Talk it out: New depression therapy may be more effective, cheaper than CBT

EXETER, United Kingdom — Cognitive Behavioral Therapy (CBT) is widely regarded as the gold standard treatment for depression, but a new therapy that’s all about simple conversations may one day dethrone CBT. Researchers at the University of Exeter report the newly developed talking therapy for depression has shown serious promise in a pilot trial.

Even better, study authors say the new approach to therapy shows promising signs of being more effective and cheaper than CBT. Researchers also believe Augmented Depression Therapy (ADepT) may represent a major step forward in depression care.

Both anhedonia (reduced interest or pleasure) and well-being deficits are considered core features of depression, but current depression psychotherapies like CBT do not adequately target these components. Consequently, ADepT was developed to pay just as much attention to building well-being as it does to reducing depressive symptoms.

“Depression is widespread and a significant contributor to global disability, resulting in extensive social and economic costs. Only around 60 percent of people will recover during our current best treatments like CBT and about half of those will relapse within two years,” says Barney Dunn, the trial leader and Professor of Clinical Psychology, in a university release.

“In ADepT, we encourage clients to take a new perspective to their difficulties, aiming to learn to live well alongside depressed mood. The primary goal is to help clients identify what is important to them in key life areas, take steps towards living a life in a way that is consistent with these values, and to take opportunities and manage challenges while they do so that they can experience wellbeing and pleasure.”

A study participant named Katie shared her personal experience with ADepT.

“I’ve got a fairly long history of using mental health services and that’s almost become my identity over the years. My focus in treatment before had always been on trying to eliminate symptoms of mental illness. ADepT has changed my outlook to help me take steps to gain wellbeing, as well as allowing me to be more authentic and act in a way more aligned to my values,” Katie explains.

“ADepT is helping me make decisions which feel right and giving me more of an identity outside of mental illness, which is amazing. I’ve learnt to be able to enjoy the good things in life that give me pleasure, even when I am having a difficult week. It really has changed things for me,” she continues.

This project was the first pilot randomized controlled trial evaluating the effects of ADepT. A total of 82 adults with moderate to severe depression participated. Those patients all exhibited symptoms of anhedonia. The researchers recruited these individuals from the National Health Service’s Talking Therapy (formerly known as Improving Access to Psychological Therapy) service waiting lists in Devon.

Study participants were randomly assigned to attend either 20 individual sessions of ADepT or CBT, delivered in the University of Exeter AccEPT clinic and supported by Devon Partnership NHS Trust, Exeter Collaboration for Academic Primary Care (APEx), and University of Exeter Psychology Department. The study authors then assessed each person on a habitual basis; at the beginning of the pilot, and after six, 12, and 18 months.

The ensuing results suggest ADepT is certainly not worse than CBT, and the new therapy even showed potential to be better than CBT at building well-being and reducing depression by the end of the treatment and over a longer-term follow-up period. ADepT was also found to be very cost effective, costing about the same amount to deliver as CBT yet resulting in greater gains in quality of life.

If these results can successfully be replicated by a subsequent definitive trial, researchers posit it would strongly suggest that ADepT can indeed offer both clinical and economic benefits across various healthcare settings. Moreover, ADepT was specifically designed so that existing CBT therapists will be able to learn and deliver it with minimal additional training.

The study is published in the journal EClinicalMedicine.