One-day cognitive-behavioural therapy self-confidence workshops for people with depression (Await additional studies; true depression is far more than lack of self-confidence)

Br J Psychiatry. 2013 Dec 19. [Epub ahead of print]

One-day cognitive-behavioural therapy self-confidence workshops for people with depression: randomised controlled trial.

Horrell L, Goldsmith KA, Tylee AT, Schmidt UH, Murphy CL, Bonin EM, Beecham J, Kelly J, Raikundalia S, Brown JS; the CLASSIC trial group.

Author information

• Linda Horrell, DipPsych, Psychology Department, Kimberley A. Goldsmith, MPH, Biostatistics Department, André T. Tylee, MD, Health Services and Population Research, Ulrike H. Schmidt, PhD, Section of Eating Disorders, Caroline L. Murphy, MSc, Clinical Trials Unit, Institute of Psychiatry, King's College London; Eva-Maria Bonin, MA, Personal Social Services Research Unit, London School of Economics and Political Science; Jennifer Beecham, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, and University of Kent; Joanna Kelly, MSc, Clinical Trials Unit, Shriti Raikundalia, MSc, Psychology Department, Institute of Psychiatry, King's College London; June S. L. Brown, PhD, Psychology Department, Institute of Psychiatry, King's College London, UK.

Abstract

BACKGROUND:

Despite its high prevalence, help-seeking for depression is low.

AIMS:

To assess the effectiveness and cost-effectiveness of 1-day cognitive-behavioural therapy (CBT) self-confidence workshops in reducing depression. Anxiety, self-esteem, prognostic indicators as well as access were also assessed.

METHOD:

An open randomised controlled trial (RCT) waiting list control design with 12-week follow-up was used (trial registration: ISRCTN26634837). A total of 459 adult participants with depression (Beck Depression Inventory (BDI) scores of ≥14) self-referred and 382 participants (83%) were followed up.

RESULTS:

At follow-up, experimental and control participants differed significantly on the BDI, with an effect size of 0.55. Anxiety and self-esteem also differed. Of those who participated, 25% were GP non-consulters and 32% were from Black and minority ethnic groups. Women benefited more than men on depression scores. The intervention has a 90% chance of being considered cost-effective if a depression-free day is valued at £14.

CONCLUSIONS:

Self-confidence workshops appear promising in terms of clinical effectiveness, cost-effectiveness and access by difficult-to-engage groups.