Associations of prior treatment, waiting time, symptom severity, and session frequency with symptom change in CBT for depression and anxiety in primary care

In routine CBT, clients with higher baseline severity benefited substantially, supporting equitable access to CBT regardless of initial symptom level. Clinical improvement was driven by the total number of attended treatment sessions rather than by the rate of attendance (i.e., the number of sessions per unit of time). This supports flexible scheduling without compromising outcomes. Longer waiting times did not systematically predict poorer results, suggesting that client- versus system-driven delays may have distinct implications. Considering prior treatment history may help tailor interventions for individuals with more persistent or treatment-resistant symptom patterns.