A brief transdiagnostic group (the take control course) compared to individual low-intensity CBT for depression and anxiety: a randomized non-inferiority trial

TY - JOUR

T1 - A brief transdiagnostic group (the take control course) compared to individual low-intensity CBT for depression and anxiety

T2 - a randomized non-inferiority trial

AU - Morris, Lydia

AU - Lovell, Karina

AU - McEvoy, Phil

AU - Emsley, Richard

AU - Carter, Lesley-Anne

AU - Edge, Dawn

AU - Bates, Rachel

AU - Wallwork, Tanya

AU - Mansell, Warren

N1 - Funding Information: This work was funded by a NorthWest Doctoral Training College, Economic and Social Research Council, CASE Studentship [grant number ES/J500094/1] awarded to the first author at the University of Manchester Many thanks to Rebekah Warke, Martina Slapkova, Saoirse Kennedy-Barton, Amel Hamlaoui, and Rebekah Amos (voluntary research assistants). Many thanks also to the team at Six Degrees Social Enterprise for all their support of the research programme that this study forms part of. Publisher Copyright: © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

PY - 2023/5

Y1 - 2023/5

N2 - Few studies have examined brief transdiagnostic groups. The Take Control Course (TCC) was developed for patients with mild to moderate common mental health problems. We examined whether TCC is non-inferior to individual low-intensity cognitive behaviour therapy (CBT) in a single-blind individually randomised parallel non-inferiority trial. The primary outcomes were depression (PHQ9) and anxiety (GAD7) at 6-month follow-up (primary outcome point) and 12-month follow-up. The non-inferiority margin that we set, based on previous trials, corresponds to approximately 3 points on the PHQ9 and approximately 2.5 points on the GAD7. Intention-to-treat (ITT) and per-protocol (PP) analyses of 6-month data of 156 randomised patients indicated that TCC was non-inferior to individual low-intensity CBT on anxiety (ITT Coefficient = 0.24; 95% CI: -1.45 to 1.92; d = 0.04; p = .79), and depression (ITT Coefficient = 0.82; 95% CI: -1.06 to 2.69; d = 0.14; p = .39) outcomes, and functioning (ITT Coefficient = 0.69; 95% CI: -2.56 to 3.94; d = 0.08; p = .68). The findings at 12 months were inconclusive and require further testing. This randomised trial provides preliminary support that TCC is not less effective than short-term individual CBT within Improving Access to Psychological Therapies (IAPT) services.

AB - Few studies have examined brief transdiagnostic groups. The Take Control Course (TCC) was developed for patients with mild to moderate common mental health problems. We examined whether TCC is non-inferior to individual low-intensity cognitive behaviour therapy (CBT) in a single-blind individually randomised parallel non-inferiority trial. The primary outcomes were depression (PHQ9) and anxiety (GAD7) at 6-month follow-up (primary outcome point) and 12-month follow-up. The non-inferiority margin that we set, based on previous trials, corresponds to approximately 3 points on the PHQ9 and approximately 2.5 points on the GAD7. Intention-to-treat (ITT) and per-protocol (PP) analyses of 6-month data of 156 randomised patients indicated that TCC was non-inferior to individual low-intensity CBT on anxiety (ITT Coefficient = 0.24; 95% CI: -1.45 to 1.92; d = 0.04; p = .79), and depression (ITT Coefficient = 0.82; 95% CI: -1.06 to 2.69; d = 0.14; p = .39) outcomes, and functioning (ITT Coefficient = 0.69; 95% CI: -2.56 to 3.94; d = 0.08; p = .68). The findings at 12 months were inconclusive and require further testing. This randomised trial provides preliminary support that TCC is not less effective than short-term individual CBT within Improving Access to Psychological Therapies (IAPT) services.

KW - Humans

KW - Depression/therapy

KW - Single-Blind Method

KW - Treatment Outcome

KW - Cost-Benefit Analysis

KW - Anxiety/therapy

KW - Cognitive Behavioral Therapy/methods

UR - http://www.scopus.com/inward/record.url?scp=85146275883&partnerID=8YFLogxK

U2 - 10.1080/16506073.2022.2143418

DO - 10.1080/16506073.2022.2143418

M3 - Article

C2 - 36625458

SN - 1650-6073

VL - 52

SP - 176

EP - 197

JO - Cognitive Behaviour Therapy

JF - Cognitive Behaviour Therapy

IS - 3

ER -