GROUP COGNITIVE-BEHAVIOR THERAPY FOR DEPRESSION IN A COMMUNITY SETTING - A CLINICAL REPLICATION SERIES

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.''.