methods · 2024
Schünemann, H. J., Vist, G. E., Higgins, J. P. T., Santesso, N., Deeks, J. J., Glasziou, P., Akl, E. A., & Guyatt, G. H. (2024). Chapter 15: Interpreting results and drawing conclusions. In J. P. T. Higgins, J. Thomas, J. Chandler, M. Cumpston, T. Li, M. J. Page, & V. A. Welch (Eds.), Cochrane handbook for systematic reviews of interventions (Version 6.5). Cochrane.
Access assessed: Official handbook chapter
Study context and limitations
- Certainty
- No new formal certainty rating
- Limitations
- Interpretation guidance; not a treatment-effect source.
Discussed in: What is CBT?.
Review methods · 2017
Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., Moher, D., Tugwell, P., Welch, V., Kristjansson, E., & Henry, D. A. (2017). AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 358, j4008. 10.1136/bmj.j4008
Access assessed: Primary methods article indexed text and publisher PDF
Study context and limitations
- Certainty
- No new formal certainty rating
- Limitations
- No summed quality score; this dossier does not claim a completed item-by-item AMSTAR2 assessment.
Publication · 2023
Sloan, D. M., Marx, B. P., Acierno, R., Messina, M., Muzzy, W., Gallagher, M. W., Litwack, S., & Sloan, C. (2023). Written Exposure Therapy vs Prolonged Exposure Therapy in the Treatment of Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA Psychiatry, 80(11), 1093–1100. 10.1001/jamapsychiatry.2023.2810
Access assessed: Publisher full text.
Study context and limitations
- Population
- Veterans; high suicide risk, psychosis and unstable bipolar disorder excluded.
- Intervention
- Five to seven clinician-led written exposure sessions.
- Comparison
- Eight to fifteen PE sessions: active treatment.
- Outcomes
- CAPS-5; noninferiority margin 10 points.
- Reported estimate
- WET met the prespecified noninferiority criterion.
- Follow-up
- Assessments at 10, 20 and 30 weeks.
- Certainty
- No independent formal rating assigned.
- Limitations
- Mostly clinician videoconferencing; not independent journaling or AI. Clinical-risk exclusions.
- Funding and interests
- VA grant CX001967; WET manual royalties disclosed.
Discussed in: CBT and trauma-focused treatments for PTSD.
Publication · 2026
So, M., Sekizawa, Y., Hashimoto, S., Kashimura, M., Yamakage, H., & Watanabe, N. (2026). Effect of AI-based natural language feedback on engagement and clinical outcomes in fully self-guided internet-based cognitive behavioral therapy for depression: 3-arm randomized controlled trial. Journal of Medical Internet Research, 28, e76902. 10.2196/76902
Access assessed: Publisher full text; abstract, participant flow, funding and outcome interpretation inspected
Study context and limitations
- Population
- Japanese adults aged 20–60; fully self-guided intervention
- Intervention
- AI natural-language feedback with cognitive-restructuring exercises
- Comparison
- Same iCBT without feedback; waitlist
- Outcomes
- Attendance and depressive symptoms; ITT and selected efficacy-analysis populations
- Reported estimate
- Better adherence; selected efficacy-analysis findings cannot replace ITT clinical inference
- Follow-up
- 7 weeks and 3 months
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Adherence-related selection and exploratory associations; AI/NLP architecture must not be assumed equivalent to current generative models
- Funding and interests
- Japanese Research Institute of Economy, Trade and Industry; no conflicts declared
Discussed in: Conversational AI and mental health.
Publication · 2022
Sohal, M., Singh, P., Dhillon, B. S., & Gill, H. S. (2022). Efficacy of journaling in the management of mental illness: A systematic review and meta-analysis. Family Medicine and Community Health, 10(1), e001154. 10.1136/fmch-2021-001154
Access assessed: Indexed PubMed abstract and publisher PDF excerpts; complete full-text audit unavailable
Study context and limitations
- Population
- Mixed mental-health samples and journaling protocols
- Intervention
- Expressive writing or gratitude journaling
- Comparison
- Control arms varied
- Outcomes
- Patient mental-health measures
- Reported estimate
- No portable pooled recovery percentage extracted
- Certainty
- Authors report Strength of Recommendation Taxonomy B; not a GRADE rating
- Limitations
- High heterogeneity; methodological weaknesses; variable content and schedules
Discussed in: Digital CBT, journaling, and mental health apps.
