scholarly journals Is bouldering-psychotherapy a cost-effective way to treat depression when compared to group cognitive behavioral therapy – results from a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Larissa Schwarzkopf ◽  
Lisa Dorscht ◽  
Ludwig Kraus ◽  
Katharina Luttenberger
Keyword(s):  
Cost Effectiveness ◽  
Cognitive Behavioral Therapy ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Productivity Loss ◽  
Cost Effective ◽  
Routine Care ◽  
Cognitive Behavioral ◽  
Distributed Model ◽  
Depression Symptoms

Abstract Background Bouldering-Psychotherapy (BPT) has proven to effectively reduce depressive symptoms, but evidence on its cost-effectiveness is lacking. Corresponding information is paramount to support health policy decision making on a potential implementation of BPT in routine care. Methods Using data from the German KuS trial BPT was compared with group Cognitive Behavioral Therapy (CBT). Severity of depression symptoms at end of the intervention was operationalized via Montgomery-Asberg Depression Rating Scale (MADRS) and Patient Health Questionnaire (PHQ-9). Adopting a societal perspective, direct medical costs and productivity loss were calculated based on standardized unit costs. To determine incremental cost-effectiveness ratios (ICER) and cost-effectiveness-acceptance curves (CEAC), adjusted mean differences (AMD) in costs (gamma-distributed model) and both effect parameters (Gaussian-distributed model) were obtained from 1000 simultaneous bootstrap replications. Results BPT was related to improved effects (AMDs: MADRS -2.58; PHQ-9: − 1.35) at higher costs (AMD: +€ 754). No AMD was significant. ICERs amounted to €288 per MADRS-point and €550 per PHQ-9-point. For both effect parameters about 20% of bootstrap replications indicated dominance of BPT, and about 75% larger effects at higher costs. At hypothetical willingness to pay (WTP) thresholds of €241 (MADRS) and €615 (PHQ-9) per unit of change BPT had a 50% probability of being cost-effective. Conclusion BPT is a promising alternate treatment strategy which – in absence of established WTP thresholds for improving symptoms of depression – cannot unambiguously be claimed cost-effective. Further studies defining subgroups that particularly benefit from BPT appear paramount to delineate recommendations for an efficient prospective roll-out to routine care.

Cost-effectiveness of digital cognitive behavioral therapy (Sleepio) for insomnia: a Markov simulation model in the United States

SLEEP ◽  
2020 ◽  
Author(s):  
Michael Darden ◽  
Colin A Espie ◽  
Jenna R Carl ◽  
Alasdair L Henry ◽  
Jennifer C Kanady ◽  
...  
Keyword(s):  
United States ◽  
Cost Effectiveness ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cost Effective ◽  
The United States ◽  
Cognitive Behavioral ◽  
Life Years ◽  
Insomnia Treatment ◽  
Group Cbt

Abstract Study Objectives To examine the cost-effectiveness and potential net monetary benefit (NMB) of a fully automated digital cognitive behavioral therapy (CBT) intervention for insomnia compared with no insomnia treatment in the United States (US). Similar relative comparisons were made for pharmacotherapy and clinician-delivered CBT (individual and group). Methods We simulated a Markov model of 100,000 individuals using parameters calibrated from the literature including direct (treatment) and indirect costs (e.g. insomnia-related healthcare expenditure and lost workplace productivity). Health utility estimates were converted into quality-adjusted life years (QALYs) and one QALY was worth $50,000. Simulated individuals were randomized equally to one of five arms (digital CBT, pharmacotherapy, individual CBT, group CBT, or no insomnia treatment). Sensitivity was assessed by bootstrapping the calibrated parameters. Cost estimates were expressed in 2019 US dollars. Results Digital CBT was cost beneficial when compared with no insomnia treatment and had a positive NMB of $681.06 (per individual over 6 months). Bootstrap sensitivity analysis demonstrated that the NMB was positive in 94.7% of simulations. Relative to other insomnia treatments, digital CBT was the most cost-effective treatment because it generated the smallest incremental cost-effectiveness ratio (−$3,124.73). Conclusions Digital CBT was the most cost-effective insomnia treatment followed by group CBT, pharmacotherapy, and individual CBT. It is financially prudent and beneficial from a societal perspective to utilize automated digital CBT to treat insomnia at a population scale.

scholarly journals Cost-effectiveness of guided internet-based cognitive behavioral therapy compared with usual care for depression: results from an implementation project (Preprint)

2021 ◽  
Author(s):  
Jordi Piera-Jiménez ◽  
Anne Etzelmueller ◽  
Spyros Kolovos ◽  
Frans Folkvord ◽  
Francisco Lupiáñez-Villanueva
Keyword(s):  
Cost Effectiveness ◽  
Cognitive Behavioral Therapy ◽  
Usual Care ◽  
Transition Probabilities ◽  
Behavioral Therapy ◽  
Scale Up ◽  
Cost Effective ◽  
Cognitive Behavioral ◽  
Sensitivity Analyses ◽  
The Cost

