Community-based group guided self-help intervention for low mood and stress: randomised controlled trial

• Published in: British journal of psychiatry 2018-02, Vol.212 (2), p.88-95
• Main Authors: Williams, Christopher, McClay, Carrie-Anne, Matthews, Lynsay, McConnachie, Alex, Haig, Caroline, Walker, Andrew, Morrison, Jill
• Format: Article
• Language: English
• Subjects: Access control; Adult; Affective Symptoms - therapy; Anxiety; Behavior modification; Cognitive ability; Cognitive behavioral therapy; Cognitive Behavioral Therapy - methods; Commercialization; Community Mental Health Services - methods; Community-based programs; Delayed; Depression - therapy; Female; Health services; Humans; Intervention; Male; Mental depression; Mental health; Middle Aged; Mood; Outcome Assessment, Health Care; Patient satisfaction; Primary care; Psychiatry; Psychotherapy, Group - methods; Questionnaires; Royalty; Self Care - methods; Self help; Social anxiety; Stress; Stress, Psychological - therapy; Support groups; Systematic review; Therapy; Thresholds; Willingness to pay
• ISSN: 0007-1250; 1472-1465; 1472-1465
• DOI: 10.1192/bjp.2017.18

To date no studies have explored the effectiveness of written cognitive-behavioural therapy (CBT) resources for low mood and stress delivered via a course of self-help classes in a community setting. Aims To assess the effectiveness of an 8-week community-based CBT self-help group classes on symptoms of depression, anxiety and social function at 6 months (trial registration: ISRCTN86292664). In total, 142 participants were randomly allocated to immediate (n = 71) or delayed access to a low-intensity CBT intervention (n = 71). Measures of depression, anxiety and social function were collected at baseline and 6 months. There was a significant improvement for the primary outcome of Patient Health Questionnaire-9 (PHQ-9) score (mean between-group difference: -3.64, 95% CI -6.06 to -1.23; P = 0.004). The percentage of participants reducing their PHQ-9 score between baseline and 6 months by 50% or more was 17.9% for the delayed access group and 43.8% for the immediate access group. Secondary outcomes also improved including anxiety and social function. The intervention was cost neutral. The probabilities of a net benefit at willingness to pay thresholds of £20 000, £25 000 or £30 000 were 0.928, 0.944 and 0.955, respectively. Low-intensity class-based CBT delivered within a community setting is effective for reducing depression, anxiety and impaired social function at little additional cost. Declaration of interest C.W. is president of British Association for Behavioural & Cognitive Psychotherapies (BABCP) - the lead body for CBT in the UK. He is also author of a range of CBT-based resources available commercially. He is developer of the LLTTF classes evaluated in this study. He receives royalty, and is shareholder and director of a company that commercialises these resources.