Counselling vs Low Intensity CBT

Project: Counselling versus low-intensity cognitive behavioural therapy for persistent sub-threshold and mild depression (CLICD): a pilot/feasibility randomised controlled trial.

Target group: Thirty females and six males took part in the study (19 PCC and 17 Li-CBT participants). The average age of the sample was 44 years old.

Settings: Participants were identified and screened for eligibility at five general practices in Glasgow (UK).

Intervention: Those randomly allocated to the Person Centred Counselling (PCC) group were offered eight weekly, 50 min, sessions of person-centred counselling delivered by qualified counsellors. Participants randomised to Li-CBT received the Living Life to the Full course (a range of written CBT self-help booklets and worksheets supported by an optional linked online support course). These participants received telephone support over a series of up to eight support sessions lasting 20–40 min.

Outcomes: Recruitment rate in relation to the number of patients approached at the general practices was 1.8 %. Patients attended an average of 5.5 sessions in both interventions. Retention rate for the 6-month follow-up assessments was 72.2 %.

Of participants assessed at six months, 71.4 % of participants with a diagnosis of mild depression at baseline had recovered, while 66.7 % with a diagnosis of persistent subthreshold depression at baseline had not developed major depression. There were no significant differences between treatment groups for both recovery and prevention of depression at six months or on any of the outcome measures.

What else? Participants’ overall satisfaction with the treatment received as measured by the Client Satisfaction Questionnaire-8 was high (Mean score 25.8, S 6.7, N = 22), (range of the instrument: 8–32). The mean CSQ-8 score for participants in the Li-CBT arm was 27.8 (SD 6.4, N = 13) and for participants in the PCC arm was 22.9 (SD 6.4, N = 9), p = 0.093.

The evidence from this study suggests that short-term Person-Centred Counselling and Low-Intensity Cognitive Behaviour Therapy are potentially effective and their effectiveness should be evaluated in a larger randomised controlled study which includes a health economic evaluation.

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