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The British Journal of Psychiatry The British Journal of Psychiatry

Article contents

One-day cognitive–behavioural therapy self-confidence workshops for people with depression: randomised controlled trial

Published online by Cambridge University Press:  02 January 2018

Linda Horrell ,
Kimberley A. Goldsmith ,
André T. Tylee ,
Ulrike H. Schmidt ,
Caroline L. Murphy ,
Eva-Maria Bonin ,
Jennifer Beecham ,
Joanna Kelly ,
Shriti Raikundalia  and
June S. L Brown
Linda Horrell
Affiliation:
Psychology Department
Kimberley A. Goldsmith
Affiliation:
Biostatistics Department
André T. Tylee
Affiliation:
Health Services and Population Research
Ulrike H. Schmidt
Affiliation:
Section of Eating Disorders
Caroline L. Murphy
Affiliation:
Clinical Trials Unit, Institute of Psychiatry, King's College London
Eva-Maria Bonin
Affiliation:
Personal Social Services Research Unit, London School of Economics and Political Science
Jennifer Beecham
Affiliation:
Personal Social Services Research Unit, London School of Economics and Political Science, and University of Kent
Joanna Kelly
Affiliation:
Clinical Trials Unit
Shriti Raikundalia
Affiliation:
Psychology Department, Institute of Psychiatry, King's College London
June S. L Brown*
Affiliation:
Psychology Department, Institute of Psychiatry, King's College London, UK
*
June S. L. Brown, Psychology Department (PO77), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: june.brown@kcl.ac.uk
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Abstract

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Background

Despite its high prevalence, help-seeking for depression is low.

Aims

To assess the effectiveness and cost-effectiveness of 1-day cognitive–behavioural therapy (CBT) self-confidence workshops in reducing depression. Anxiety, self-esteem, prognostic indicators as well as access were also assessed.

Method

An open randomised controlled trial (RCT) waiting list control design with 12-week follow-up was used (trial registration: ISRCTN26634837). A total of 459 adult participants with depression (Beck Depression Inventory (BDI) scores of 14) self-referred and 382 participants (83%) were followed up.

Results

At follow-up, experimental and control participants differed significantly on the BDI, with an effect size of 0.55. Anxiety and self-esteem also differed. Of those who participated, 25% were GP non-consulters and 32% were from Black and minority ethnic groups. Women benefited more than men on depression scores. The intervention has a 90% chance of being considered cost-effective if a depression-free day is valued at £14.

Conclusions

Self-confidence workshops appear promising in terms of clinical effectiveness, cost-effectiveness and access by difficult-to-engage groups.

Type
Papers
Information
The British Journal of Psychiatry , Volume 204 , Issue 3 , March 2014 , pp. 222 - 233
Copyright
Copyright © Royal College of Psychiatrists, 2014 

Footnotes

∗

Joint first authors.

Declaration of interest

None.

