Which is the most effective treatment of depression: counselling, CBT or usual care by the GP?
(After Ward et al, 2000) This study aimed to compare the effectiveness of non-directive counselling with cognitive behavioural therapy (CBT) or usual care for patients presenting with depression to their GP. It used broad inclusion criteria anyone aged over 18 who had a Beck Depression Inventory (Beck et al, 1961) score >13 was eligible, provided that they did not have serious suicidal intent, recent exposure to the therapies being compared or an organic brain syndrome. Of those referred to the study, 74% were included. Patients with a strong preference for one treatment were allowed to opt for that, and the majority chose CBT (81) as opposed to counselling (54) or usual care (2). The investigators changed the protocol during the study because many patients who wanted a psychological treatment, but did not have a strong view about which one they received, opted for the patient-preference arm in order to avoid usual care. A three-way randomisation was made on 197 patients and 130 were r
