Guided Self-Help Cognitive Behavioural Therapy for Depression in Primary Care: A Randomised Controlled Trial
Open Access
- 11 January 2013
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 8 (1), e52735
- https://doi.org/10.1371/journal.pone.0052735
Abstract
Access to Cognitive behavioural therapy (CBT) for depression is limited. One solution is CBT self-help books. Trial Objectives: To assess the impact of a guided self-help CBT book (GSH-CBT) on mood, compared to treatment as usual (TAU). Hypotheses: Participants: Adults attending seven general practices in Glasgow, UK with a BDI-II score of ≥14. 141 randomised to GSH-CBT and 140 to TAU. Interventions: RCT comparing ‘Overcoming Depression: A Five Areas Approach’ book plus 3–4 short face to face support appointments totalling up to 2 hours of guided support, compared with general practitioner TAU. Primary outcome: The BDI (II) score at 4 months. Numbers analysed: 281 at baseline, 203 at 4 months (primary outcome), 117 at 12 months. Outcome: Mean BDI-II scores were lower in the GSH-CBT group at 4 months by 5.3 points (2.6 to 7.9, pAdverse effects/Harms: Significantly less deterioration in mood in GSH-CBT (2.0% compared to 9.8% in the TAU group for BDI—II category change). Weaknesses: Our follow-up rate of 72.2% at 4 months is better than predicted but is poorer at 12 months (41.6%). In the GSH-CBT arm, around 50% of people attended 2 or fewer sessions. 22% failed to take up treatment. GSH-CBT is substantially more effective than TAU. Controlled-Trials.com ISRCTN13475030This publication has 12 references indexed in Scilit:
- Clinical effectiveness of online computerised cognitive–behavioural therapy without support for depression in primary care: randomised trialThe British Journal of Psychiatry, 2009
- Mindfulness-based cognitive therapy as a treatment for chronic depression: A preliminary studyBehaviour Research and Therapy, 2009
- Can People Read Self-Help Manuals for Depression? A Challenge for the Stepped Care Model and Book Prescription SchemesBehavioural and Cognitive Psychotherapy, 2007
- What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regressionPsychological Medicine, 2007
- Self-help books for depression: how can practitioners and patients make the right choice?2005
- PHASE: a randomised, controlled trial of supervised self-help cognitive behavioural therapy in primary care.2003
- Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE–OMThe British Journal of Psychiatry, 2002
- Written and computer-based self-help treatments for depressionBritish Medical Bulletin, 2001
- Mental health literacyThe British Journal of Psychiatry, 2000
- Assessment of client/patient satisfaction: Development of a general scaleEvaluation and Program Planning, 1979