Effectiveness of cognitive behavioural therapy in primary health care: a review

Høifødt, Ragnhild Sørensen; Ström, Christine; Kolstrup, Nils; Eisemann, Martin; Waterloo, Knut

doi:10.1093/fampra/cmr017

Cited by 93 publications

(87 citation statements)

References 77 publications

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“…The results are in line with those from a meta-analyses which showed that psychotherapy (including, but not limited to CBT) is effective for depression symptoms in primary care (40,41), a meta-analyses which showed that brief psychotherapy (including, but not limited to CBT) is effective for both anxiety and depression symptoms in primary care (42), and a systematic review which showed that CBT is effective for anxiety and depression symptoms in primary care (7). What is unique about this study is that it reviewed through meta-analysis CBT's effectiveness in primary care for anxiety and depression symptoms, across delivery formats and also in specific delivery formats (e.g.…”

Section: Comparison With Existing Literaturesupporting

confidence: 86%

“…Despite its increased provision in primary care, the vast majority of research on CBT has focused on one-to-one CBT, in specialized mental health services (7). The few available evaluations of CBT's effectiveness in primary care have yielded positive results, for example, a systematic review indicating that CBT is effective for symptoms of anxiety and depression in primary care (7).…”

Section: Introductionmentioning

confidence: 99%

“…The few available evaluations of CBT's effectiveness in primary care have yielded positive results, for example, a systematic review indicating that CBT is effective for symptoms of anxiety and depression in primary care (7). What has not yet been examined (at least through metaanalysis) is the effectiveness of CBT across low-intensity and high-intensity delivery formats in primary care, for symptoms of anxiety and depression.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of Cognitive Behavioural Therapy for Anxiety and Depression in Primary Care: a Meta-analysis

Twomey

O’Reilly

Byrne

2015

European Psychiatry

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BackgroundCognitive behavioural therapy (CBT) is increasingly being delivered in primary care, in a variety of delivery formats such as guided self-help CBT, telephone-based CBT, computerized CBT and standard, one-to-one CBT. However, the vast majority of research has focused on CBT in specialized services, and no previous meta-analysis has examined CBT’s effectiveness across delivery formats in primary care.ObjectiveTo determine the effectiveness of multi-modal CBT (i.e. CBT across delivery formats) for symptoms of anxiety and depression, in primary care.MethodsA meta-analysis of CBT-focused RCTs, for symptoms of anxiety or depression, in primary care. The authors searched four databases. To be included, RCTs had to be set in primary care or have primary care participants. Results. Twenty-nine RCTs were included in three separate meta-analyses. Results showed multi-modal CBT was more effective than no primary care treatment (d =0.59), and primary care treatment-as-usual (TAU) (d = 0.48) for anxiety and depression symptoms. Moreover, multimodal CBT in addition to primary care TAU was shown to be more effective than primary care TAU for depression symptoms (no comparisons of this kind were available for anxiety) (d = 0.37).ConclusionsThe results from conducted meta-analyses indicate that multi-modal CBT is effective for anxiety and depression symptoms in primary care. Furthermore, based on CBT’s economic viability, increasing the provision of CBT in primary care seems justified. Future research should examine if varying levels of qualification among primary care CBT practitioners impacts on the effectiveness of CBT in this setting.

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Section: Comparison With Existing Literaturesupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness of Cognitive Behavioural Therapy for Anxiety and Depression in Primary Care: a Meta-analysis

Twomey

O’Reilly

Byrne

2015

European Psychiatry

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“…There is strong support for CBT in the treatment of a series of conditions, including anxiety, panic, depressive symptoms (103)(104)(105), and NCCP (106). A Cochrane review found CBT useful and moderately successful, despite the multifaceted aetiology in NCCP (107).…”

