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Effectiveness of Cognitive Behavioral Therapy in Public Mental Health: Comparison to Treatment as Usual for Treatment-Resistant Depression

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Abstract

State mental health systems have been leaders in the implementation of evidence-based approaches to care for individuals with severe mental illness. Numerous case studies of the wide-scale implementation of research-supported models such as integrated dual diagnosis treatment and assertive community treatment are documented. However, relatively few dissemination efforts have focused on cognitive behavioral therapy (CBT) for individuals with major depression despite evidence indicating its efficacy with this population. A multi-site effectiveness trial of CBT was conducted within the Texas public mental health system. Eighty-three adults with major depression received CBT from community clinicians trained through a workshop and regular consultation with a master clinician. Outcomes were compared to a matched sample of individuals receiving pharmacotherapy. Outcome measures used included the quick inventory of depressive symptomatology and beck depression inventory. Individuals receiving CBT showed greater improvements in depression symptoms than those in the comparison group. Greater pre-treatment symptom severity predicted better treatment response, while the presence of comorbid personality disorders was associated with poorer outcomes.

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Acknowledgments

Research reported in this publication was supported by a grant from the National Institute of Mental Health under award number R34MH074749. The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Institutes of Health. This work was prepared while Monica Basco was employed at the University of Texas at Arlington. The opinions expressed in this article are the author’s own and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government.

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  1. School of Social Work, The University of Texas at Austin, 1717 West 6th Street, Suite 335, Austin, TX, 78703, USA

    Molly A. Lopez

  2. Center for Scientific Review, National Institute of Health, Bethesda, MD, USA

    Monica A. Basco

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  1. Molly A. Lopez
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  2. Monica A. Basco
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Correspondence to Molly A. Lopez.

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Lopez, M.A., Basco, M.A. Effectiveness of Cognitive Behavioral Therapy in Public Mental Health: Comparison to Treatment as Usual for Treatment-Resistant Depression. Adm Policy Ment Health 42, 87–98 (2015). https://doi.org/10.1007/s10488-014-0546-4

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  • DOI: https://doi.org/10.1007/s10488-014-0546-4

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