“Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority trial” was published by The Lancet on 7-22-16. The article begins by reviewing the effectiveness of both antidepressant medication and CBT treatment for depression, and notes that research generally finds the two treatments to be “equivalent.” It goes on to review the limitations of both treatment modalities: medication is often too expensive, patients often do not take it consistently, and when they stop taking it depression symptoms may return.

CBT requires a relatively high level of training and often the duration of treatment is longer than patients prefer. The article notes that Behavioral Activation (BA) therapy is a viable option with the advantages of a shorter duration of treatment and, in particular, it can be provided by paraprofessionals with relatively brief training. The authors compared the results of CBT and BA, and found BA to be “not inferior” to CBT. It also was found to be “more cost-effective than is CBT against commonly applied decision-maker willingness to pay thresholds.” The authors conclude, “our most striking finding is that BA leads to similar clinical outcomes for patients with depression, but at eye financial saving to clinical providers of 21% compared with the costs of provision of CBT, with no compensatory use of other health-care services by patients.”

mnconcierge’s take: this information is important for therapists to keep in mind when considering the emerging competition from lesser-trained therapy providers. We may want to consider developing our own BA skills in order to both provide financially competitive services and also less intensive, but potentially equally effective, services for people who are not interested in more long-term therapy.

This article comes to our attention courtesy of the prolific psychology posting service provided by Ken Pope, PhD.

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