Cognitive behavioural therapy interventions for depression in homeless populations: a meta-analysis
Abstract
Abstract Homelessness affects approximately 567,715 individuals in the United States, and its prevalence is increasing over time (Greenberg and Rosenheck, 2010; National Alliance to End Homelessness, 2020; Tsai, 2018). Cognitive behavioural therapy (CBT) is commonly used to treat depression, requiring few intervention sessions (Center for Substance Abuse Treatment, 1999). Few studies have been conducted to establish CBT’s efficacy in treating depression in individuals experiencing homelessness which was the goal of the present meta-analysis. Inclusion criteria included experimental studies with English publication, participants experiencing homelessness, validated depression measures, and recent publication. PsycInfo, PsycArticles, SocINDEX, MEDLINE, ProQuest, Taylor & Francis, PubMed, and Scopus were used to identify articles, and the most recent search was conducted in August 2025. Results identified a total of 11 studies with a total of 14 effect sizes and found that the pooled estimate suggested a small, non-significant difference in depression symptoms between CBT and comparison conditions (g = −0.356, p = .079; 95% confidence interval of [−0.75, 0.04]). Significant moderating variables included intervention setting, the format of therapy, participant age group, type of control utilized, and the specific CBT subtype being provided. Limitations included reliance on previously published articles, low power, and the use of one data coder. The researchers received no funding for this study, and the study was not pre-registered. Key learning aims (1) Readers will understand the need for established evidence-based interventions for individuals experiencing homelessness and the way in which treating this population differs from the general population. (2) Readers will learn about the overall therapeutic effect of cognitive behavioural therapy in its treatment of depression in individuals experiencing homelessness. (3) Readers will learn ways cognitive behavioural therapy can be adjusted to better meet the needs of the homeless population.