Cognitive Behavioral Analysis System of Psychotherapy as group psychotherapy for chronically depressed inpatients: a naturalistic multicenter feasibility trial

Abstract

The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is a relatively new approach in the treatment of chronic depression (CD). Adapted as group psychotherapy for inpatients, CBASP is attracting increasing attention. In this naturalistic multicenter trial, we investigated its feasibility after 10 sessions of CBASP group therapy over a treatment time of at least 5 to a maximum of 10 weeks. Treatment outcome was additionally assessed. Across four centers, 116 inpatients with CD (DSM-IV-TR) attended CBASP group psychotherapy. Feasibility was focused on acceptance, and evaluated for patients and therapists after five (t1) and ten sessions (t2) of group psychotherapy. Observer- and self-rating scales (Hamilton Depression Rating Scale-24 items, HDRS; Beck Depression Inventory-II, BDI-II; World Health Organization Quality of Life assessment, WHOQOL-BREF) were applied before group psychotherapy (t0) and at t2. Dropouts were low (10.3%). Patients' evaluation improved significantly from t1 to t2 with a medium effect size (d = 0.60). Most of the patients stated that the group had enriched their treatment (75.3%), that the size (74.3%) and duration (72.5%) were 'optimal' and 37.3% wished for a higher frequency. Patients gave CBASP group psychotherapy an overall grade of 2 ('good'). Therapists' evaluation was positive throughout, except for size of the group. Outcome scores of HDRS, BDI-II, and WHOQOL-BREF were significantly reduced from t0 to t2 with medium to large effect sizes (d = 1.48; d = 1.11; d = 0.67). In this naturalistic open-label trial, CBASP, when applied as inpatient group psychotherapy, was well accepted by patients and therapists. The results point towards a clinically meaningful effect of inpatient treatment with CBASP group psychotherapy on depression and quality of life. Other potential factors that could have promoted symptom change were discussed. A future controlled study could investigate the safety and efficacy of CBASP group psychotherapy for inpatients.

Group Cognitive Behavioral Analysis System of Psychotherapy (CBASP): A Pilot Study for Bipolar Depression

“…Results reported by Sabass et al. ( 23 ) for inpatient group CBASP reveal a comparable large effect size ( d =1.11) at posttreatment for 24 sessions of group CBASP using the BDI-II ( 64 ) as is reported for this study sample (eta square=0.18).…”

“…The feasibility of a maximum of 10 sessions of CBASP group therapy adapted for chronically depressed unipolar inpatients was assessed in a large multicenter study by Sabass et al. ( 23 ). The concept of acceptability was measured by self-report questionnaires completed by patients and therapists separately.…”

Group Cognitive Behavioural Analysis System of Psychotherapy (CBASP) for persistently depressed outpatients: a retrospective chart review

“…Secondly, the effect of PMT that was incorporated in the CBASP program is not entirely clear, although we found that effects on depression severity continued after PMT had stopped. It is known that participants in other Group‐CBASP studies have also received other interventions, for example, therapies that are offered on the unit where patients stay while receiving Group‐CBASP (Sabaß et al ., 2018). This limits comparisons between studies and is an important issue to take into account in future Group‐CBASP investigations.…”

“…Treatment outcome studies on both types of programmes are scarce. Regarding the inpatient setting, two feasibility studies, of 70 and 116 patients, respectively, indicate that Group‐CBASP is a feasible psychotherapy with promising outcomes for persistently depressed patients (Brakemeier et al ., 2015; Sabaß et al ., 2018). In the few studies conducted on outpatients, Group‐CBASP appeared to be equally effective or even more effective than treatment‐as‐usual (Locke et al ., 2017; Michalak, Schultze, Heidenreich & Schramm, 2015; Negt et al ., 2016).…”

CBASP als stationäres Behandlungskonzept der therapieresistenten chronischen Depression: Eine Pilotstudie zum Zusammenhang von Nebenwirkungen und Therapieerfolg

“…Zudem vermag das intensive stationäre CBASP-Konzept, welches ja speziell auf die Bedürfnisse und Probleme der chronisch depressiven und zuvor als therapieresistent eingestuften Patienten ausgerichtet ist, womöglich diesen Patienten durch den störungsspezifischen maßgeschneiderten Zuschnitt der Strategien auf ihre Probleme zumindest einen ersten Schritt aus der chronischen Depression aufzeigen, sodass sich niemand in der Fremdbeurteilung verschlechterte. Ähnliche positive Ergebnisse zeigt auch eine naturalistische Multicenterstudie, welche die stationäre CBASP-Gruppentherapie untersuchte [41].…”