Effectiveness of Cognitive Behavioral Therapy in Public Mental Health: Comparison to Treatment as Usual for Treatment-Resistant Depression
Open accessAbstract
State mental health systems have been leaders in the implementation of evidence-based approaches to care for individuals with severe mental illness. Numerous case studies of the wide-scale implementation of research-supported models such as integrated dual diagnosis treatment and assertive community treatment are documented. However, relatively few dissemination efforts have focused on cognitive behavioral therapy (CBT) for individuals with major depression despite evidence indicating its efficacy with this population. A multi-site effectiveness trial of CBT was conducted within the Texas public mental health system. Eighty-three adults with major depression received CBT from community clinicians trained through a workshop and regular consultation with a master clinician. Outcomes were compared to a matched sample of individuals receiving pharmacotherapy. Outcome measures used included the quick inventory of depressive symptomatology and beck depression inventory. Individuals receiving CBT showed greater improvements in depression symptoms than those in the comparison group. Greater pre-treatment symptom severity predicted better treatment response, while the presence of comorbid personality disorders was associated with poorer outcomes.
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According to the results of Lopez et al., cognitive behavioral therapy compared to medicinal therapy has been more effective in improving depression symptom.
“According to the results of Lopez et al., cognitive behavioral therapy compared to medicinal therapy has been more effective in improving depression symptom.[8]”
From The effect of group cognitive behavioral therapy on stress, anxiety, and depression of women with multiple sclerosis (2017) · cites this paper as [8]
The Results (Participant Depression Outcomes; page unavailable) report a greater reduction in depressive symptoms in the CBT group than in the treatment-as-usual group. But the Methods (Treatment; page unavailable) say both groups received medication: CBT was added to pharmacological care, not compared as a standalone alternative to medicinal therapy. The finding also concerns adults with treatment-resistant depression, rather than depression generally. (LLM, conf=0.88)
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Franco, B. A., Quagliato, L. A., & Nardi, A. E. (2024) · Springer eBooks · doi:10.1007/978-3-031-63494-9_14
Strength-Focused Treatment is Associated with Positive Outcomes in Implemented Multisystemic Therapy
Turner, E. H., Holmes, K. L., & Mueller, C. W. (2026) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-026-01523-9
- Authors
- Lopez, M. A., & Basco, M. A.
- Affiliations
- The University of Texas at Austin (US)
- Corresponding author
- Lopez, Molly A.
- ORCID
- Lopez, Molly A.
- Venue
- Administration and Policy in Mental Health and Mental Health Services Research
- Published
- 2014-04-02
- Volume
- 42
- Issue
- 1
- Pages
- 87-98
- ISSN
- 0894-587X (ISSN-L)
- 1573-3289
- PMC
- PMC4183730
- OpenAlex
- W2076536875
- Cited by
- 42
- References
- 66
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 1
- FWCI
- 3.93
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Administration and Policy in Mental Health and Mental Health Services Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services
- University of Texas at Arlington
- National Institutes of Health
- National Institute of Mental Health (R34MH074749)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- cognitive behavioral therapy, treatment-resistant depression, major depressive disorder, public mental health system, community mental health centers, drug therapy comparison, dissemination of evidence-based treatment, treatment response, symptom severity, personality disorders, Texas
- MeSH terms
- Adult, Age Factors, Antidepressive Agents, Community Mental Health Services, Major Depressive Disorder, Female, Humans, Male, Mental Health, Middle Aged, Psychiatric Status Rating Scales, Severity of Illness Index, Sex Factors, Socioeconomic Factors, Texas, Comorbidity, Cognitive Behavioral Therapy
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