Alternative Brief Interventions for Mild Depression
By Irene Markman Geisner, MS |
October 1, 2006
In a primary care study of 156 adult outpatients with depression, investigators sought to enhance treatment with antidepressants by providing written and videotaped educational materials that explained biologic and behavioral elements of depression.30 In addition to those materials, the patients attended 4 to 6 sessions of psychotherapy with behavioral activation and cognitive interventions geared to education, skills training, and homework. The study found that 70% of the patients who received education and psychotherapy intervention had a 50% or more reduction in symptoms compared with 40% in the treatment-as-usual cohort.
Recently, researchers have successfully used normative mailed feedback to reduce college students' problem drinking.31-36 In a recent study, this approach was extended to the treatment of college students with depressed mood. The study showed that symptoms of depression were reduced by 20% in students who were given a personalized letter that reflected the symptoms they were experiencing and positive coping strategies they were using; in addition they received a brochure listing a variety of additional strategies shown to combat depression (eg, seeking social support, pleasant activities, exercise, suggestions for self-help literature) compared with a reduction of 8% in the control group. In addition, receiving the information reduced hopelessness by 31% in the intervention group compared with 7% in the control group.37 This was a low-cost intervention that could be used alone for those with mild depression or in conjunction with other approaches for those on the higher end of the depression continuum.
There are beneficial clinical implications of alternative approaches that have been shown to reduce depressed mood. Low-cost approaches that provide education for those experiencing subthreshold depression could prevent full-blown major depressive episodes. Mailing materials removes some of the barriers to treatment often encountered in mental health. Finally, for those already depressed and seeking treatment, providing concrete, simple techniques that can be accessed at home may augment existing approaches. Future directions should aim at studying the effectiveness of such alternative approaches in psychiatric and primary care settings, as well as with those persons who have more severe depression.
Irene Geisner is a project coordinator in the department of psychiatry and behavioral sciences at the University of Washington in Seattle and a PhD candidate. She reports that she has no conflicts of interest concerning the subject matter of this article. This research was supported in part by the National Institute on Alcohol(Drug information on alcohol) Abuse and Alcoholism Grant T32AA07455 and the Stanley Foundation.
- Geisner IM, Neighbors C, Larimer ME. A randomized clinical trial of a brief, mailed intervention for symptoms of depression. J Consult Clin Psychol. 2006;74: 393-399.
- Scogin F, Jamison C, Davis N. Two-year follow-up of bibliotherapy for depression in older adults. J Consult Clin Psychol. 1990;58:665-667.
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