Cost utility of behavioural activation delivered by the non-specialist

Ekers, David; Godfrey, Christine; Gilbody, Simon; Parrott, Steve; Richards, David; Hammond, Danielle; Hayes, Adele M.

doi:10.1192/bjp.bp.110.090266

Cited by 52 publications

(60 citation statements)

References 18 publications

(22 reference statements)

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“…Although BA has a higher initial cost, this evened itself out at the 9-month point and then antidepressants became increasingly expensive 39. A further study suggested that the economic benefits of helping people to recover Quality Adjusted Life Years outweighed the service delivery costs 36. This study went on to demonstrate that the costs were the same as ‘treatment as usual’ but with better treatment outcomes.…”

Section: Resultsmentioning

confidence: 84%

Behavioural activation for the treatment of depression in military personnel

Whybrow

2013

J R Army Med Corps

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INTRODUCTION: Depression is a common mental health problem in both civilian and military populations. Access to evidence based psychological therapies for treating common mental health problems such as depression may not be adequate at present. Behavioural Activation (BA) represents a National Institute for Clinical Excellence recommended, evidence-based treatment for depression. The aim of this review was to review the literature to determine how BA could work as a therapeutic approach for military personnel with depression. METHOD: Five specialty-specific electronic databases were searched using the key words 'behavioural activation', 'activity scheduling' and 'depression'. Emerging themes were drawn out of the literature using a long table approach to thematic analysis. RESULTS: Seven themes were identified: Clinical Effectiveness, Cultural Competence, Co-morbidity, Cost Effectiveness, Alternatives to Face-to-Face Therapy, Training and Patient Experience. CONCLUSIONS: Group based BA is a cost effective option that may build upon service personnel's cultural affinity to teamwork and peer support. Brief training workshops and supervision could be provided to military mental health nurses to deliver group based BA. However service delivery may also be enhanced by enabling some nurses to specialise as Cognitive Behavioural Psychotherapists. More research is needed to understand whether this pragmatic, two pronged approach to training would result in the sustained dissemination of evidence based practice.

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Section: Resultsmentioning

confidence: 84%

Behavioural activation for the treatment of depression in military personnel

Whybrow

2013

J R Army Med Corps

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“…As such treatments are effective at higher levels of depression (Ekers et al, 2008), the fact that they have 'less moving parts', and as such less components to master, may suggest a high level of stability in results when disseminated. Such ideas are starting to show promise in terms of clinical and cost effectiveness (Ekers et al, 2011a(Ekers et al, , 2011b. Results need replication in larger studies across multiple sites and with more therapists to test this hypothesis further.…”

Section: Discussion Of Findingsmentioning

confidence: 96%

An overview of the effectiveness of psychological therapy for depression and stepped care service delivery models

Ekers

Webster

2012

Journal of Research in Nursing

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Depression is one of the most prevalent health disorders globally and causes significant distress and cost to the sufferer and society. Psychological therapy for depression has been recommended over a number of decades; however, access to these treatments remains limited. Cognitive behaviour therapy, behavioural activation, self-help approaches, interpersonal therapy and nondirective therapy all demonstrate moderate to large effect sizes when compared to treatment as usual. Differences between psychological interventions however are small and unstable when reviewed in meta-analyses suggesting that for most people adding complexity to treatment does not result in improved outcomes. Stepped care is one system used to organise delivery of psychological therapy that stratifies interventions across several levels of symptom severity. There is debate regarding the ideal design and operation of this complex system resulting in considerable variability in its use in clinical settings. Further research is needed to identify the most cost effective approach to the delivery of psychological therapies for depression as we need to continue to reduce the gap between demand and access to therapy.

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“…The treatment was also cost-effective. 25 Given the significant differences in durability of behavioral activation relative to antidepressant medication, recovery could be extended if behavioral activation treatment were provided as an adjunct to routine medication management in psychiatric practice.…”

Section: Contemporary Approachesmentioning

confidence: 99%

Behavioral Activation

Sudak

Majeed

Youngman

2014

Journal of Psychiatric Practice

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Behavioral activation is an empirically validated treatment for depression pioneered in 1973 by Ferster, based on B.F. Skinner's behavioral principles. After publication of Beck's work on cognitive therapy, the boundaries of behavioral and cognitive therapies were blurred and the two now overlap substantially. Behavioral activation is also used as a stand-alone treatment and can also be effective in conjunction with antidepressant medication. Case conceptualization in behavioral activation entails an assessment of the behaviors that the patient has stopped that produce pleasure or are of importance, as well as behaviors essential to self-care. Activity monitoring, which provides treatment targets and leads to the case conceptualization in behavioral activation, consists of using charts, forms, or other prompts to track the relationship between activities and other variables (e.g., mood, enjoyment). That technique is also used to target rumination, procrastination, and avoidance and may also be helpful for patients with psychosis.

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Cost utility of behavioural activation delivered by the non-specialist

Cited by 52 publications

References 18 publications

Behavioural activation for the treatment of depression in military personnel

Behavioural activation for the treatment of depression in military personnel

An overview of the effectiveness of psychological therapy for depression and stepped care service delivery models

Behavioral Activation

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