Clinical and cost-effective components of psychological therapies for depression
Establishing effective treatment for depression is a population health priority. Pharmacological therapies are a mainstay of depression treatment, however meta-analyses of cognitive behavioural therapy (CBT) versus pharmacological treatments suggest CBT may be equally effective as antidepressants and preferred by patients. However meta-analytical methods group interventions together as the same “treatment” and make a lumped comparison of “all CBT” vs. comparator. This only answers the research question “Is CBT in general effective?” However, psychological interventions are complex, consisting of multiple components which are structured and can be classified. For example 1 intervention may be primarily group-level cognitive and another behavioral. Differences between components can be modelled using a form of meta-regression called network meta-analysis to establish which component or combinations of components have the greatest probability of being effective for treating depression.
Aims & Objectives
1. Develop a taxonomy of psychological therapy components used for treatment of depression;
2. Establish which interventions with a particular component or combination of components are effective?
3. Establish which interventions with a particular component or combination of components are cost-effective?
This PhD will utilise mixed methods: both qualitative and quantitative.
1. Qualitative methods may include: small group interviews or focus groups and Delphi consensus exercise.
2. Quantitative methods may include: linear regression, logistic regression, meta-analysis, network meta-analysis, economic modelling and value of information analyses
1. Welton NJ et al. American Journal of Epidemiology 2009;169:1158-65.
2. Caldwell DM et al British Medical Journal. 2005;331;897-900.
3. Barth et al Comparative Efficacy of Seven Psychotherapeutic Interventions for Patients with Depression: A Network Meta-Analysis. PLoS Medicine. 2013