This study is subject to some limitations that are unique to routine clinical practice. First, only patients who consented for their data to be used were included in this analysis, and if they did not provide consent at all three data points, their data were withdrawn. Second, patients not consenting for their data to be used in such study may be reflective of dissatisfaction with treatment modalities offered. Third, more confounding variables exist in routine clinical practice when compared to RCTs; for example, in routine clinical practice a wider range of patients tend to be seen with physical and psychiatric comorbidities, less commonly seen in patients in a RCT. Also, there is less control over treatment fidelity in routine clinical practice when compared to RCTs.