Behavior Activation vs CBT: Which is Better for Depression?
Behavioral activation is as effective as and less costly than cognitive behavioral therapy (CBT) for patients with depression, according to a new study from the United Kingdom.
CBT has been shown to be effective, and, therefore, patients with depression often request it. However, this therapy is complex and is expensive for patients.
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Therefore, the researchers of this study aimed to examine whether behavioral activation, a less-intensive therapy option, could be as effective as and more affordable than CBT.
The researchers conducted their study between September 26, 2012, and April 3, 2014, by recruiting patients aged 18 and older who had received a diagnosis of major depressive disorder and were receiving treatment at primary care or psychological clinics in Devon, Durham, and Leeds in the United Kingdom.
Participants were randomly assigned to receive behavioral activation from junior mental health workers or CBT from psychological therapists (up to 20 sessions over 16 weeks). Participants then self-reported depression severity after 1 year.
A total of 221 patients were assigned to behavioral activation, and 219 received CBT. After 1 year, patients in both groups reported improved depression symptoms, with no significant differences between the groups.
In addition, behavioral activation was less costly to patients, mainly because the junior mental health workers were paid less.
“We found that [behavioral activation], a simpler psychological treatment than CBT, can be delivered by junior mental health workers with less intensive and costly training, with no lesser effect than CBT,” the researchers concluded. “Effective psychological therapy for depression can be delivered without the need for costly and highly trained professionals.”
—Amanda Balbi
Reference:
Richards DA, Ekers D, McMillan D, et al. Cost and outcome of behavioural activation versus cognitive behavioural therapy for depression (COBRA): a randomised, controlled, non-inferiority trial [published online July 22, 2016]. Lancet. http://dx.doi.org/10.1016/S0140-6736(16)31140-0.