Third-Wave Therapies in Primary Care: A Systematic Review with Meta-Analysis
Le résumé fourni par la source
Primary care represents the first level of healthcare and serves as the main entry point to health systems, playing a central role in promoting access to mental health services and supporting the social and economic development of communities. In recent decades, third-wave psychotherapies have been increasingly investigated as brief, transdiagnostic, and potentially scalable interventions for use in primary care settings. However, evidence regarding their efficacy in this context remains fragmented. The main aim of this study was to evaluate the efficacy of third-wave therapies in primary care for mental health outcomes, including negative and positive outcomes. Specifically, the review aimed to (1) assess their efficacy in reducing mental health symptoms; (2) examine the effects of specific approaches—Behavioral Activation (BA), Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), Functional Analytic Psychotherapy (FAP), and Dialectical Behavior Therapy (DBT); and (3) investigate potential moderators of therapeutic effects, including intervention format, type of control group, professional delivering the intervention, therapy intensity, number of sessions, follow-up duration, country, and risk of bias. This systematic review and meta-analysis evaluated the efficacy of third-wave psychological therapies delivered in primary care settings for mental health outcomes in adults. Comprehensive searches were conducted in PubMed, EMBASE, SCOPUS, Web of Science, Cochrane CENTRAL, LILACS, and APA PsycInfo. Randomized controlled trials (RCTs) involving adults (≥18 years) and third-wave interventions implemented in primary care were included. Study quality was assessed using the Risk of Bias 2 (RoB 2) tool, and data were synthesized through qualitative analysis and random-effects meta-analyses. The findings have important implications for clinical practice in primary care and for public mental health policies, informing future research design and supporting a more equitable integration of psychological science within health systems.
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