HealthDay News — Group, telephone, and guided self-help cognitive behavioral therapy (CBT) formats are as effective as individual CBT for adult depression, according to research published online April 17 in JAMA Psychiatry.
Pim Cuijpers, Ph.D., from Vrije Universiteit Amsterdam, and colleagues conducted a network meta-analysis on randomized clinical trials of CBT for adult depression to examine the most effective delivery format. Five treatment formats (individual, group, telephone-administered, guided self-help, and unguided self-help formats) were compared to each other and to control conditions (waiting list, care as usual, and pill placebo). Data were included for 155 trials with 15,191 participants.
The researchers observed no statistically significant difference in the effectiveness of individual, group, telephone, and guided self-help CBT. These formats were significantly more effective than the waiting-list and care-as-usual conditions (standardized mean differences, 0.87 to 1.02 and 0.47 to 0.72, respectively) as well as unguided self-help (standardized mean difference, 0.34 to 0.59). Compared with guided self-help, individual and group CBT were significantly better in terms of acceptability (dropout for any reason; relative risks, 1.44 and 1.38, respectively). Compared with being on a waiting list and care as usual, guided self-help was less acceptable (relative risks, 0.63 and 0.72, respectively).
“Applying effective and acceptable CBT in a range of different formats will make CBT easier to implement, disseminate, and deliver across different settings and diverse patient populations,” the authors write.
Two authors disclosed financial ties to the pharmaceutical industry; one author holds a pending patent.
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