The clinical effectiveness of cognitive behaviour therapy: Outcome for a large sample of adults treated in routine practice

2007 ◽  
Vol 45 (7) ◽  
pp. 1703-1704 ◽  
Author(s):  
David Westbrook ◽  
Joan Kirk
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Clinical Effectiveness ◽  
Therapy Outcome ◽  
Routine Practice ◽  
Behaviour Therapy ◽  
Large Sample ◽  
Cognitive Behaviour

FC16-04 - The clinical effectiveness of individual cognitive behaviour therapy for depressed older people in primary care and the use of a talking control (TC)

2011 ◽  
Vol 26 (S2) ◽  
pp. 1907-1907 ◽  
Author(s):  
M.A. Serfaty ◽  
H. Deborah ◽  
M. Buszewicz ◽  
M. Blanchard ◽  
S. Murad ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Cognitive Behaviour Therapy ◽  
Causal Effect ◽  
Controlled Trial ◽  
Clinical Effectiveness ◽  
Behaviour Therapy ◽  
Treatment As Usual ◽  
Cognitive Behaviour ◽  
Specific Factors

ObjectiveTo determine the clinical effectiveness of Cognitive Behaviour Therapy (CBT) delivered in primary care for older people with depression and evaluation of a talking control (TC).MethodsA single-blind, randomized, controlled trial with 4- and 10-month follow-up. 204 people, aged 65 years or more, with a Geriatric Mental State diagnosis of depression were recruited from primary care. The interventions were: treatment as usual (TAU), TAU plus TC, or TAU plus CBT. The TC and CBT were offered over 4 months. The TC was to control for common effects in therapy. The Beck Depression Inventory-II (BDI-II) was the main outcome. Subsidiary measures were the Beck Anxiety Inventory, Social Functioning Questionnaire, and Euroqol. Intention to treat analysis (ITT) and Compliance Average Causal Effect (CACE) analyses was employed. The Cognitive therapy scale (CTS) evaluated common and specific factors in therapy.ResultsA mean of 7 sessions of TC or CBT were delivered. ITT analysis found improvements of −3.07 (95% confidence interval [CI], −5.73 to −0.42) and −3.65 (95% CI, −6.18 to −1.12) in BDI-II scores in favour of CBT vs TAU and TC respectively. CACE analysis found a benefit of 0.4 points (95% CI, 0.01 to 0.72) per therapy session of CBT over TC. Ratings for CBT on the CTS were high (mean [SD], 54.2 [4.1]) and showed no difference for nonspecific, but significant differences for specific factors in therapy.ConclusionCBT is an effective treatment for depressed older people. Improvement appears to be associated with specific factors in CBT.

scholarly journals Organisational Implementation Climate in implementing internet-based Cognitive Behaviour Therapy for depression

2021 ◽  
Author(s):  
Christiaan Vis ◽  
Annet Kleiboer ◽  
Mayke Mol ◽  
Claus Duedal Pedersen ◽  
Tracy Finch ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Behaviour Therapy ◽  
Progress Monitoring ◽  
Routine Care ◽  
Routine Practice ◽  
Behaviour Therapy ◽  
Implementation Climate ◽  
Cross Sectional Survey ◽  
Cognitive Behaviour ◽  
The Impact

Abstract Background. Internet-based Cognitive Behaviour Therapy (iCBT) services for depression have been implemented in routine care in 14 European regions. This study aimed to advance understanding of the nature and value of organisational implementation climate in implementing iCBT services from the perspectives of implementers and service deliverers.Methods. A mixed method approach was applied. Based on concept mapping, a workshop with implementers was conducted to qualitatively conceptualise organisational implementation climate conducive to optimizing iCBT use in routine practice. Mental health service deliverers involved in the provision of iCBT services were invited to participate in a cross-sectional survey assessing levels of satisfaction and usability of iCBT, and of the organisational implementation climate. Associations between satisfaction, usability and implementation climate were explored.Results. 16 implementers representing 14 service delivery organisations participated in the workshop. The top-3 characteristics of a strong organisational implementation climate included: (1) clear roles and skills of implementers, (2) feasible implementation targets, and (3) a dedicated implementation team. The top-3 tools for creating a good implementation climate included: (1) job performance feedback, (2) progress monitoring in achieving implementation targets, and (3) guidelines for assessing the impact of iCBT. 111 respondents (73% female) completed the survey. Respondents were generally satisfied delivering iCBT services (MCSQ = 9.11, SD = 1.96, range = 3-15, n = 108) and found their usability slightly below average (MSUS = 63.76, SD = 15.53, range = 0-100, n = 103). They regarded their organisational implementation climate as supportive in implementing iCBT services (MICS = 43.21, SD = 5.62, range = 12-60, n = 89). Organisational implementation climate was weakly associated with usability (r = 0.25, p =.03) and moderately with satisfaction (r = .51, p £ .00).Conclusions. Organisational implementation climate as part of the wider organisational context in which implementation processes take place, is a relevant factor to implementers and service deliverers in implementing iCBT in routine care. The qualitative conceptual findings align with the quantitative approach applied in this study for measuring organisational implementation climate. Implementers can use various practical tools to shape organisational implementation climate to increase acceptance and improve implementation of iCBT in mental health care.

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