References

1 World Health Organization. The Global Burden of Disease: 2004 Update. WHO, 2008.Google Scholar
2 Collins, KA, Westra, HA, Dozois, DJA, Burns, DD. Gaps in accessing treatment for anxiety and depression: challenges for the delivery of care. Clin Psychol Rev 2004; 24: 583–616.CrossRefGoogle ScholarPubMed
3 Bebbington, PE, Meltzer, H, Brugha, TSA, Farrell, M, Jenkins, R, Ceresa, C, et al. Unequal access and unmet need: neurotic disorders and the use of primary care services. Psychol Med 2000; 30: 1359–67.CrossRefGoogle ScholarPubMed
4 Riedel-Heller, SG, Matschinger, H, Angermeyer, MC. Mental disorders – who and what might help? Soc Psychiatry Psychiatr Epidemiol 2005; 40: 167–74.CrossRefGoogle ScholarPubMed
5 Layard, R. The case for psychological treatment centres. BMJ 2006; 332: 1030–2.CrossRefGoogle ScholarPubMed
6 Williams, P, Turpin, G, Hardy, G. Clinical psychology service provision and ethnic diversity within the UK: a review of the literature. Clin Psychol Psychother 2006; 13: 324–38.CrossRefGoogle Scholar
7 Clark, DM, Layard, R, Smithies, R, Richards, DA, Suckling, R, Wright, B. Improving access to psychological therapy: Initial evaluation of two UK demonstration sites. Behav Res Ther 2009; 47: 910–20.CrossRefGoogle ScholarPubMed
8 DeRubeis, RJ, Hollon, SD, Amsterdam, JD, Shelton, RC, Young, PR, Salomon, RM, et al. Cognitive therapy vs. medications in the treatment of moderate to severe depression. Arch Gen Psychiatry 2005; 62: 409–16.CrossRefGoogle ScholarPubMed
9 McDermut, W, Miller, I, Brown, R. The efficacy of group psychotherapy for depression: a meta-analysis and review of the empirical research. Clin Psychol Sci Pract 2001; 8: 98–116.CrossRefGoogle Scholar
10 National Collaborating Centre for Mental Health. Depression: The NICE Guideline on the Treatment and Management of Depression in Adults (Updated Edition) (National Clinical Practice Guideline 90). British Psychological Society and Royal College of Psychiatrists, 2009.Google Scholar
11 White, J, Keenan, M, Brooks, N. Stress control: a controlled comparative investigation of large group therapy for generalized anxiety disorder. Behav Psychother 1992; 20: 97–114.CrossRefGoogle Scholar
12 Brown, JSL, Cochrane, R, Hancox, T. Large scale stress management workshops for the general public: a controlled evaluation. Behav Cog Psychother 2000; 28: 139–51.Google Scholar
13 Watkins, E, Elliott, S, Stanhope, N, Button, J, Williams, J, Brown, JSL. Meeting the needs for psychological treatment of people with common mental disorders: an exploratory study. J Ment Health 2000; 9: 445–56.Google Scholar
14 Brown, JSL, Elliott, SA, Boardman, J, Ferns, J, Morrison, J. Meeting the unmet need for depression services with psycho-educational self-confidence workshops: preliminary report. Br J Psychiatry 2004; 185: 511–5.CrossRefGoogle ScholarPubMed
15 Brown, JSL, Elliott, SA, Boardman, J, Andiappan, M, Landau, S, Howay, E. Can the effects of a 1-day CBT psychoeducational workshop on self-confidence be maintained after 2 years? A naturalistic study. Depress Anxiety 2008; 25: 632–40.CrossRefGoogle Scholar
16 Leeser, R. English Indices of Deprivation 2010: A London Perspective. Greater London Authority, 2011.Google Scholar
17 Beck, AT, Steer, RA, Brown, GK. Manual for the Beck Depression Inventory-II. Psychological Corporation, 1996.Google Scholar
18 Fennell, M. Overcoming Low Self-Esteem: A Self-Help Guide using Cognitive Behavioural Techniques. Robinson, 1999.Google Scholar
19 Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561–71.CrossRefGoogle ScholarPubMed
20 Lave, J, Frank, R, Schulberg, H, Kamlet, M. Cost-effectiveness of treatments for major depression in primary care practice. Arch Gen Psychiatry 1998; 55: 645–51.CrossRefGoogle ScholarPubMed
21 Spitzer, RL, Kroenke, K, Williams, JBW, Lowe, B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166: 1092–7.CrossRefGoogle ScholarPubMed
22 Blascovich, J, Tomaka, J. Measures of self-esteem. In Measures of Personality and Social Psychological Attitudes (3rd edn) (eds Robinson, JP, Shaver, PR, Wrightsman, LS): 115–60. Institute for Social Research 1993.Google Scholar
23 EuroQol Group. EuroQol – a new facility for the measurement of health related quality of life. Health Policy 1990; 16: 199–208.CrossRefGoogle Scholar
24 Dolan, P. Modeling valuations for EuroQol health states. Med Care 1997; 35: 1095–108.CrossRefGoogle ScholarPubMed
25 Beecham, J, Knapp, M. Costing psychiatric interventions. In Measuring Mental Health Needs (2nd edn) (ed. Thornicroft, G): 200–24. Gaskell 2001.Google Scholar
