Articlegreen2010

A pragmatic randomized controlled trial of a guided self‐help intervention versus a waiting list control in a routine primary care mental health service

20 citations0/0 files storedBritish Journal of Clinical Psychology

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Digital Mental Health Interventions Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Mental Health Treatment and Access

Abstract

OBJECTIVES. To evaluate the effectiveness of a two session guided self-help (GSH) intervention provided by primary care graduate mental health workers (PCGMHWs) in a primary care mental health service. DESIGN. Pragmatic randomized trial, with a wait list control design. METHOD. Patients presenting with significant anxiety and depression problems were given one or more self-help booklets at screening and randomly allocated to an immediate (ITG) or delayed treatment group (DTG). Following this, a two-session GSH intervention was provided by one of two PCGMHWs, with a review session to decide on the need for further intervention. The DTG began the intervention 8 weeks after the screening and the primary outcome was Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) scores after 8 weeks. RESULTS. A total of 63 patients were allocated to the ITG, 59 to the DTG. Analysis of covariance, carried out on an intention to treat basis, showed a significant treatment effect, F(1,98) = 15, p < .001, and a comparison of means at 8 weeks showed a significant difference, t(116) = 2.1 (95% CI [1.1, 5.9]), p= .042 with an effect size, d= 0.375. Taking the two groups together, CORE-OM scores for patients who completed the intervention reduced between screening and the review session by an average of 7.9 (95% CI [6.3, 9.5]), effect size of 1.2. Between screening and the review session, 47% showed a reliable and clinically significant improvement. CONCLUSIONS. The study provides some support for the effectiveness of a two-session GSH intervention and a stepped-care service model.

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References

1992A power primer.1996What Works for Whom?: A Critical Review of Psychotherapy Research 2002Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE–OM 2001A multidimensional meta-analysis of treatments for depression, panic, and generalized anxiety disorder: An empirical examination of the status of empirically supported therapies.2002A multi-dimensional meta-analysis of treatments for depression, panic, and generalized anxiety disorder: An empirical examination of the status of empirically supported therapies 2007What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression 2000The effects of psychological therapies under clinically representative conditions: A meta-analysis.1995A meta‐analysis of bibliotherapy studies

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2021Discovering Common Elements of Empirically Supported Self-Help Interventions for Depression in Primary Care: a Systematic Review 2018Niedrigintensive Interventionen zur Reduktion depressiver Symptome vor Beginn einer ambulanten Psychotherapie 2015Reduced Contact Cognitive-Behavioral Interventions for Adult Depression: A Review 2014Self‐help Treatments and Stepped Care

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