Transdiagnostic CBT for depression and anxiety
This study aims to evaluate the feasibility, acceptability and efficacy of transdiagnostic Cognitive Behavioural Therapy (tCBT) in comparison to 7-week delayed treatment for comorbid depression and anxiety in older people.
Why carry out the research?
Cognitive Behavioural Therapy (CBT) is a form of ‘talking therapy’ that has been recommended by the National Institute for Health and Clinical Excellence for the treatment of mood disorders. While traditional disorder-specific CBT has been found to be effective at alleviating individual mood disorders (e.g. depression or anxiety), it may be less effective when multiple mood disorders are present (i.e. when there is psychological comorbidity). Transdiagnostic CBT (tCBT) is a form of CBT that targets cognitive and behavioural processes common to a range of mood disorders. Consequently, it may be better placed to address psychological comorbidity than disorder-specific CBT, both in terms of clinical- and cost-effectiveness. There is growing evidence that tCBT has beneficial effects on both depression and anxiety in working age people. However, the potential benefits of this approach have not yet been examined in older people, in whom psychological comorbidity is a frequent problem.
The aims of the pilot randomised controlled trial are to:
1) Examine whether it is feasible to establish a tCBT intervention for older people with comorbid depression and anxiety;
2) Assess the acceptability of tCBT for comorbid depression and anxiety in older people;
3) Determine preliminary estimates of the efficacy of tCBT for reducing symptoms of depression and anxiety in older people.
How is the research being undertaken?
The study aims to recruit 22 older people who are experiencing comorbid depression and anxiety from community mental health teams (CMHTs) within the Mental Health of Older Adults Clinical Academic Group (MHOA&D CAG) in South London and Maudsley NHS Foundation Trust (SLaM). Participants are being randomly allocated to receive tCBT plus treatment-as-usual (TAU) or 7-week delayed tCBT plus TAU. tCBT is being delivered on an individual basis in 12 sessions, each lasting 1 hour, over 14 weeks. A number of outcome measures are being used to evaluate the feasibility, acceptability and efficacy of tCBT, including ratings on mood questionnaires, attrition rates and reasons for attrition. Outcome measures are being collected before the intervention starts, halfway through the intervention, at the end of the intervention, and at 7-week follow-up.
Where is it happening?
Participants are being recruited from CMHTs within the MHOA&D CAG in SLaM. Participants are either seen in their own homes or within outpatient clinics.
Who is involved?
What is the timescale?
Clinicians based at the Institute of Psychiatry and in the MHOA&D CAG within SLaM, including:
Dr Rebecca Gould (clinical psychologist), Ms Siobhan Marnoch (trainee clinical psychologist), Ms Debbie Walker (consultant psychotherapist), Dr Patrick McGuinness (consultant clinical psychologist) and Professor Robert Howard (Professor of Old Age Psychiatry and Psychopathology).
Recruitment is currently underway. The project is due to finish in autumn 2014.
To find out more please contact:-
Dr Rebecca Gould