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Improving cost-effectiveness and access to cognitive behavior therapy for depression: providing remote-ready, computer-assisted psychotherapy in times of crisis and beyond

Improving cost-effectiveness and access to cognitive behavior therapy for depression: providing remote-ready, computer-assisted psychotherapy in times of crisis and beyond

Thase, Michael E, McCrone, Paul ORCID: 0000-0001-7001-4502, Barrett, Marna S, Eells, Tracy D, Wisniewski, Stephen R, Balasubramani, G K, Brown, Gregory K and Wright, Jesse H (2020) Improving cost-effectiveness and access to cognitive behavior therapy for depression: providing remote-ready, computer-assisted psychotherapy in times of crisis and beyond. Psychotherapy and Psychosomatics. ISSN 0033-3190 (Print), 1423-0348 (Online) (In Press) (doi:https://doi.org/10.1159/000508143)

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Abstract

Introduction. There is growing evidence that computer-delivered or –assisted forms of cognitive-behavior therapy (CCBT) are helpful, but cost-effectiveness versus standard therapies is not well established.

Objective. To evaluate the cost-effectiveness of a therapist-supported method for CCBT in comparison to standard CBT.

Method. 154 drug-free MDD outpatients were randomly assigned to either 16 weeks of standard CBT (up to twenty 50-minute sessions) or CCBT using the Good Days Ahead program (including up to 5.5 hours of therapist contact). Outcomes were assessed at baseline, weeks 8 and 16, and at 3 and 6 months post-treatment. Economic analyses took into account the costs of services received and work/social role impairment.

Results. In the context of almost identical efficacy, a form of CCBT that used only about onethird the amount of therapist contact as conventional CBT was highly cost-effective compared to conventional therapy and reduced cost of treatment by $928 per patient.

Conclusions. A method of CCBT that blended internet-delivered modules and abbreviated therapeutic contact reduced the cost of treatment substantially without adversely affecting outcomes. Results suggest that use of this approach can more than double the access to CBT. Because clinician support in CCBT can be provided by telephone, videoconference, and/or email, this highly efficient form of treatment could be a major advance in remote treatment delivery.

Item Type: Article
Uncontrolled Keywords: cost-effectiveness, depression, cognitive behaviour therapy
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Faculty / Department / Research Group: Faculty of Education, Health & Human Sciences
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Mental Health
Last Modified: 29 May 2020 12:27
Selected for GREAT 2016: None
Selected for GREAT 2017: None
Selected for GREAT 2018: None
Selected for GREAT 2019: None
Selected for REF2021: REF 4
URI: http://gala.gre.ac.uk/id/eprint/27973

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