2025/01/23 by Julia Velten, Hanna Christiansen, Jürgen Hoyer +30 · 1 voice
Psychology · #Mental Health Treatment and Access #Child and Adolescent Psychosocial and Emotional Development #Personality Disorders and Psychopathology
paper · doi:10.1016/j.brat.2025.104691
openalex publication_date 2025/01/23 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/31
Practice-based evidence has emerged as an important complementary paradigm to studies in controlled trials. This paper presents results of a large research-practice network at German university outpatient clinics; the KODAP initiative. Pre-post effect sizes, direct assessments of change, and rates of clinically significant and reliable improvement are reported in a heterogeneous clinical sample of 6624 adult patients treated between 2023 and 2014 in 29 psychotherapeutic outpatient clinics. Clinical diagnoses, determined with structured diagnostic clinical interviews at baseline across all clinics, encompassed a wide range of psychopathology. Effectiveness was comparable to other studies in naturalistic settings ( d ≈ 0.75–0.95) and somewhat lower than changes reported in disorder-specific CBT efficacy trials. In direct assessments of change, only 1.9% of the patients reported symptom worsening and 3.4% reported no change during treatment. Overall, the results show the potential of multi-site naturalistic research initiatives in general and the effectiveness of outpatient CBT at German university outpatient clinics in particular. • This study is the first to present pre-post changes in symptoms in a large research-practice network with 6624 patients at 29 university outpatient clinics in Germany. • Large pre-post treatment effects were found on psychometric measures assessing depressive symptoms and psychological distress. • Treatments provided under routine conditions were associated with improved symptoms reported by both patients and therapists. • The study supports the effectiveness of cognitive-behavioral therapy across a diverse range of clinical diagnoses. • Multi-site naturalistic research initiatives inform clinical practice, promoting an evidence-based approach that bridges the gap between research and clinical application.