Publication · 2024
Southward, M. W., Kushner, M. L., Terrill, D. R., & Sauer-Zavala, S. (2024). A review of transdiagnostic mechanisms in cognitive behavior therapy. Psychiatric Clinics of North America, 47(2), 343–354. 10.1016/j.psc.2024.02.003
Access assessed: Published paper PDF on author institution website; selected conceptual and evidence sections inspected
Study context and limitations
- Population
- Multiple diagnoses and psychotherapy studies
- Intervention
- CBT skills and common processes
- Comparison
- Varied evidence designs
- Outcomes
- Proposed change processes
- Reported estimate
- No new pooled clinical effect extracted
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Putative mechanisms and heterogeneous designs; causal inference unresolved
- Funding and interests
- NIMH K23MH126211 support; Sauer-Zavala royalties disclosed in institutional metadata
Discussed in: How CBT may work.
Publication · 2024
Steinmetz, L., Simon, L., Feige, B., Riemann, D., Johann, A. F., Ell, J., Ebert, D. D., Baumeister, H., Benz, F., & Spiegelhalder, K. (2024b). Network meta-analysis examining efficacy of components of cognitive behavioural therapy for insomnia. Clinical Psychology Review, 114, 102507. 10.1016/j.cpr.2024.102507
Access assessed: Indexed PubMed abstract plus indexed publisher methods/limitations; original full article not appraised. Full published correction assessed separately (B27).
Study context and limitations
- Population
- Adults; mean age 44.9; 70.1% women.
- Intervention
- CBT-I components.
- Comparison
- Network component comparisons.
- Outcomes
- Insomnia severity; sleep-continuity outcomes.
- Reported estimate
- Read with B27: corrected text finds small significant cognitive-therapy and sleep-restriction effects on insomnia severity.
- Certainty
- No formal outcome rating extracted.
- Limitations
- Original abstract omitted significant cognitive-therapy findings and contained an incorrect sleep-restriction confidence interval; B27 replaces those passages.
- Funding and interests
- Funding not extracted; digital-insomnia commercial interest disclosed by one author.
Discussed in: CBT for insomnia.
Publication · 2024
Steinmetz, L., Simon, L., Feige, B., Riemann, D., Johann, A. F., Ell, J., Ebert, D. D., Baumeister, H., Benz, F., & Spiegelhalder, K. (2024a). Corrigendum to “Network meta-analysis examining efficacy of components of cognitive behavioural therapy for insomnia” [Clinical Psychology Review 114 (2024) 102507]. Clinical Psychology Review, 114, 102519. 10.1016/j.cpr.2024.102519
Access assessed: Full published correction PDF hosted by German National Library (https://d-nb.info/1351210343/34); PubMed metadata verified.
Study context and limitations
- Population
- Same review as B11.
- Intervention
- CBT-I component network analysis.
- Comparison
- Same network as B11.
- Outcomes
- Insomnia severity.
- Reported estimate
- Corrected cognitive-therapy d = −0.28 (95% CI −0.48 to −0.09); corrected sleep-restriction CI −0.63 to −0.26.
- Follow-up
- Same review as B11.
- Certainty
- No new formal grade extracted.
- Limitations
- Corrects descriptions after updated literature search; not an independent replication.
- Funding and interests
- Funding not extracted; correction declares no competing interests.
Discussed in: CBT for insomnia.
