Sudden gains during psychological treatments of anxiety and depression: A meta-analysis

Idan M. Aderka, Angela Nickerson, Hans Jakob Bøe, Stefan G. Hofmann

Research output: Contribution to journalArticlepeer-review


Objective: The present study quantitatively reviewed the literature on sudden gains in psychological treatments for anxiety and depression. The authors examined the short-and long-term effects of sudden gains on treatment outcome as well as moderators of these effects. Method: The authors conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. The meta-analysis was based on 16 studies and included 1,104 participants receiving psychological treatment for major depressive disorder or an anxiety disorder. Results: Effect size estimates suggest that sudden gains had a moderate effect on primary outcome measures at posttreatment (Hedges's g = 0.62) and follow-up (Hedges's g = 0.56). These effect sizes were robust and unrelated to publication year or number of treatment sessions. The effect size of sudden gains in cognitive-behavioral therapy was higher (Hedges's g = 0.75) than in other treatments (Hedges's g = 0.23). Conclusions: These results suggest that sudden gains are associated with short-term and long-term improvements in depression and anxiety, especially in cognitive-behavioral therapy.

Original languageEnglish
Pages (from-to)93-101
Number of pages9
JournalJournal of Consulting and Clinical Psychology
Issue number1
StatePublished - Feb 2012
Externally publishedYes


  • anxiety disorders
  • depression
  • meta-analysis
  • sudden gains
  • treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology


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