Effectiveness and Implementation of Brief Cognitive Behavioral Therapy in CBOCs (MyBriefCBT)

VA Office of Research and Development

Status: Completed

Conditions: Depression

Treatments: Behavioral: bCBT

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT02466126

IIR 13-315

Details and patient eligibility

About

The purpose of this study is to determine the effectiveness of a brief cognitive behavioral therapy (bCBT) intervention for Veterans with depression delivered by mental health providers located at VA Community Based Outpatient Clinics (CBOC's) associated with the Houston and Oklahoma City VAMCs.

Full description

Depression is a serious health condition that places tremendous burden on patients and healthcare systems and is especially prevalent in Veterans. In 2008, the VHA released the Uniform Mental Health Services Handbook (Handbook 1160.01) in an effort to expand services for Veterans with depression, including those in primary care and CBOC settings.

The VA remains a national leader in mental health services, but the provision of psychotherapy within VA is limited, especially for rural Veterans and those cared for in CBOCs. The VA has invested significant resources to improve access to high-quality mental health care, including a rapid expansion into CBOCs. Currently, there is a need to work with clinicians and stakeholders to address practice barriers related to mental health practices in CBOCs. A recent survey of 4,200 mental health providers in VA found that, although robust expansion and improved quality of mental health care services has occurred, access to proven effective psychotherapies in CBOCs remains a focused area for improvement. The study will examine whether existing VA CBOC mental health clinicians, with training and support, can effectively administer a structured brief cognitive behavioral therapy (bCBT) intervention for Veterans with clinically elevated symptoms of depression.

Enrollment: 189 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• must have clinically significant symptoms of depression;
• must be current recipients of services at CBOCs associated with the Houston and Oklahoma City VAMCs.

Exclusion criteria

• cognitive impairment;
• presence of bipolar, psychotic or substance-abuse disorders.
• Veterans currently receiving psychotherapy WILL be excluded.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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189 participants in 2 patient groups

bCBT/Direct Referral

Experimental group

Description:

A brief cognitive behavioral therapy intervention that offers 6 active- treatment sessions, each lasting 30 to 40 minutes, and telephone booster sessions to maintain changes.

Treatment:

Behavioral: bCBT

Enhanced Usual Care (EUC)

No Intervention group

Description:

Participants are provided with educational information on depression and will be encouraged to seek additional depression care options through their primary care providers.