scholarly journals Online randomized controlled trial of brief and full cognitive behaviour therapy for depression

2006 ◽  
Vol 36 (12) ◽  
pp. 1737-1746 ◽  
Author(s):  
H. CHRISTENSEN ◽  
K. M. GRIFFITHS ◽  
A. J. MACKINNON ◽  
KYLIE BRITTLIFFE

Background. Effective internet-based programs for depression usually incorporate a component that provides telephone or email contact. Open access websites, without such contact, show high rates of attrition and poorer outcomes. The present study was designed as an exploratory investigation of the parameters that influence the effectiveness and retention of users on open access websites. We investigated whether brief cognitive behaviour therapy (CBT) was as effective as an extended version, whether add-on components of behaviour therapy or stress management contributed to positive outcomes, and whether longer programs were associated with greater attrition.Method. An online randomized controlled trial (RCT) was conducted between 13 January 2005 and 26 May 2005 (19 weeks). A total of 2794 registrants (1846 women and 948 men; median age category 35–44 years) with elevated scores on the Goldberg Depression Scale of 5·96 (S.D.=2·09) elected online to be randomized to one of six versions of a CBT website. The versions were compiled consisting of various components of brief CBT, extended CBT, behaviour strategies, stress management and problem solving.Results. A total of 20·4% of participants completed the assigned intervention. The interaction of measurement occasion and treatment version was significant [F(13,131)=2·20, p=0·01]. A single module of brief introductory CBT was not effective in reducing depression symptoms. However, extended CBT with or without the addition of behaviour strategies resulted in the reduction of depression.Conclusions. Brief CBT-based interventions are not as effective as extended interventions. However, longer programs are associated with higher rates of dropout.

2003 ◽  
Vol 31 (1) ◽  
pp. 69-83 ◽  
Author(s):  
Ronald Siddle ◽  
Freda Jones ◽  
Fairuz Awenat

Patients referred with anger problems often do not attend for treatment. The aim of this study was to determine if group Cognitive Behaviour Therapy (CBT) was feasible. Patients referred for help with their anger were assessed, given 6 sessions of group CBT and re-assessed. Of 119 patients referred, 49 (41%) did not attend the initial appointment. Patients who attended for interview were invited to participate in the group CBT. Only 11 patients (9%) of those referred for therapy attended for the full course of CBT. Thirty-four patients (29%) were exposed to at least one session of CBT, while 66 patients (56%) did not attend for any therapy. Patients who attended for some or all of the CBT treatment reported reductions in the frequency and intensity of their anger outbursts. There was also a significant reduction in measures of their anger traits. It could be concluded that group CBT is an appropriate way to deliver this therapy to patients with anger problems, but it is clear that many of those referred are ambivalent about therapy and will not attend. Figures are given that will allow the planning of a randomized controlled trial to evaluate the difference between individual and group based CBT for patients with anger problems.


2014 ◽  
Vol 43 (6) ◽  
pp. 641-654 ◽  
Author(s):  
Sarah Knott ◽  
Debbie Woodward ◽  
Antonia Hoefkens ◽  
Caroline Limbert

Background: Enhanced Cognitive Behaviour Therapy (CBT-E) (Fairburn, Cooper and Shafran, 2003) was developed as a treatment approach for eating disorders focusing on both core psychopathology and additional maintenance mechanisms. Aims: To evaluate treatment outcomes associated with CBT-E in a NHS Eating Disorders Service for adults with bulimia and atypical eating disorders and to make comparisons with a previously published randomized controlled trial (Fairburn et al., 2009) and “real world” evaluation (Byrne, Fursland, Allen and Watson, 2011). Method: Participants were referred to the eating disorder service between 2002 and 2011. They were aged between 18–65 years, registered with a General Practitioner within the catchment area, and had experienced symptoms fulfilling criteria for BN or EDNOS for a minimum of 6 months. Results: CBT-E was commenced by 272 patients, with 135 completing treatment. Overall, treatment was associated with significant improvements in eating disorder and associated psychopathology, for both treatment completers and the intention to treat sample. Conclusions: Findings support dissemination of CBT-E in this context, with significant improvements in eating disorder psychopathology. Improvements to global EDE-Q scores were higher for treatment completers and lower for the intention to treat sample, compared to previous studies (Fairburn et al., 2009; Byrne et al., 2011). Level of attrition was found at 40.8% and non-completion of treatment was associated with higher levels of anxiety. Potential explanations for these findings are discussed.


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