TY  - JOUR
PY  - 2023//
TI  - Brief cognitive-behavioral therapy for depression in community clinics: a hybrid effectiveness-implementation trial
JO  - Psychiatric services
A1  - Cully, Jeffrey A.
A1  - Hundt, Natalie E.
A1  - Fletcher, Terri
A1  - Sansgiry, Shubhada
A1  - Zeno, Darrell
A1  - Kauth, Michael R.
A1  - Kunik, Mark E.
A1  - Sorocco, Kristen
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: The authors examined whether brief cognitive-behavioral therapy (bCBT) for depression, delivered by mental health providers in community-based outpatient clinics (CBOCs) of the Veterans Health Administration, improved depression outcomes and was feasible and acceptable in clinical settings. <br><br>METHODS: The authors used a type-2 hybrid effectiveness-implementation, patient-randomized trial to compare bCBT with enhanced usual care. Participants (N=189) with moderate symptoms of depression (Patient Health Questionnaire-9 [PHQ-9] score ≥10) were enrolled from CBOCs in the southern United States. bCBT (N=109) consisted of three to six sessions, delivered by mental health providers (N=17) as part of routine clinic practices. Providers received comprehensive training and support to facilitate bCBT delivery. Recipients of enhanced usual care (N=80) were given educational materials and encouraged to discuss treatment options with their primary care provider. The primary effectiveness outcome was PHQ-9-assessed depression symptoms posttreatment (4 months after baseline) and at 8- and 12-month follow-ups. Implementation outcomes focused on bCBT dose received, provider fidelity, and satisfaction with bCBT training and support. <br><br>RESULTS: bCBT improved depression symptoms (Cohen's d=0.55, p<0.01) relative to enhanced usual care posttreatment, and the improvement was maintained at 8- and 12-month follow-ups (p=0.04). bCBT participants received a mean±SD of 3.7±2.7 sessions (range 0-9), and 64% completed treatment (≥3 sessions). Providers delivered bCBT with fidelity and reported that bCBT training and support were feasible and effective. <br><br>CONCLUSIONS: bCBT had a modest treatment footprint of approximately four sessions, was acceptable to participants and providers, was feasible for delivery in community-based outpatient clinics, and produced meaningful sustained improvements in depression.<p />  <p>Language: en</p>
LA  - en
SN  - 1075-2730
UR  - http://dx.doi.org/10.1176/appi.ps.20220582
ID  - ref1
ER  -