The Feasibility of Delivering Two Brief Psychotherapies for the Treatment of Depression in Primary Care

Abstract

Objective: The objective of this study was to evaluate the feasibility of delivering two psychotherapies for primary care patients with depression. Methods: Patients were referred for psychotherapy from primary care services and were randomly assigned to either Intensive Activation Therapy (IAT; behavioural activation therapy plus cognitive remediation) or Patient-directed Psychoeducation (PDP; a novel psychotherapy based on the diathesis-stress model). The interventions were delivered over 10–12 sessions (IAT) and five sessions (PDP). Feasibility was evaluated by recruitment numbers, patient interviews, ability to deliver an adequate dose, managing risk in a non-medical setting, training new therapists and ensuring treatment fidelity. Mood and functioning were measured at baseline and 12 weeks. Qualitative interviews were conducted at 12 weeks. Results: It was feasible to deliver both therapies to primary care patients with severe depression at baseline. Both therapies were effective, with no difference in improving mood and functioning. Conclusions: This feasibility study suggests that both IAT and PDP can be feasibly delivered in primary care and could be effective in treating severe depression. The next phase will involve training primary care clinicians to deliver the interventions within routine practice and a further study of the effectiveness of the two therapies in routine clinical care.