Trial platform of guided self-help for mild/moderate depression in primary care: An exploratory randomised controlled trial

Abstract

Depression of mild to moderate severity is a common problem that can cause significant distress to patients and their families. Most patients suffering from mild to moderate depression are managed in primary care settings, but many do not receive successful treatment. A technique called cognitive behavioural therapy (CBT) is often offered to these individuals, but access to this type of treatment is poor because there are few therapists available.

To improve access to effective treatment, recent guidelines suggest the adoption of simpler treatments that can be made more accessible to patients. One of these treatments is guided self−help, where patients learn simple CBT techniques from books, audiotapes or computer programmes, while receiving brief but regular support from a healthcare professional. Preliminary research suggests that guided self−help is potentially effective, but most of the evidence comes from outside the United Kingdom. It is also unclear exactly how guided self−help should be provided. Key questions are: which professional group is most suited to providing guided self help? What level and type of guidance do patients require? Which type of self−help resource should be used?

The current study intends to answer these questions, to develop a state of the art guided self−help treatment that can be fully tested in a later study. In phase I we will interview patients, doctors and other health professionals involved in treating depression in primary care in order to design and develop the guided self help intervention. In phase II, we will conduct a pilot study of this intervention, comparing the outcomes of people who receive it with those of people who receive standard care. This pilot study will provide us with several pieces of information that we need to design a larger, more definitive trial, such as the acceptability of the treatment to patients, and the number of patients who might be needed for a definitive trial.

Duration of the project

24 months

Funding body

Medical Research Council (MRC)

Members of the project

Dr Judith GellatlyResearch associate
Professor Karina LovellPrincipal investigator
Professor Peter BowerCo-investigator
RogersCo-investigator
Professor Bonnie SibbaldCo-investigator
Chris RobertsCo-investigator
Professor Linda DaviesCo-investigator
Professor David RichardsCo-investigator
Professor Michael BarkhamCo-investigator
Sue HennessyResearch associate
Dr Nagina KhanPhD student

Outputs

  • Gellatly JL, Bower PJ, Hennessy S, Richards DA, GilbodyS, Lovell K. (2007). What makes self help interventions effective in the management of depressive symptoms? Meta analysis and meta regression. Psychological Medicine, 37 (9), 1217-1228. eScholarID:1d27619