Abstract

BackgroundCognitive behavioural therapy (CBT) is recommended for the treatment of depression and anxiety. However, access is limited. Low-intensity approaches such as guided CBT self-help (bibliotherapy) can increase access to treatment and is recommended by UK guidelines. No previous research has explored the provision of group-based guidance/support for a bibliotherapy approach for depression and anxiety in community settings. The objective was to carry out a pilot study of a group guided self-help intervention, using community based recruitment methods.MethodA randomised controlled trial comparing an 8 week CBT group guided self-help intervention to usual care. Recruitment and the delivery of the intervention were carried out in Glasgow and Derry/Londonderry in partnership with national depression charities. Fifty-three people were randomised, however we refer only to the forty-six participants who provided baseline data: 16 males and 30 females, aged 16 or over, with a PHQ-9 score of ≥ 5, were recruited from the community. The mean age of the sample was 43.7 (sd = 13) and 93.5% of participants had suffered from low mood for a year or more.ResultsThere was effective recruitment, randomisation, uptake and adherence with 21 Immediate Access (IA) and 25 Delayed Access Control (DAC) participants. The intervention was highly acceptable to participants attending on average 4.46 of the 8 sessions (sd 3.06), 65.2% attended more than half of all sessions. The mean satisfaction on the Client Satisfaction Questionnaire was 28 out of 32 (sd 4.8). The provisional results in the pilot suggest the intervention may improve both anxiety and depression. At three months, data collection was achieved from 74% of participants. The trial successfully provided estimates of the sample size needed for the future planned trial.ConclusionsLow-intensity group-based classes may offer an alternative method of managing depression and anxiety and warrant further research.Trial registrationCurrent Controlled Trials ISRCTN84893887. Registered 3 November 2011.

Highlights

  • Cognitive behavioural therapy (CBT) is recommended for the treatment of depression and anxiety

  • Low-intensity group-based classes may offer an alternative method of managing depression and anxiety and warrant further research

  • One of the aims of the stepped care model is to reduce waiting lists for individual therapy and increase the capacity and efficiency of services [6]. This approach is utilised in the Increasing Access to Psychological Treatment (IAPT) government programme across England which was introduced due to the commitment to widening access to psychological therapies for mental health problems such as depression, anxiety and eating disorders

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Summary

Introduction

Cognitive behavioural therapy (CBT) is recommended for the treatment of depression and anxiety. Low-intensity approaches such as guided CBT self-help (bibliotherapy) can increase access to treatment and is recommended by UK guidelines. An alternative is to supplement high-intensity delivery with low intensity CBT [3] This can be successfully achieved by utilising a guided self-help approach [4,5]. One of the aims of the stepped care model is to reduce waiting lists for individual therapy and increase the capacity and efficiency of services [6] This approach is utilised in the Increasing Access to Psychological Treatment (IAPT) government programme across England which was introduced due to the commitment to widening access to psychological therapies for mental health problems such as depression, anxiety and eating disorders

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