Ultra-brief psychological treatment for adults with depression or anxiety symptoms: a systematic review and meta-analysis

Depression and anxiety are common but most adults experiencing these symptoms do not receive psychological treatment. Ultra-brief psychological treatments are a time-limited and potentially lower cost option for those who would otherwise not receive treatment. This prospectively registered review examined the acceptability and efficacy of ultra-brief psychological treatments for adults with depression or anxiety symptoms. A systematic search was undertaken up to April 2025. All clinical trials examining an ultra-brief psychological treatment for adults with depression or anxiety symptoms were included. This review returned 16,670 results and included 34 studies (N = 3,679). High rates of uptake (91% [95% CI 86, 94]) and completion (96% [95% CI 90, 98]) were reported. Compared to control, treatment resulted in small to moderate reductions in depression g = 0.35 (k = 20, 95% CI 0.13, 0.56) and moderate reductions in anxiety g = 0.51 (k = 14, 95% CI 0.40, 0.61) at post-treatment. Within-group effects appear to be maintained at follow-up. Overall heterogeneity was high; several moderators of between-group and within-group effects were identified. Control groups and follow-up periods varied greatly. Ultra-brief treatments appear to be acceptable and associated with significant symptom improvements. Larger clinical trials with longer follow-up periods are needed.