concept

treatment as usual

Also known as: TAU

Facts (80)

Sources

A systematic review of cognitive behavioral therapy-based ... frontiersin.org Frontiers 72 facts

referenceIn a 2011 non-randomized controlled trial conducted in Germany, Tlach and Hampel studied patients with chronic low back pain (CLBP) and depression, comparing a treatment group receiving Cognitive Behavioral Therapy (CBT) plus treatment as usual (TAU) (n=44) against a control group receiving only TAU (n=40).

measurementAcceptance and Commitment Therapy (ACT) demonstrated significant improvement in psychological flexibility compared to Treatment as Usual (TAU) with a medium effect size (d = 0.52) at post-treatment and a small effect size (d = 0.37) at follow-up.

claimThere were no significant differences between Behavioral Activation Therapy for Depression (BATD) and Treatment as Usual (TAU), or between Acceptance and Commitment Therapy (ACT) and Treatment as Usual (TAU), in the improvement of depressive, anxiety, and stress symptoms.

measurementA study by Migliorini et al. (2016) identified significant differences in improved stress symptoms at follow-up in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with a small effect size (d = 0.47).

measurementBehavioral Activation Treatment for Depression (BATD) showed significant differences in behavioral activation compared to Treatment as Usual (TAU) with a small effect size (d = 0.46) at post-treatment, but not at follow-up.

referenceChurchill et al. (2013) conducted a Cochrane systematic review comparing 'third wave' cognitive and behavioural therapies against treatment as usual for depression.

claimSchlicker et al. (2020) and Baumeister et al. (2021) found no significant differences in work capacity at post-treatment or follow-up when comparing cognitive behavioral therapy (CBT) to treatment as usual (TAU).

claimIncluding remote synchronous video group-based Acceptance and Commitment Therapy (ACT) or Behavioral Activation Treatment for Depression (BATD) as adjuncts to Treatment As Usual (TAU) provides clinical utility for improving pain interference and pain catastrophizing in patients with chronic low back pain (CLBP) and comorbid depressive symptoms.

referenceIn a study by Schlicker et al. (2020) in Germany, patients with chronic low back pain (CLBP) and depression were treated with either Cognitive Behavioral Therapy (CBT) combined with Treatment As Usual (TAU) or TAU alone, delivered via weekly online sessions.

measurementIn a systematic review of cognitive behavioral therapy-based interventions, four out of six studies (66%) found significant differences in the reduction of depressive symptoms at follow-up in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with effect sizes (d) ranging from 0.75 to 0.26.

measurementAcceptance and Commitment Therapy (ACT) showed significant differences in behavioral activation compared to Treatment as Usual (TAU) with a small effect size (d = 0.30) at post-treatment, but not at follow-up.

measurementBehavioral Activation Treatment for Depression (BATD) demonstrated significant improvement in psychological flexibility compared to Treatment as Usual (TAU) with a small effect size (d = 0.40) at post-treatment, but this difference was not maintained at follow-up.

referenceThe study by Ólason et al. (2018) in Iceland evaluated the efficacy of CBT combined with treatment as usual (TAU) versus TAU alone for patients with chronic pain and depression or anxiety.

measurementAcceptance and Commitment Therapy (ACT) demonstrated significant improvement in pain interference compared to Treatment as Usual (TAU) at post-treatment (effect size d = 0.64) and at follow-up (effect size d = 0.73).

measurementBehavioral Activation Therapy for Depression (BATD) was statistically superior to Treatment as Usual (TAU) in improving pain interference only at follow-up, with a medium effect size (d = 0.66).

measurementIn a study by De Jong et al. (2016, 2018), Mindfulness-Based Interventions (MBI) showed a significant difference in the reduction of depressive symptoms at post-treatment compared to Treatment As Usual (TAU), with a very small effect size (d = 0.13).

measurementTwo studies (Buhrman et al., 2015; Gasslander et al., 2022) found no significant differences between cognitive behavioral therapy (CBT) and treatment as usual (TAU) at post-treatment regarding the reduction of fear of anxiety symptoms.

claimMindfulness-Based Interventions (MBI) produced a significant reduction in depressive symptoms at post-treatment in one out of two studies (De Jong et al., 2018) and an increase in emotional awareness and self-regulation in the one study that addressed this (De Jong et al., 2016), compared to Treatment As Usual (TAU).

claimNo significant differences were found between Acceptance and Commitment Therapy (ACT) and Treatment as Usual (TAU) regarding depressive and anxiety symptoms.

measurementOne study (Ólason et al., 2018) identified significant differences in improved social functioning at follow-up in favor of Cognitive Behavioral Therapy (CBT) compared to Treatment As Usual (TAU), with a medium effect size (d = 0.51).

