The feasibility of training general practitioners to do cognitive behavioural therapy in routine practice—A qualitative study

BackgroundFatigue is a common complaint that may lead to long-term sick leave and work disability.AimsTo assess the efficacy of cognitive–behavioural therapy by general practitioners for unexplained, persistent fatigue among employees.MethodA randomised controlled trial, using a pre-randomisation design in primary care, investigated 151 employees on sick leave with fatigue. Participants in the experimental group were offered five to seven 30 min sessions of cognitive–behavioural therapy by a general practitioner; those in the control group were offered no treatment. Main outcome measures (fatigue severity self-reported absenteeism, registered absenteeism and clinical recovery) were assessed at 4 months, 8 months and 12 months.ResultsAt baseline, 44% of the patients already met research criteria for chronic fatigue syndrome. There was no significant difference between the experimental group and the control group on primary or secondary outcomes at any point.ConclusionsCognitive–behavioural therapy by general practitioners for unexplained, persistent fatigue did not prove to be an effective intervention. Since these doctors were unable to deliver this therapy effectively under ideal circumstances, it is unlikely that doctors in routine practice would be more successful in doing so.

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Training general practitioners in cognitive behavioural therapy for panic disorder: Randomized-controlled trial

Journal of Mental Health ◽

10.1080/09638230500047877 ◽

2005 ◽

Vol 14 (1) ◽

pp. 73-82 ◽

Cited By ~ 13

Author(s):

Charles Heatley ◽

Tom Ricketts ◽

Julie Forrest

Keyword(s):

Randomized Controlled Trial ◽

Panic Disorder ◽

General Practitioners ◽

Cognitive Behavioural Therapy ◽

Controlled Trial ◽

Behavioural Therapy ◽

Randomized Controlled ◽

Cognitive Behavioural

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Faculty Opinions recommendation of Patients' perspective on cognitive behavioural therapy after surgical treatment of endometriosis: a qualitative study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.739618929.793584731 ◽

2021 ◽

Author(s):

Edgardo Rolla

Keyword(s):

Surgical Treatment ◽

Qualitative Study ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Cognitive Behavioural ◽

Patients Perspective

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Improving adherence and effectiveness of computerised cognitive behavioural therapy without support for depression: A qualitative study on patient experiences

Journal of Affective Disorders ◽

10.1016/j.jad.2010.09.012 ◽

2011 ◽

Vol 129 (1-3) ◽

pp. 117-125 ◽

Cited By ~ 94

Author(s):

S.A.H. Gerhards ◽

T.A. Abma ◽

A. Arntz ◽

L.E. de Graaf ◽

S.M.A.A. Evers ◽

...

Keyword(s):

Qualitative Study ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Patient Experiences ◽

Cognitive Behavioural

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Effectiveness of cognitive behavioural therapy augmentation in major depression treatment (ECAM study): study protocol for a randomised clinical trial

BMJ Open ◽

10.1136/bmjopen-2014-006359 ◽

2014 ◽

Vol 4 (10) ◽

pp. e006359 ◽

Cited By ~ 4

Author(s):

Atsuo Nakagawa ◽

Mitsuhiro Sado ◽

Dai Mitsuda ◽

Daisuke Fujisawa ◽

Toshiaki Kikuchi ◽

...

Keyword(s):

Major Depression ◽

Cognitive Behavioural Therapy ◽

Study Protocol ◽

Rating Scale ◽

Behavioural Therapy ◽

Depression Symptoms ◽

Routine Practice ◽

Depression Care ◽

Treatment As Usual ◽

Cognitive Behavioural

IntroductionMajor depression is a serious mental disorder that causes substantial distress and impairment in individuals and places an enormous burden on society. Although antidepressant treatment is the most common therapy provided in routine practice, there is little evidence to guide second-line therapy for patients who have failed to respond to antidepressants. The aim of this paper is to describe the study protocol for a randomised controlled trial that measures the clinical effectiveness of cognitive behavioural therapy (CBT) as an augmentation strategy to treat patients with non-psychotic major depression identified as suboptimal responders to usual depression care.Methods and analysisThe current study is a 16-week assessor-blinded randomised, parallel-groups superiority trial with 12-month follow-up at an outpatient clinic as part of usual depression care. Patients aged 20–65 years with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Major Depressive Disorder who have experienced at least one failed trial of antidepressants as part of usual depression care, will be randomly assigned to receive CBT plus treatment as usual, or treatment as usual alone. The primary outcome is the change in clinician-rated 17-item GRID-Hamilton Depression Rating Scale (GRID-HAMD) score at 16 weeks, and secondary outcomes include severity and change in scores of subjective depression symptoms, proportion of responders and remitters, safety and quality of life. The primary population will be the intention-to-treat patients.Ethics and disseminationAll protocols and the informed consent form comply with the Ethics Guideline for Clinical Research (Japanese Ministry of Health, Labour and Welfare). Ethics review committees at the Keio University School of Medicine and the Sakuragaoka Memorial Hospital approved the study protocol. The results of the study will be disseminated at several research conferences and as published articles in peer-reviewed journals. The study will be implemented and reported in line with the CONSORT statement.Trial registration numberUMIN Clinical Trials Registry: UMIN000001218.

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