BACKGROUND Major depressive disorder (MDD) is a chronic condition whereby the prevalence is expected to grow with the aging trend of high-income countries. Internet-based cognitive-behavioral therapy (iCBT) has proven efficacy in treating MDD. OBJECTIVE The objective of this study was to assess the cost-effectiveness of implementing a community-based iCBT intervention (Super@, the Spanish program for the MasterMind project) for treating MDD. METHODS The cost-effectiveness of the Super@ program was assessed with the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing (MAFEIP) tool, using a 3-state Markov model. Data from the cost and effectiveness of the intervention were prospectively collected from the implementation of the program by a healthcare provider in Badalona (Spain); the corresponding data for usual care were gathered from the literature. The health states, transition probabilities, and utilities were computed using the scores of the patient health questionnaire 9 (PHQ-9). RESULTS The analysis was performed using data from 229 participants using the Super@ program. Results showed that the intervention was more costly than usual care; the 3%-discounted and non-discounted incremental cost-effectiveness ratios (ICERs) were € 29,367 and € 26,484 per quality-adjusted life-year (QALY), respectively. The intervention was cost-effective based on the 30K willingness-to-pay (WTP) threshold typically applied in Spain. According to the deterministic sensitivity analyses, the potential reduction of costs associated with intervention scale-up would reduce the ICER of the intervention, although it remained more costly than usual care. A discount in the incremental effects up to 5% exceeded the WTP threshold of 30K. CONCLUSIONS The Super@ program, an iCBT intervention for treating MDD, was more costly than TAU. Still, its implementation in Spain would be cost-effective from the healthcare and societal perspective at a WTP threshold of 30K compared with TAU. CLINICALTRIAL Not applicable

Brief cognitive-behavioral therapy with fibromyalgia patients in routine care

2009 ◽  
Vol 50 (6) ◽  
pp. 517-525 ◽  
Author(s):  
Susana Vázquez-Rivera ◽  
César González-Blanch ◽  
Laura Rodríguez-Moya ◽  
Dolores Morón ◽  
Sara González-Vives ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Routine Care ◽  
Cognitive Behavioral

Cost‐effectiveness of telephone cognitive behavioral therapy for osteoarthritis‐related insomnia

2021 ◽  
Author(s):  
Kai Yeung ◽  
Weiwei Zhu ◽  
Susan M. McCurry ◽  
Michael Von Korff ◽  
Robert Wellman ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral

scholarly journals Emotion-Abstraction Patterns and Cognitive Interventions in a Single Case of Standard Cognitive-Behavioral Therapy

2015 ◽  
Vol 17 (2) ◽  
Author(s):  
Sandra Sassaroli ◽  
Romina Brambilla ◽  
Eva Cislaghi ◽  
Roberta Colombo ◽  
Eva Cislaghi ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Therapeutic Process ◽  
Therapeutic Change ◽  
Cognitive Behavioral ◽  
Therapeutic Interventions ◽  
Abstract Thinking ◽  
Cognitive Content ◽  
Cognitive Interventions

Cognitive-behavioral therapy (CBT) assumes that therapeutic change de-pends mainly on change of cognitive content, while, from a theoretical viewpoint, other processes are excluded. This study aims to explore standard CBT interventions using a model of therapeutic change that includes both emotional and cognitive processes, i.e., the therapeutic cycle model (TCM; Mergenthaler, 1985; 1996), which describes the pro-cesses of therapeutic change in terms of cycles involving both emotional arousal and ab-stract thinking activation. We classified standard CBT interventions in three main are-as: assessing, disputing, and reframing biased beliefs. In 10 individual cognitive therapy sessions with a 30-year-old patient affected by a panic disorder with agoraphobia (PDA), this study aimed to explore whether cognitive interventions are not only related to abstract thinking but also to the emotional activation phases of TCM. Three inde-pendent judges assessed the presence of cognitive therapeutic interventions using the Comprehensive Psychotherapeutic Interventions Rating Scale (CPIRS; Trijsburg et al., 2002). A software program measured the TCM cognitive and emotional variables. The measures revealed significant correlations between cognitive therapeutic interventions and phases of abstract thinking activation during the therapeutic process. The results clarified the role of cognitive interventions in the therapeutic process as a useful instru-ment aimed to increase reality testing.

Suitability for Short-Term Cognitive-Behavioral Therapy

2007 ◽  
Vol 21 (4) ◽  
pp. 334-345 ◽  
Author(s):  
Gail Myhr ◽  
Jeanne Talbot ◽  
Lawrence Annable ◽  
Gilbert Pinard
Keyword(s):  
Anxiety Disorder ◽  
Cognitive Behavioral Therapy ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Linear Regression Analysis ◽  
Cognitive Behavioral ◽  
Reliable Change Index ◽  
Short Term ◽  
Variable Model ◽  
Wide Range

The Suitability for Short-Term Cognitive Therapy Rating Scale (SRS) defines 10 criteria to assess suitability for short-term cognitive-behavioral therapy (CBT). This study examines the relationships between pretreatment SRS scores and outcome of 113 patients treated with short-term CBT for a wide range of disorders. Using the reliable change index (RCI) as a measure of outcome, 65 individuals (57.5%) of the sample experienced statistically reliable improvement. Married status, employed status, female gender, and anxiety disorder as a primary diagnosis were positively correlated with posttreatment RCI. Awareness of emotion and security operations were the SRS items most strongly correlated with outcome. Also correlated were the two alliance potential items (in-session and out-of-session evidence) and the acceptance of personal responsibility for change. Hierarchical multiple linear regression analysis resulted in a three-variable model where married status, primary anxiety disorder, and mean SRS score accounted for 20% of the variance in RCI scores. We conclude that the SRS adds predictive value to the assessment of potential to succeed in CBT.

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