Publication · 2020
Storebø, O. J., Stoffers-Winterling, J. M., Völlm, B. A., Kongerslev, M. T., Mattivi, J. T., Jørgensen, M. S., Faltinsen, E., Todorovac, A., Sales, C. P., Callesen, H. E., Lieb, K., & Simonsen, E. (2020). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews(5), CD012955. 10.1002/14651858.CD012955.pub2
Access assessed: Indexed PubMed metadata and official Cochrane abstract/summary
Study context and limitations
- Population
- BPD, all ages; mainly female samples
- Intervention
- BPD-specific psychological therapies including DBT
- Comparison
- Usual care, waitlist/no treatment and active interventions
- Outcomes
- BPD severity, functioning and other outcomes
- Reported estimate
- Some favourable DBT comparisons with usual care; not a ranking proving DBT superior to every treatment
- Certainty
- Published low-quality evidence for relevant DBT findings
- Limitations
- Mixed ages and interventions; not all records are DBT studies; direct PMC returned browser-check page.
Discussed in: ACT, DBT, MBCT, and REBT.
Publication · 2024
Trenoska Basile, V., Newton-John, T., McDonald, S., & Wootton, B. M. (2024). Internet videoconferencing delivered cognitive behaviour therapy for generalized anxiety disorder: A randomized controlled trial. British Journal of Clinical Psychology, 63(4), 487–506. 10.1111/bjc.12482
Access assessed: full text, publisher
Study context and limitations
- Population
- Adults with GAD; mostly women; Australian recruitment
- Intervention
- High-intensity videoconference CBT
- Comparison
- Waitlist
- Outcomes
- GAD symptoms; diagnostic status
- Reported estimate
- Posttreatment between-group d0.80; CI not extracted
- Follow-up
- 3months within treated group
- Limitations
- Waitlist comparison cannot establish parity with active face-to-face care.
Discussed in: CBT for generalized anxiety.
Publication · 2021
Tyrer, P., Wang, D., Crawford, M., Dupont, S., Cooper, S., Nourmand, S., Lazarevic, V., Philip, A., & Tyrer, H. (2021a). Sustained benefit of cognitive behaviour therapy for health anxiety in medical patients (CHAMP) over 8 years: a randomised-controlled trial. Psychological Medicine, 51(10), 1714–1722. 10.1017/S003329172000046X
Access assessed: Indexed complete PubMed abstract and publisher bibliographic record.
Study context and limitations
- Population
- General-hospital outpatients aged 16–75, predominantly adults.
- Intervention
- Adapted CBT for health anxiety, mean six sessions.
- Comparison
- Standard care.
- Outcomes
- HAI and secondary mental-health outcomes.
- Reported estimate
- Eight-year HAI difference 1.83 points (95% CI 0.25–3.40), favouring CBT.
- Follow-up
- 8 years.
- Certainty
- No formal rating assigned.
- Limitations
- Not all participants adults; medical-outpatient setting. Corrected subgroup table exists.
Discussed in: CBT for health anxiety.
Publication · 2021
Tyrer, P., Wang, D., Crawford, M., Dupont, S., Cooper, S., Nourmand, S., Lazarevic, V., Philip, A., & Tyrer, H. (2021b). Sustained benefit of cognitive behaviour therapy for health anxiety in medical patients (CHAMP) over eight years: randomised controlled trial – CORRIGENDUM. Psychological Medicine, 51(10), 1723. 10.1017/S0033291720001932
Access assessed: Publisher correction text indexed in search; bibliographic record verified.
Study context and limitations
- Population
- Same CHAMP cohort as B16.
- Outcomes
- Corrected Table 4.
- Reported estimate
- Replaces patient counts and subgroup model estimates in Table 4.
- Follow-up
- Same eight-year report.
- Limitations
- Does not supply an independent replication.
Discussed in: CBT for health anxiety.
Clinical guidance · 2023
U.S. Department of Veterans Affairs, & U.S. Department of Defense (2023). VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder. VA/DoD clinical practice guideline, version 4.0.
Access assessed: Official full guideline PDF.
Study context and limitations
- Population
- Adults with PTSD or acute stress disorder; U.S. military/VA context.