referenceIn a study by Gasslander et al. (2022) in Sweden, patients with chronic pain (CP) and psychological distress were treated with either online CBT or Treatment As Usual (TAU) in weekly sessions.

referenceIn a study by Baumeister et al. (2021) in Germany, patients with chronic back pain (CBP) and depression were treated with either online CBT or Treatment As Usual (TAU) in weekly sessions.

referenceIn a study by Gardiner et al. (2019) in the United States, patients with non-specific chronic pain (NSCP) and major depressive disorder (MDD) were treated with Integrative Medical Group Visits (IMGV) combined with treatment as usual (TAU) versus TAU alone, with delivery occurring weekly via face-to-face and online sessions.

measurementFour out of six studies (67%) found significant differences in improving quality of life at post-treatment in favor of Cognitive Behavioral Therapy (CBT) compared to Treatment As Usual (TAU), with medium to invaluable effect sizes (d ranging from 0.78 to 0.02).

claimNo significant differences were found between Acceptance and Commitment Therapy (ACT) and Treatment as Usual (TAU), between Behavioral Activation Therapy for Depression (BATD) and Treatment as Usual (TAU), or between ACT and BATD regarding pain intensity.

claimResearch by De Jong et al. (2016, 2018) reported no significant differences between mindfulness-based interventions (MBI) and treatment as usual (TAU) at post-treatment and follow-up regarding the reduction of behavioral activation.

measurementDe Jong et al. (2016, 2018) found no significant differences in anxiety symptoms at post-treatment or follow-up when comparing Cognitive Behavioral Therapy (CBT) to Treatment As Usual (TAU).

measurementTwo studies (Buhrman et al., 2015; Gasslander et al., 2022) indicated significant differences in increased pain acceptance at post-treatment in favor of Cognitive Behavioral Therapy (CBT) compared to Treatment As Usual (TAU), with very small (d = 0.12) and small (d = 0.30) effect sizes, but no significant differences were found at follow-up.

measurementGardiner et al. (2019) found no significant difference in depressive symptoms between Mindfulness-Based Interventions (MBI) and Treatment As Usual (TAU) at follow-up.

measurementBaumeister et al. (2021) found significant differences in pain self-efficacy between Cognitive Behavioral Therapy (CBT) and Treatment As Usual (TAU) at post-treatment with a small effect size (d = 0.39) and at follow-up with a small effect size (d = 0.33).

measurementIn a systematic review of cognitive behavioral therapy-based interventions, three out of four studies (75%) showed significant differences in the reduction of anxiety symptoms at follow-up in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with effect sizes (d) ranging from 1.07 to 0.27.

claimBuhrman et al. (2015) found no significant differences in cognitive and behavioral coping strategies at follow-up when comparing cognitive behavioral therapy (CBT) to treatment as usual (TAU).

claimGasslander et al. (2022) found no significant differences between cognitive behavioral therapy (CBT) and treatment as usual (TAU) at post-treatment regarding kinesiophobia and life control.

measurementPatients assigned to Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD) reported a significant reduction in pain catastrophizing compared to Treatment as Usual (TAU) at post-treatment (ACT effect size d = 0.45; BATD effect size d = 0.59) and at follow-up (both effect sizes d = 0.59).

measurementIn the systematic review, three out of four studies of traditional Cognitive Behavioral Therapy reported significant differences in the reduction of anxiety symptoms at follow-up compared to treatment as usual, with effect sizes (d) ranging from 1.07 to 0.27.

measurementTwo studies (Buhrman et al., 2015; Gasslander et al., 2022) found no significant differences in pain catastrophizing between Cognitive Behavioral Therapy (CBT) and Treatment As Usual (TAU) at post-treatment, and one study (Buhrman et al., 2015) found no significant differences at follow-up.

measurementDe Jong et al. (2016, 2018) and Torrijos-Zarcero et al. (2021) reported no significant differences in the reduction of pain intensity at post-treatment when comparing Mindfulness-Based Interventions (MBI) to Treatment As Usual (TAU) or Cognitive Behavioral Therapy (CBT).

measurementIn a systematic review of cognitive behavioral therapy-based interventions, five out of six studies (83%) showed significant differences in the reduction of anxiety symptoms at post-treatment in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with effect sizes (d) ranging from 1.08 to 0.19.

measurementAcceptance and Commitment Therapy (ACT) showed significant improvement in pain acceptance compared to Treatment as Usual (TAU) at post-treatment (effect size d = 0.34) and at follow-up (effect size d = 0.42).

