Improving health and productivity of depressed workers: a pilot randomized controlled trial of telephone cognitive behavioral therapy delivery in workplace settings.
OBJECTIVE
To examine the feasibility of telephone-delivered cognitive behavioral therapy (T-CBT) in an occupational context, with reference to participant recruitment, treatment adherence, follow-up and effect.


METHODS
Eligible participants comprised all employees of a large communications company with authorized work absence due to mild/moderate mental health difficulties over a 10-month period. Fifty-three consenting participants were centrally randomized to 12 weeks T-CBT or usual care, with minimization on age, gender and illness severity. Primary (symptom severity) and secondary outcomes (self-rated work performance and productivity) were measured at baseline and 3-months via postal questionnaires. Intention-to-treat analysis comprised multiple regression modeling with adjustment for missing response predictors, minimization variables and baseline values.


RESULTS
Twenty-three employees attended one or more T-CBT sessions. T-CBT was associated with medium-large effects sizes on clinical outcomes (0.63-0.77) and work productivity scores (0.75-0.88). Twenty-one patients failed to return 3-month primary outcome data. Non-respondents were more likely to be male and more severely ill.


CONCLUSIONS
Delivery of T-CBT in an occupational context is feasible with evidence of potential effect. Larger-scale trials are warranted. These studies demand assertive outreach or telephone-based assessment strategies in order to maximize participant recruitment and follow-up.
Bee
Penny E
PE
School of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, M13 9PL, UK. penny.bee@manchester.ac.uk
Bower
Peter
P
Gilbody
Simon
S
Lovell
Karina
K
D000328:Adult; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D010865:Pilot Projects; D013689:Telephone; D006113:United Kingdom; D017132:Workplace