- Intervention
- Manualized individual CPT, EMDR and PE; WET and other alternatives separately.
- Comparison
- Recommendation, not a new trial.
- Outcomes
- PTSD management.
- Reported estimate
- Recommendation 8: strong for CPT, EMDR or PE. WET recommendation is weak for.
- Certainty
- Recommendation strength is not a universal high-certainty label for every outcome.
- Limitations
- Evidence search through 2022-05-04; later trials considered separately.
- Funding and interests
- U.S. VA and Department of Defense guideline.
Discussed in: What is CBT?; CBT and trauma-focused treatments for PTSD.
Company documentation · 2026
Umbrella Journal (2026c). Umbrella Journal company and app overview.
Access assessed: Local repository HTML inspected
Study context and limitations
- Intervention
- Journaling and CBT-informed reflection tools
- Certainty
- No new formal certainty rating
- Limitations
- Company description,not efficacy evidence.
Discussed in: What is CBT?.
Company documentation · 2026
Umbrella Journal (2026a). Meet Ella.
Access assessed: Local repository HTML/product documentation inspected
Study context and limitations
- Intervention
- AI-guided conversations,check-ins,reflection
- Certainty
- No new formal certainty rating
- Limitations
- Company description,not efficacy evidence.
Discussed in: What is CBT?; ACT, DBT, MBCT, and REBT.
Company documentation · 2026
Umbrella Journal (2026b). Meet Nuggets.
Access assessed: Local repository HTML/product documentation inspected
Study context and limitations
- Intervention
- Journaling and habit-building support
- Certainty
- No new formal certainty rating
- Limitations
- Company description,not efficacy evidence.
Discussed in: What is CBT?.
Publication · 2020
van Dis, E. A. M., van Veen, S. C., Hagenaars, M. A., Batelaan, N. M., Bockting, C. L. H., van den Heuvel, R. M., Cuijpers, P., & Engelhard, I. M. (2020). Long-term outcomes of cognitive behavioral therapy for anxiety-related disorders: A systematic review and meta-analysis. JAMA Psychiatry, 77(3), 265–273. 10.1001/jamapsychiatry.2019.3986
Access assessed: primary abstract and indexed full-text excerpts; PMC challenge/repository403
Study context and limitations
- Population
- Outpatients with anxiety-related disorders
- Intervention
- CBT broadly defined
- Comparison
- Control conditions
- Follow-up
- At least1 month after treatment; longer intervals analyzed separately
- Limitations
- Sparse relapse and longer-term evidence; no lifetime cure inference.
Discussed in: CBT for generalized anxiety; CBT for panic and agoraphobia; Exposure therapy for specific phobias.
Publication · 2019
Wechsler, T. F., Kümpers, F., & Mühlberger, A. (2019). Inferiority or even superiority of virtual reality exposure therapy in phobias? A systematic review and quantitative meta-analysis on randomized controlled trials specifically comparing the efficacy of virtual reality exposure to gold standard in vivo exposure in agoraphobia, specific phobia, and social phobia. Frontiers in Psychology, 10, 1758. 10.3389/fpsyg.2019.01758
Access assessed: full text, publisher
Study context and limitations
- Intervention
- VR exposure
- Comparison
- In-vivo exposure
- Reported estimate
- Specific-phobia g−0.15,95%CI−0.47 to0.16
- Limitations
- Small pooled subtype samples; interval permits meaningful differences.
Discussed in: Exposure therapy for specific phobias.
Publication · 2026 · Preprint, not peer reviewed
Weilnhammer, V., Dolan, R., Luettgau, L., Corno, V., Wilkinson, E., Sounderajah, V., Richardson, H., Kelly, C., & Nour, M. M. (2026). Path-dependent triage: Early judgments lead conversational AI chatbots to miss mental-health emergencies. arXiv preprint, arXiv:2611.09647v1. 10.48550/arXiv.2611.09647
Access assessed: Primary arXiv abstract and submission history; not peer reviewed
Study context and limitations
- Population
- Simulated users grounded in clinical case files; not real-world harm surveillance
- Intervention
- Multi-turn chatbot triage evaluation
- Comparison
- All-details-at-once and conversation-representation conditions
- Outcomes
- Emergency under-triage
- Reported estimate
- Reported under-triage 20.3% multi-turn vs 5.6% single-message
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Very recent preprint; simulation design and model versions; not incidence among users
Discussed in: Conversational AI and mental health.
