Is behavioural activation effective in treating severe depression when cognitive therapy is not?

This chapter provides a summary of a landmark study on major depressive disorder. Is paroxetine or cognitive therapy more effective in treating patients with moderate to severe major depressive disorder? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

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An Initial Evaluation of the Clinical and Fitness for Work Outcomes of a Military Group Behavioural Activation Programme

Behavioural and Cognitive Psychotherapy ◽

10.1017/s135246581300043x ◽

2013 ◽

Vol 42 (2) ◽

pp. 243-247 ◽

Cited By ~ 4

Author(s):

Matthew Wesson ◽

Dean Whybrow ◽

Matthew Gould ◽

Neil Greenberg

Keyword(s):

Military Personnel ◽

Psychological Treatment ◽

Severe Depression ◽

Service Evaluation ◽

Self Report ◽

Work Outcomes ◽

Primary Role ◽

Behavioural Activation ◽

Group Setting ◽

Patient Health

Background: Behavioural Activation (BA) is an evidence-based psychological treatment for depression based on behavioural theory. However, in common with other talking therapies, there is limited evidence about occupational factors related to treatment. This is an important gap in the research given the emphasis placed on employment considerations in recent service initiatives. Aim: A service evaluation to investigate the clinical and fitness to work outcomes of a group BA programme for serving military personnel. Method: 46 patients experiencing moderate to severe depression attended a 12-session Military Behavioural Activation and Rehabilitation Course (MBARC). The primary outcomes were the Patient Health Questionnaire-9 (PHQ-9), a self-report measure of depression and the patient's medical employability category. Results: Clinical and statistically significant changes were found on the PHQ-9 between pre-course and 3-month follow-up. Pretreatment 3 patients (6.5%) were psychologically fit to deploy on full operational duties in their primary role; this increased to 25 (56.8%) and 29 (65.9%) at 3 and 6-months respectively. Conclusion: Preliminary findings suggest that MBARC is a clinically and occupationally effective treatment for depression in military personnel. Further research is required to identify if BA delivered in a group setting would be effective in non-military settings and whether treatment benefits are maintained in the longer term.

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