UK Study Finds Simpler, More Cost-Effective Treatment for Depression

Depression affects nearly 350 million people worldwide, but long waiting lines and limited access to services have impeded depression treatment. Only about a quarter of patients in the United States have received any type of psychological therapy in the last year and 1 in 10 UK citizens have been waiting over a year to receive treatment. However, new research published in The Lancet found that behavioral activation (BA), a talking therapy, is as effective as the traditional cognitive behavioral therapy (CBT) and can be delivered at far less of a cost.

CBT has long been the gold standard for psychological therapy among patients with depression, in which the treatment takes an “inside out” approach that focuses on the way the individual thinks. Under this treatment, therapists help their patients understand how he or she thinks about themselves and the world around them as well as encourages them to modify negative beliefs, said lead study author David Richards, Professor of Mental Health Services Research at the University of Exeter, UK.

On the other hand, BA therapy is a much simpler and newer therapy that takes the opposite approach, an “outside in” tactic, when treating the patient. Richards explained that BA therapy helps patients change the way they act by helping them to better link their behavior to their moods and encourages individuals to seek more positive experiences.

Richards and his research team completed one of the largest study’s regarding psychological treatment for depression and discovered that BA therapy not only produced similar outcomes to that of CBT, but could also be delivered by non-specialist staff, which leads to lower costs and greater accessibility.

The trial recruited about 440 adults with depression from primary care and psychological therapy services from 3 specific areas in England. Researchers randomly divided study participants in half, the first receiving BA therapy from junior mental health workers and the later receiving CBT by experienced psychological therapists, as CBT can only be delivered by specialist clinicians and therapists who are expensive to both train and employ.

The study found that two-thirds of both study groups reported at least a 50% decrease in depression symptoms and reported similar numbers for depression-free days and anxiety diagnoses. Researchers suggested that the outcomes found among those who underwent BA therapy were no worse than the outcomes obtained in patients receiving CBT.

"Our findings challenge the dominance of CBT as the leading evidence-based psychological therapy for depression", said Richards in a statement. "Behavioral activation should be a front-line treatment for depression in the UK and has enormous potential to improve reach and access to psychological therapy worldwide."

The researchers added that the study’s findings have substantial implications on the accessibility to psychological therapy and the greater ease with which a BA workforce could be trained in the future. While CBT has been the dominant therapy option for years, the authors wrote that this study’s findings have great potential to challenge the future of depression treatment across the globe.