Section: Management Of Non-cardiac Chest Painmentioning

confidence: 99%

“…Therapist guided Internet-delivered CBT is similar to face-to-face treatment with regard to treatment effects (115)(116)(117)(118)(119), despite different therapist backgrounds (120)(121)(122). Guided Internet-delivered CBT has been proven to be effective in the treatment of mild to moderate symptoms of depression and anxiety (104,123), and does not differ from face-to-face treatment. However, there is a big difference between guided and unguided Internet-delivered CBT (115,124).…”

Section: Cognitive Behavioural Therapymentioning

confidence: 99%

Improving care for patients with non-cardiac chest pain : Description of psychological distress and costs, and evaluation of an Internet-delivered intervention

Mourad¹

2015

Linköping University Medical Dissertations

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Introduction: More than half of all patients seeking care for chest pain do not have a cardiac cause for this pain. Despite recurrent episodes of chest pain, many patients are discharged without a clear explanation of the cause for their pain. A lack of explanation may result in a misinterpretation of the pain as being cardiac-related, causing worry and uncertainty, which in turn leads to substantial use of healthcare resources. Psychological distress has been associated with non-cardiac chest pain (NCCP), but there is limited research regarding the relationship between different psychological factors and their association with healthcare utilization. There is a need for interventions to support patients to manage their chest pain, decrease psychological distress, and reduce healthcare utilization and costs. Aim: The overall aim of this thesis was to improve care for patients with non-cardiac chest pain by describing related psychological distress, healthcare utilization and societal costs, and by evaluating an Internet-delivered cognitive behavioural intervention. Designs and methods: This thesis presents results from four quantitative studies. Studies I and II had a longitudinal descriptive and comparative design. The studies used the same initial cohort. Patients were consecutively approached within 2 weeks from the day of discharge from a general hospital in southeast Sweden. In study I, 267 patients participated (131 with NCCP, 66 with acute myocardial infarction (AMI), and 70 with angina pectoris (AP)). Out of these, 199 patients (99 with NCCP, 51 with AMI, 49 with AP) participated in study II. Participants were predominantly male (about 60 %) with a mean age of 67 years. Data was collected on depressive symptoms (Study I), healthcare utilization (Study I, II), and societal costs (Study II). Study III had a cross-sectional explorative and descriptive design. Data was collected consecutively on depressive symptoms, cardiac anxiety and fear of body sensations in 552 patients discharged with diagnoses of NCCP (51 % women, mean age 64 years) from four hospitals in southeast Sweden. Patients were approached within one month from the day of discharge. Study IV was a pilot randomized controlled study including nine men and six women with a median age of 66 years, who were randomly assigned to an intervention (n=7) or control group (n=8). The intervention consisted of a four-session guided Internet-delivered cognitive behavioural therapy (CBT) program containing psychoeducation, exposure to physical activity, and relaxation. The control group received usual care. Data was collected on chest pain frequency, cardiac anxiety, fear of body sensations, and depressive symptoms. Results: Depressive symptoms were prevalent in 20 % (Study IV) and 25 % (Study I, III) of the patients, and more than half of the patients still experienced depressive symptoms one year later (Study I). There were no significant differences in prevalence and severity of depressive symptoms between patients diagnosed with NCCP, AMI or AP. Living a...

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Chatbot-Based Mood and Activity Journaling for Resource-Oriented CBT Support of Students

Striegl,

Fekih,

Weber

et al. 2024

Digital Human Modeling and Applications in Health, Safety, Ergonomics and Risk Management

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Effectiveness of cognitive behavioural therapy in primary health care: a review

Abstract: CBT delivered in primary care, especially including computer- or Internet-based self-help programs, is potentially more effective than usual care and could be delivered effectively by primary care therapists.

Cited by 93 publications

References 77 publications

Effectiveness of Cognitive Behavioural Therapy for Anxiety and Depression in Primary Care: a Meta-analysis

Effectiveness of Cognitive Behavioural Therapy for Anxiety and Depression in Primary Care: a Meta-analysis

Improving care for patients with non-cardiac chest pain : Description of psychological distress and costs, and evaluation of an Internet-delivered intervention

Chatbot-Based Mood and Activity Journaling for Resource-Oriented CBT Support of Students

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