One-day cognitive behavioural therapy (CBT) self-confidence workshops should be more widely used because they are a cost-effective way of reducing depression, the Institute of Psychiatry (IoP) has said.
Researchers from King’s College London trialled the effectiveness of one-day workshops for treating people with depression across eight London boroughs and concluded that they were "clinically effective at improving depression, reducing levels of anxiety and increasing self-esteem".
Traditional group CBT involves small groups of 8-10 people meeting for 10-12 two-hour sessions and often require a GP referral.
But delivering these more convenient one-day workshops based on CBT principles provides a lower-cost alternative and can reach up to 30 people per workshop, according to study lead Dr June Brown, senior lecturer in clinical psychology at the IoP.
"Our trial shows that self-confidence workshops are clinically effective at improving depression, reducing levels of anxiety and increasing self-esteem," Brown said.
"Many people with depression are reluctant to seek help from their GP, especially those from black and minority communities. But we found that advertising our workshops, using a ‘self-confidence’ label, was an effective way of reaching out to members of the public with depression who had not previously sought help.
"How members of the public describe their psychological problems is extremely important. When we ran depression workshops, very few people came. We changed the label to self-confidence because there is a strong link between depression and low self-esteem, and many more people came forward.
"Our trial suggests that these accessible workshops – which are relatively cheap to run – can be a very effective way of engaging people with depression in treatment, and could help the under treatment of depression in the UK."
Alongside the 'label' change, in order to make them more accessible, IoP ran the workshops at the weekend in community settings such as leisure centres and libraries.
Members of the public did not have to be referred by their GPs but could self-refer in response to flyers advertising the workshops, which were titled ‘How to improve your self-confidence’. These were distributed in libraries, GP surgeries, community centres, leisure centres and pharmacies. Advertisements were also placed in local magazines.
People were invited to attend an introductory talk about the workshops, where they completed a questionnaire to screen for depression. In total, 1,042 people enquired about the workshops but after screening 459 people – all aged over 18 and who had depression – were invited to participate in the trial.
Of these, 228 participants took part in the one-day workshops, which are run by psychologists, while the remaining 231 were assigned to a waiting list and acted as a control group. All participants were followed up after 12 weeks to determine if the workshop had improved their depressive symptoms.
At the follow-up, researchers found that the depression scores of those people who completed the workshop were significantly lower than the control group, and women benefitted more than men. The workshop participants also reported lower levels of anxiety and increased self-esteem.
A quarter of the workshop participants had never consulted their GP about their depressive symptoms. Researchers also found a much higher proportion (32%) of people from black and minority ethnic (BME) groups signed up for the workshops than expected.
Participants represented 1.5 times the BME population in five boroughs, and twice the Asian population in three boroughs.
Finally, the average cost of the intervention was relatively cheap, at £161 per person.
Read the study in full at: http://bjp.rcpsych.org/content/early/2013/12/05/bjp.bp.112.121855