title: Effectiveness of cognitive behavioral therapy in public mental health: comparison to treatment as usual for treatment-resistant depression.
abstract: State mental health systems have been leaders in the implementation of evidence-based approaches to care for individuals with severe mental illness. Numerous case studies of the wide-scale implementation of research-supported models such as integrated dual diagnosis treatment and assertive community treatment are documented. However, relatively few dissemination efforts have focused on cognitive behavioral therapy (CBT) for individuals with major depression despite evidence indicating its efficacy with this population. A multi-site effectiveness trial of CBT was conducted within the Texas public mental health system. Eighty-three adults with major depression received CBT from community clinicians trained through a workshop and regular consultation with a master clinician. Outcomes were compared to a matched sample of individuals receiving pharmacotherapy. Outcome measures used included the quick inventory of depressive symptomatology and beck depression inventory. Individuals receiving CBT showed greater improvements in depression symptoms than those in the comparison group. Greater pre-treatment symptom severity predicted better treatment response, while the presence of comorbid personality disorders was associated with poorer outcomes.
authors.affiliation: School of Social Work, The University of Texas at Austin, 1717 West 6th Street, Suite 335, Austin, TX, 78703, USA, mlopez@mail.utexas.edu.
authors.forename: Molly A
authors.initials: MA
authors.lastname: Lopez
authors.forename: Monica A
authors.initials: MA
authors.lastname: Basco
mesh_terms: D000328:Adult; D000367:Age Factors; D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003156:Community Mental Health Services; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D013781:Texas
chemical_list: D000928:Antidepressive Agents