26 Attkisson, CC, Zwick, R. The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome. Eval Prog Plan 1982; 5: 233–7.Google ScholarPubMed
27 Larsen, DL, Attkisson, CC, Hargreaves, WA, Nguyen, TD. Assessment of client/patient satisfaction: development of a general scale. Eval Prog Plan 1979; 2: 197–207.CrossRefGoogle ScholarPubMed
28 Office for National Statistics. Ethnic Groups by Broad Ethnicity, Age and Gender. ONS, 2007.Google Scholar
29 Royston, P. Multiple imputation of missing values. Stata J 2004; 4: 227–41.Google Scholar
30 Little, RJA, Rubin, DB. Statistical Analysis with Missing Data. John Wiley, 1987.Google Scholar
31 White, IR, Carpenter, J, Horton, NJ. Including all individuals is not enough: lessons for intention-to-treat-analysis. Clin Trials 2012; 9: 396–407.CrossRefGoogle Scholar
32 Curtis, L. Unit Costs of Health and Social Care 2011. Personal Social Services Research Unit, University of Kent, 2011.Google Scholar
33 Bonin, E-M, Beecham, J. Costing multi-site, group-based CBT workshops. In Unit Costs of Health & Social Care 2012 (ed. Curtis, L): 17–21. Personal Social Services Research Unit, University of Kent 2012.Google Scholar
34 Zellner, A. An efficient method of estimating seemingly unrelated regression equations and tests for aggregation bias. J Am Stat Assoc 1962; 57: 348–68.CrossRefGoogle Scholar
35 Hoch, JS, Briggs, AH, Willan, AR. Something old, something new, something borrowed, something blue: a framework for the marriage of health econometrics and cost-effectiveness analysis. Health Econ 2002; 11: 415–30.CrossRefGoogle ScholarPubMed
36 van Hout, BA, Al, MJ, Gordon, GS, Rutten, FF. Costs, effects and C/E-ratios alongside a clinical trial. Health Econ 1994; 3: 309–19.CrossRefGoogle Scholar
37 Cuijpers, P, van Straten, A, van Schaik, A, Andersson, G. Psychological treatment of depression in primary care: a meta-analysis. Br J Gen Pract 2009; 59: e51–60.CrossRefGoogle ScholarPubMed
38 Brown, JSL, Boardman, J, Whittinger, N, Ashworth, M. Can a self-referral system help improve access to psychological treatments? Br J Gen Pract 2010; 60: 365–71.CrossRefGoogle ScholarPubMed
39 Cornford, CS, Hill, A, Reilly, J. How patients with depressive symptoms view their condition: a qualitative study. Fam Pract 2007; 24: 358–64.CrossRefGoogle ScholarPubMed
40 Knapp, M, Mangalore, R. “The trouble with QALYs …”. Epidemiol Psichiatr Soc 2007; 16: 289–93.CrossRefGoogle Scholar
41 Cuijpers, P, Muñoz, RF, Clarke, GN, Lewinsohn, PM. Psychoeducational treatment and prevention of depression: the “coping with depression” course thirty years later. Clin Psychol Rev 2009; 29: 449–58.CrossRefGoogle Scholar
42 Spek, V, Cuijpers, P, Nyklicek, I, Riper, H, Keyzer, J, Pop, V. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychol Med 2007; 37: 319–28.CrossRefGoogle ScholarPubMed
43 Katon, W, Guico-Pabia, JG. Improving quality of depression care using organized systems of care: a review of the literature. Pr Care Companion CNS Disord 2011; 13: e1–8.Google ScholarPubMed
44 Cuijpers, P, Donker, T, Johansson, R, Mohr, DC, van Straten, A, Andersson, G. Self-guided psychological treatment for depressive symptoms: a meta-analysis. PloS One 2011; 6: e21274.CrossRefGoogle ScholarPubMed
45 Gellatly, J, Bower, P, Hennessy, S, Richards, D, Gilbody, S, Lovell, K. What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychol Med 2007; 37: 1217–28.CrossRefGoogle ScholarPubMed
46 McCrone, P, Knapp, M, Proudfoot, J, Ryden, C, Cavanagh, K, Shapiro, DA, et al. Cost-effectiveness of computerised cognitive–behavioural therapy for anxiety and depression in primary care: randomised controlled trial. Br J Psychiatry 2004; 185: 55–62.CrossRefGoogle ScholarPubMed
47 Holman, AJ, Serfaty, MA, Leurent, BE, King, MB. Cost-effectiveness of cognitive behaviour therapy versus talking and usual care for depressed older people in primary care. BMC Health Serv Res 2011; 11: 33.CrossRefGoogle ScholarPubMed
48 van Steenbergen-Weijenburg, KM, van, der Feltz-Cornelis CM, Horn, EK, van Marwijk, HW, Beekman, AT, Rutten, FF, et al. Cost-effectiveness of collaborative care for the treatment of major depressive disorder in primary care. A systematic review. BMC Health Serv Res 2010; 10: 19.CrossRefGoogle ScholarPubMed
49 Moeller-Leimkuehler, AM. Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. J Affect Disord 2002; 71: 1–9.CrossRefGoogle Scholar
50 Angst, J, Gamma, A, Gastpar, M, Lepine, J-P, Mendlewicz, J, Tylee, A. Gender differences in depression: Epidemiological findings from the European DEPRES I and II studies. Eur Arch Psychiatry Clin Neurosci 2002; 252: 201–9.CrossRefGoogle ScholarPubMed
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