referenceSanabria-Mazo et al. (2023) conducted a randomized controlled trial in Spain involving patients with chronic low back pain (CLBP) and depression, comparing Acceptance and Commitment Therapy plus Treatment as Usual (ACT+TAU), Behavioral Activation Therapy plus Treatment as Usual (BATD+TAU), and Treatment as Usual (TAU) alone.

measurementIn a systematic review of cognitive behavioral therapy-based interventions, six out of eight studies (75%) found significant differences in the reduction of depressive symptoms at post-treatment in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with effect sizes (d) ranging from 1.31 to 0.18.

measurementCompared to Treatment As Usual (TAU), traditional Cognitive Behavioral Therapy (CBT) reported significant differences in the reduction of depressive and anxiety symptoms and in the increase of quality of life at post-treatment and at follow-up, with effect sizes ranging from very large to small.

claimÓlason et al. (2018) found no significant differences between cognitive behavioral therapy (CBT) and treatment as usual (TAU) at post-treatment regarding fear avoidance.

measurementDe Jong et al. (2016, 2018) found a significant difference in improving quality of life at post-treatment in favor of Mindfulness-Based Interventions (MBI) compared to Treatment As Usual (TAU), with a very small effect size (d = 0.19).

claimEvidence is emerging regarding the effects of third-wave CBT therapies compared with treatment as usual (TAU), but further research is required to determine which therapy is most effective for specific circumstances and populations, as supported by studies from De Jong et al. (2016, 2018), Gardiner et al. (2019), Bell et al. (2020), Torrijos-Zarcero et al. (2021), and Sanabria-Mazo et al. (2023).

measurementGasslander et al. (2022) found that cognitive behavioral therapy (CBT) resulted in significant differences in coping strategies of ignoring and catastrophizing at post-treatment compared to treatment as usual (TAU), with small effect sizes of d = 0.38 and d = 0.34.

referenceTable 4 in the systematic review provides a synthesis of evidence comparing Cognitive Behavioral Therapy (CBT), Mindfulness-Based Interventions (MBI), Acceptance and Commitment Therapy (ACT), or Behavioral Activation Treatment for Depression (BATD) against Treatment as Usual (TAU).

claimNo significant differences were found between Behavioral Activation Therapy for Depression (BATD) and Treatment as Usual (TAU), or between Acceptance and Commitment Therapy (ACT) and BATD, regarding pain acceptance.

referenceIn a study by De Jong et al. (2016, 2018) in the United States, patients with chronic pain (CP) and major depressive disorder (MDD) were treated with Mindfulness-Based Cognitive Therapy (MBCT) combined with treatment as usual (TAU) versus TAU alone, with the intervention group receiving weekly face-to-face sessions.

measurementIn the systematic review, five out of six studies of traditional Cognitive Behavioral Therapy reported significant differences in the reduction of anxiety symptoms at post-treatment compared to treatment as usual, with effect sizes (d) ranging from 1.08 to 0.19.

referenceThe study by Aragonès et al. (2019) in Spain evaluated the efficacy of CBT combined with treatment as usual (TAU) versus TAU alone for patients with chronic musculoskeletal pain and major depressive disorder.

claimThe systematic review concludes that traditional Cognitive Behavioral Therapy may produce significant benefits for the improvement of depression, anxiety, and quality of life, but not for pain intensity and pain catastrophizing.

measurementTwo studies (Schlicker et al., 2020; Gasslander et al., 2022) found no significant differences in pain self-efficacy between Cognitive Behavioral Therapy (CBT) and Treatment As Usual (TAU) at post-treatment, and one study (Schlicker et al., 2020) found no significant differences at follow-up.

claimThe systematic review found no significant differences between traditional Cognitive Behavioral Therapy and treatment as usual at post-treatment and follow-up regarding pain intensity and pain catastrophizing.

measurementDe Jong et al. (2016, 2018) reported no significant differences in the reduction of pain self-efficacy at post-treatment or follow-up when comparing Mindfulness-Based Interventions (MBI) to Treatment As Usual (TAU).

measurementIn a systematic review, two out of three studies (67%) found significant differences in the reduction of pain interference at post-treatment in favor of Cognitive Behavioral Therapy (CBT) compared to Treatment As Usual (TAU), with small to very small effect sizes (d ranging from 0.22 to 0.12).

measurementA study by Baumeister et al. (2021) identified significant differences in improved pain intensity at post-treatment in favor of cognitive behavioral therapy (CBT) compared to treatment as usual (TAU), with a small effect size (d = 0.42).

measurementIn the systematic review, four out of six studies of traditional Cognitive Behavioral Therapy reported significant differences in the reduction of depressive symptoms at follow-up compared to treatment as usual, with effect sizes (d) ranging from 0.75 to 0.26.

