• A feasibility study of a novel work-focused relational group CBT treatment programme for moderate to severe recurrent depression

      Walker, Nicola; Vernon-Smith, Madeleine; Townend, Michael; Teesside University; Leeds and York Partnership NHS Foundation Trust; University of Derby (Emerald, 2021-09-02)
      No current psychotherapeutic intervention is designed to enhance job retention in employees with moderate-severe recurrent depression. We hypothesized that interdisciplinary, work-focused psychotherapy would have the triple benefits of alleviating depression, improving interpersonal difficulties, and enhancing job retention. To test the feasibility of a new Work-focused Relational Group-CBT Treatment Programme for moderate-severe depression. The new programme was based on a theoretical integration of occupational stress, psychological, social/interpersonal, and bio-medical theories and consisted of (i) 1:1 psychotherapist sessions; (ii) a work-focused, twelve-week group CBT programme; and (iii) optional 1:1 sessions with an occupational therapist. Depression, coping/self-efficacy, health-related quality of life (HRQoL), interpersonal difficulty, and work/social functioning outcomes were assessed before and after group therapy using validated instruments. Intervention delivery, therapeutic alliance, client satisfaction, and programme cost were assessed. While there was no statistically significant change in HAM-D depression scores after therapy (n=5; p=0.313), there was a significant decrease in BDI-II depression scores after therapy (n=8; -20.0 median change, p=0.016; 6/8 responses, 7/8 minimal clinically important differences, 2 remissions). There were significant reductions in clinically relevant psychological distress, coping self-efficacy, HRQoL, and interpersonal difficulties after therapy. All clients in work at the start of therapy remained in work at the end of therapy. The intervention was safe, had 100% retention, and clients were satisfied with their treatment. The Work-focused Relational Group-CBT Treatment Programme showed promising immediate positive outcomes in terms of depressive symptoms, interpersonal difficulties, and job retention that warrant further exploration in a longer-term definitive study.