Publication · 2020
Williams, A. C. de C., Fisher, E., Hearn, L., & Eccleston, C. (2020). Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database of Systematic Reviews, 2020(8), CD007407. 10.1002/14651858.CD007407.pub4
Access assessed: Full PMC text.
Study context and limitations
- Population
- Adults with noncancer chronic pain, excluding headache.
- Intervention
- Psychological therapies; CBT results kept separate.
- Comparison
- Active controls and treatment as usual separately.
- Outcomes
- Pain, disability and distress.
- Reported estimate
- Pain at treatment end: active control SMD −0.09 (95% CI −0.17 to −0.01); usual care −0.22 (−0.33 to −0.10).
- Follow-up
- 6–12 months; findings depend on comparator/outcome.
- Certainty
- Published moderate certainty for these pain estimates; other outcomes vary.
- Limitations
- Condition and outcome variation; no cure inference.
Discussed in: CBT for chronic pain.
Publication · 2026
Winter, H. R., Norton, A. R., & Wootton, B. M. (2026). Videoconferencing-delivered cognitive behavioural therapy for social anxiety disorder: A randomised controlled trial. Cognitive Behaviour Therapy, 55(6), 880–896. 10.1080/16506073.2025.2540916
Access assessed: publisher indexed abstract/methods/results excerpts; full direct access not established
Study context and limitations
- Population
- Adults with SAD
- Intervention
- Videoconference CBT
- Comparison
- Waitlist
- Outcomes
- SPS-6;SIAS-6
- Reported estimate
- Between-group SIAS-6:d0.55,95%CI0.09–1.00
- Follow-up
- 3months treated-group follow-up
- Limitations
- Benchmarking against historical face-to-face studies is not randomized equivalence.
Discussed in: CBT for social anxiety.
Clinical guidance · 2023
World Health Organization (2023). Brief structured psychological interventions.
Access assessed: full official recommendation webpage
Study context and limitations
- Population
- Adults with GAD and/or panic disorder
- Intervention
- Brief structured CBT-based psychological interventions
- Certainty
- WHO published strong recommendation; moderate-certainty evidence
- Limitations
- Recommendation refers to structured interventions, not any commercial chat app.
Discussed in: CBT for generalized anxiety; CBT for panic and agoraphobia.
Publication · 2024
Zainal, N. H., Soh, C. P., Van Doren, N., & Benjet, C. (2024). Do the effects of internet-delivered cognitive-behavioral therapy (i-CBT) last after a year and beyond? A meta-analysis of 154 randomized controlled trials (RCTs). Clinical Psychology Review, 114, 102518. 10.1016/j.cpr.2024.102518
Access assessed: PubMed abstract and author-repository abstract/PDF excerpts; repository open challenged
Study context and limitations
- Population
- Multiple clinical conditions; population applicability must remain condition-specific
- Intervention
- Guided or self-guided iCBT
- Comparison
- Multiple controls
- Outcomes
- Symptoms and binary treatment outcomes
- Reported estimate
- Long-term outcome synthesis reported; numerical pooled effects not extracted
- Follow-up
- At least 12 months
- Certainty
- No new formal GRADE assessment performed
- Limitations
- Overlaps earlier iCBT trial pools; not an independent new 45335-person trial; formats and outcomes differ
Discussed in: Digital CBT, journaling, and mental health apps.
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These are source records, not 100 independent clinical trials. Some reviews contain overlapping studies, and company documentation is not treatment-effect evidence. Missing extracted details do not establish absence of an outcome or adverse event.