Evidence Based Practice Unit


New paper on adolescents’ reliable improvement rates in depression & anxiety at the end of treatment

18 July 2018

by Holly Bear

New paper

There is evidence to suggest that levels of anxiety and depression in adolescents is increasing. Discussion and research efforts have predominantly focussed on increasing the availability of treatment to meet this increasing demand and encouraging children and young people to seek help for the mental health problems they are experiencing.

However, there is much less discussion about how many children and young people are significantly better following treatment nor how to discuss this at the outset of the treatments being provided.  This is crucial information to help practitioners set realistic expectations for outcomes and support adolescents to make informed choices about their care.

There has therefore been a call for a focus on statistical metrics of outcome that focus on individual responses to treatment that may be more clinically meaningful. The metric of ‘reliable change’ involves taking the noise of the measure into account. It means that once the data have been analysed, we can say that the results are unlikely to be due to simple measurement unreliability.

In this study, data was collected from 4464 adolescents, seen in 75 specialist mental health services in England. In total, 53% of those with anxiety, 44% with depression, and 35% with comorbid depression and anxiety showed reliable improvement.

These findings raise important implications for research and practice in relation to meeting the needs of young people with anxiety and depression. One key implication for practice is the need for a recalibration of what is said to young people and the wider public about the likely outcome of therapy, particularly, that not everyone will be measurably improved by the end of treatment.

Director of the Evidence Based Practice Unit and co-author, Professor Miranda Wolpert, said: “This research highlights the need for a more open discussion about the likely outcomes following treatment”.

Read the full paper here.