A community-based pilot randomised controlled study of life skills classes for individuals with low mood and depression

Abstract

BackgroundCognitive behavioural therapy (CBT) is recommended for the treatment of depression and anxiety. However, access is limited. Low-intensity approaches such as guided CBT self-help (bibliotherapy) can increase access to treatment and is recommended by UK guidelines. No previous research has explored the provision of group-based guidance/support for a bibliotherapy approach for depression and anxiety in community settings. The objective was to carry out a pilot study of a group guided self-help intervention, using community based recruitment methods.MethodA randomised controlled trial comparing an 8 week CBT group guided self-help intervention to usual care. Recruitment and the delivery of the intervention were carried out in Glasgow and Derry/Londonderry in partnership with national depression charities. Fifty-three people were randomised, however we refer only to the forty-six participants who provided baseline data: 16 males and 30 females, aged 16 or over, with a PHQ-9 score of ≥ 5, were recruited from the community. The mean age of the sample was 43.7 (sd = 13) and 93.5% of participants had suffered from low mood for a year or more.ResultsThere was effective recruitment, randomisation, uptake and adherence with 21 Immediate Access (IA) and 25 Delayed Access Control (DAC) participants. The intervention was highly acceptable to participants attending on average 4.46 of the 8 sessions (sd 3.06), 65.2% attended more than half of all sessions. The mean satisfaction on the Client Satisfaction Questionnaire was 28 out of 32 (sd 4.8). The provisional results in the pilot suggest the intervention may improve both anxiety and depression. At three months, data collection was achieved from 74% of participants. The trial successfully provided estimates of the sample size needed for the future planned trial.ConclusionsLow-intensity group-based classes may offer an alternative method of managing depression and anxiety and warrant further research.Trial registrationCurrent Controlled Trials ISRCTN84893887. Registered 3 November 2011.

Evaluation and treatment of low and anxious mood in Chinese-speaking international students studying in Scotland: study protocol of a pilot randomised controlled trial

“…There is evidence supporting the use of the CBT self-help approaches for depression and anxiety by teaching problem-solving skills, assertiveness, tackling negative thinking and increasing activity levels [11, 12, 24, 25]. By using the package, it is hoped that participants may learn new skills to help with symptoms of low mood, anxiety or depression.…”

“…The course teaches key life skills and is based on an existing CBT model with a strong educational focus. The content has been evaluated as a series of face-to-face classes [11, 12]. The free-access English language website is widely used with just under 30 million hits a year.…”

Evaluating an online support package delivered within a disability unemployment service: study protocol for a randomised controlled feasibility study

“…We have examined completion rates of equivalent modules delivered in face to face classes. In our pilot study 65% of people attended half of face to face sessions [7]. We judge an acceptable completion rate as 55% of people completing four or more of the eight course modules.…”

“…Research has provided us with empirical evidence that the proposed approach is effective in aiding a variety of problems related to low mood and stress by teaching problem-solving skills, assertiveness, tackling negative thinking and increasing activity levels [6,7]. This study looks at applying similar approaches in a back to work setting.…”

“…However, it is difficult to provide this high-intensity specialist CBT (HI CBT) due to the large volume of people with depression needing treatment. In order to increase access to CBT, low-intensity (LI) CBT in the form of bibliotherapy (online or paper based) can be successful in improving symptoms in low-risk individuals whose condition is not complex [6,7]. NICE [3] and Gellatly et al [8] recommend that including guidance/support in using bibliotherapy and cCBT significantly improves outcomes for those with depression using these approaches.…”