measurementAcceptance and Commitment Therapy (ACT) showed significant improvement in stress symptoms at post-treatment (effect size d = 0.69) compared to Treatment as Usual (TAU), but this effect was not sustained at follow-up.

referenceIn a 2015 randomized controlled trial conducted in Sweden, Buhrman et al. studied patients with chronic pain (CP) and depression, comparing a treatment group receiving CBT plus treatment as usual (TAU) (n=28) against a control group receiving only TAU (n=24).

measurementStudies by De Jong et al. (2016, 2018) and Gardiner et al. (2019) found no significant differences in pain interference at post-treatment or follow-up when comparing Mindfulness-Based Interventions (MBI) to Treatment As Usual (TAU).

claimStudies exploring pain intensity and pain catastrophizing found no significant differences between traditional Cognitive Behavioral Therapy (CBT) and Treatment As Usual (TAU) at post-treatment and follow-up.

claimNo significant differences in depressive or anxiety symptoms were found in Acceptance and Commitment Therapy (ACT) and Behavioral Activation Treatment for Depression (BATD) compared to Treatment As Usual (TAU) at any assessment time points.

measurementBaumeister et al. (2021) found that cognitive behavioral therapy (CBT) led to significant improvements in pain-related disability at post-treatment compared to treatment as usual (TAU), with a small effect size of d = 0.35, though this effect was not maintained at follow-up.

measurementDe Jong et al. (2016, 2018) found no significant difference in the reduction of pain catastrophizing at post-treatment when comparing Mindfulness-Based Interventions (MBI) to Treatment As Usual (TAU).

measurementTwo studies (Buhrman et al., 2015; Aragonès et al., 2019) found no significant differences in the reduction of pain interference at follow-up when comparing Cognitive Behavioral Therapy (CBT) to Treatment As Usual (TAU).

measurementTwo out of four studies (50%) found significant differences in improving quality of life at follow-up in favor of Cognitive Behavioral Therapy (CBT) compared to Treatment As Usual (TAU), with medium to small effect sizes (d = 0.78 and d = 0.33).

referenceA study by Sanabria-Mazo et al. (2023) evaluated the efficacy of Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD) compared to Treatment as Usual (TAU), using an intention-to-treat (ITT) analysis with pre-, post-, and follow-up assessments, focusing on pain interference as the primary outcome.

measurementIn the systematic review, six out of eight studies of traditional Cognitive Behavioral Therapy reported significant differences in the reduction of depressive symptoms at post-treatment compared to treatment as usual, with effect sizes (d) ranging from 1.31 to 0.18.

measurementOne study (Buhrman et al., 2015) found no significant differences between cognitive behavioral therapy (CBT) and treatment as usual (TAU) at follow-up regarding the reduction of fear of anxiety symptoms.

measurementFour studies (Migliorini et al., 2016; Ólason et al., 2018; Aragonès et al., 2019; Schlicker et al., 2020) found no differences in pain intensity at follow-up when comparing cognitive behavioral therapy (CBT) to treatment as usual (TAU).

measurementGardiner et al. (2019) found a significant effect in improving quality of life at follow-up in favor of Mindfulness-Based Interventions (MBI) compared to Treatment As Usual (TAU), with a relative risk (RR) of 1.07.

Efficacy of Cognitive Behavioral Therapy for Anxiety-Related Disorders link.springer.com Springer Dec 19, 2022 8 facts

claimTreatment as usual (TAU) is a suboptimal control condition in Cognitive Behavioral Therapy studies because it is heterogeneous and not structurally equivalent within or between studies.

claimNondirective supportive therapy (NDST) shows positive effects compared to waitlist (WL) and treatment as usual (TAU) conditions, but is less effective than active psychological treatments.

claimComparing an active intervention with a psychological or pill placebo is a systematic approach to address the limitations of TAU and WL control conditions in Cognitive Behavioral Therapy research.

referenceWatts et al. performed a meta-analysis comparing Cognitive Behavioral Therapy to Treatment-as-Usual (TAU) for anxiety and depression, noting that TAU is highly variable.

referenceMunder et al. conducted a preregistered meta-analysis of randomized controlled trials to examine how the intensity of Treatment-as-Usual impacts the effects of face-to-face and internet-based psychotherapy for depression.

claimTreatment as usual (TAU) and waitlist (WL) comparators in Cognitive Behavioral Therapy studies are considered suboptimal because they potentially inflate estimates of treatment efficacy.

claimThe magnitude of effect sizes in Cognitive Behavioral Therapy studies is influenced by the comparison conditions used, such as waitlist (WL) or treatment as usual (TAU).

claimTreatment as Usual (TAU) is considered a suboptimal control condition in Randomized Controlled Trials (RCTs) because it is associated with type 1 errors that result in an overestimation of treatment effect size.