Simpler, cheaper psychological treatment as effective as cognitive behavioural therapy for treating depression

http://www.eurekalert.org/pub_releases/2016-07/tl-tls072116.php

Public Release: 22-Jul-2016
The Lancet: Simpler, cheaper psychological treatment as effective as cognitive behavioural therapy for treating depression
Behavioral activation treatment could offer cost savings of over 20 percent
The Lancet

A simple and inexpensive psychotherapy or talking therapy known as behavioural activation (BA) is as effective at treating depression in adults as the gold-standard cognitive behavioural therapy (CBT), and can be delivered by non-specialist staff with minimal training at far less cost, according to new research published in The Lancet.

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"Behavioural activation is an 'outside in' treatment that focuses on helping people with depression to change the way they act. The treatment helps people make the link between their behaviour and their mood. Therapists help people to seek out and experience more positive situations in their lives. The treatment also helps people deal with difficult situations and helps them find alternatives to unhelpful habitual behaviours," explains Professor Richards. "In contrast, CBT is an 'inside out' treatment where therapists focus on the way a person thinks. Therapists help people to identify and challenge their thoughts and beliefs about themselves, the world, and their future. CBT helps people to identify and modify negative thoughts and the beliefs that give rise to them."[1]

One year after the start of treatment, behavioural activation was found to be non-inferior (not worse than) CBT, with around two-thirds of participants in both groups reporting at least a 50% reduction in depressive symptoms (tables 2 and 3). Participants in both groups also reported similar numbers of depression free days and anxiety diagnoses, and were equally likely to experience remission. Three participants receiving behavioural activation and eight receiving CBT reported depression-related, but not treatment-related, serious adverse events (self harm and overdose).

Importantly, the average intervention costs were significantly lower for behavioural activation than CBT (£974.81 vs £1235.23 per person); amounting to a 20% financial saving for health care systems (table 4). Additionally, cost-effectiveness analysis showed that behavioural activation is highly cost-effective and affordable compared with CBT, mainly due to the low cost of non-specialist mental health providers.

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