Al. Peterson et Ts. Halstead, GROUP COGNITIVE-BEHAVIOR THERAPY FOR DEPRESSION IN A COMMUNITY SETTING - A CLINICAL REPLICATION SERIES, Behavior therapy, 29(1), 1998, pp. 3-18
Several controlled treatment-outcome studies have demonstrated the cli
nical efficacy of group behavioral and cognitive behavioral treatments
for depression. However, there is a significant lack of evidence on m
ental health outcome evaluation studies for depression conducted in no
nresearch clinical settings. Subjects in research settings may represe
nt only about 20% of the clinical population because of stringent incl
usion criteria, requirements to accept random assignment to conditions
, etc. The present study is a clinical replication series of the effec
tiveness of group cognitive behavior therapy for depression administer
ed in a nonresearch community setting. The subjects included 138 adult
patients referred by mental health clinic providers for participation
in a six-session (12-hour) depression management group. Outcome measu
res using the Beck Depression Inventory indicated that the level of de
pression was decreased for 84% of the participants, the average reduct
ion in depression as measured by the BDI was 38%, and 43% of the patie
nts had a greater than 50% reduction in their BDI score. The results i
ndicated that group cognitive behavior therapy can be effectively appl
ied in a clinical setting with a heterogeneous patient population, alt
hough the magnitude of the treatment effect was somewhat less than fou
nd in research settings (38% reduction on the BDI as compared to 57%).
Group cognitive behavior therapy is a cost-effective treatment approa
ch and the potential for benefits significantly outweighs the cost. In
this era of managed care initiatives, group cognitive behavior therap
y for depression should be considered as a first-line treatment interv
ention for many patients with depression as part of a stepped-care tre
atment approach to provide ''the best treatment at the best value.''.