Evaluating brief cognitive behavioural therapy within primary care
| Date | 02 September 2014 |
| Published date | 02 September 2014 |
| DOI | https://doi.org/10.1108/MHRJ-02-2014-0004 |
| Pages | 196-206 |
| Author | Patrick McHugh,Michael Gordon,Michael Byrne |
| Subject Matter | Health & social care,Mental health |
Evaluating brief cognitive behavioural
therapy within primary care
Patrick McHugh, Michael Gordon and Michael Byrne
Patrick McHugh is a Research
Assistant, based at
Roscommon Psychology
Department, HSE West,
Roscommon, Ireland.
Dr Michael Gordon is an
Assistant Professor, based at
School of Psychology, Trinity
College Dublin, Dublin, Ireland.
Dr Michael Byrne, based at
Roscommon Psychology
Department, HSE West,
Roscommon, Ireland.
Abstract
Purpose – The purpose of this paper is to evaluate the clinical effectiveness of a brief CBT intervention
within a primary care adult mental health service.
Design/methodology/approach – In total, 92 participants with mild to moderate mental health difficulties
were provided with five sessions of brief CBT. Clinical improvement was measured using the Clinical
Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at pre-treatment, mid-treatment and post-
treatment, and on the Beck Depression Inventory-II (BDI-II) at pre-treatment and post-treatment.
Findings – The planned five sessions of CBT were completed by 48.9 percent (n ¼45) of participants.
Treatment completers with full clinical data (n¼31) showed large statistically significant improvements on
the CORE-OM and BDI-II from pre-therapy to post-therapy. Of treatmentcompleters and non-completers
with post-therapy and mid-therapy CORE-OM data, respectively (n ¼34), 61.8 percent showed reliable
and clinically significant change. No statistically significant differences were found between treatment
completers (n ¼45) and non-completers (n ¼47) in their pre-therapy clinical scores or socio-demographic
characteristics.
Practical implications – Brief CBT can be a clinically effective primary care intervention but needs to be
implemented in a way that ensures high treatment engagement across a range of service users.
Originality/value – This paper contributes to the evidence base of a primary care psychological
intervention and demonstrates the importance of assessing treatment completion when evaluating clinical
effectiveness.
Keywords Dropout, Primary care, Brief therapy, Cognitive behavioural therapy
Paper type Research paper
Introduction
The proportion of primary care attendees with mental health difficulties in the Republic of Ireland
is substantial, with estimates ranging from 25 percent to 33 percent (Copty and Whitford, 2005;
Hughes et al., 2010). Approximately 80 percent of these service users will have their difficulties
managed in primary care (Tedstone-Doherty et al., 2008). In recent years, there has been
a reliance on medication to treat mental health difficulties in primary care (Grace et al., 2012),
even though such treatment has been increasingly considered inappropriate for those with
mild to moderate difficulties (Baumeister, 2012; National Institute of Clinical Excellence (NICE),
2009, 2011).
Psychological treatment in primary care
In order to provide timely and appropriate treatment for those with mild to moderate mental
health difficulties, there is a need to increase access to psychological treatments in primary
care. The Improving Access to Psychological Therapies (IAPT) programme in the UK is
one example of how health services are attempting to achieve this. Established in 2008, IAPT
aimed to provide accessible evidenced-based psychological treatment for adults with mild
to moderate mental health difficulties, and more recently has expanded to support child and
adolescent services in the National Health Service (Clark, 2011; Cohen, 2008). The service is
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MENTAL HEALTH REVIEW JOURNAL
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VOL. 19 NO. 3 2014, pp. 196-206, CEmerald Group Publishing Limited, ISSN 1361-9322 DOI 10.1108/MHRJ-02-2014-0004
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