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Stepped care in psychological therapies: access, effectiveness and efficiency: Narrative literature review
Open accessAbstract
Background: There is a significant gap between the demand for psychological therapy services and the available supply. One proposal to overcome this problem is to increase efficiency of provision through the adoption of briefer ‘minimal interventions' within stepped care models. Aims: To examine the theoretical underpinnings of stepped care, together with the practicalities of the adoption of this system of care. Method: Narrative literature review. Results: The potential clinical and economic benefits of stepped care are dependent upon underlying assumptions of equivalence in terms of clinical outcomes, efficiency in terms of resource use and costs, and acceptability of ‘minimal interventions' to patients and therapists. Illustrative studies of these issues are considered. Conclusions: Although psychological services might benefit from the adoption of the stepped care model, a substantial research agenda needs to be fulfilled before a judgement can be made as to whether stepped care might be an efficient method of delivering psychological services.
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“but usually offered on an individual basis (Bower and Gilbody, 2005).”
From Do depressed and anxious men do groups? What works and what are the barriers to help seeking? (2014) · cites this paper as Bower and Gilbody, 2005
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“Therefore, treatment costs tend to be higher compared to primary care (Spijker et al., 2013) in combination with long waiting lists due to treatment duration and limited financial resources (Bower and Gilbody, 2005, Lovell and Richards, 2000).”
From Development and initial evaluation of blended cognitive behavioural treatment for major depression in routine specialized mental health care (2016) · cites this paper as Bower and Gilbody, 2005
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“Finally, the fact that few participants had previously consulted suggests that online interventions are attractive for first time consultations; they may demystify treatment and act as a stepping stone toward other more intensive intervention modalities (Bower and Gilbody, 2005).”
From Online and Mobile Interventions for Problem Gambling, Alcohol, and Drugs: A Systematic Review (2017) · cites this paper as Bower and Gilbody, 2005
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Citations
Cites
Jacobson, N. S., & Truax, P. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.1.12 · Cited by 7,770
Unützer, J., Katon, W., Callahan, C. M., Williams, Jr., Hunkeler, E., Harpole, L., Hoffing, M., Della Penna, R. D., Noël, P. H., Lin, E. H. B., et al. (2002) · JAMA · doi:10.1001/jama.288.22.2836 · Cited by 2,405
Design Sensitivity: Statistical Power for Experimental Research.
Eliason, S. R., & Lipsey, M. W. (1991) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2072167 · Cited by 1,038
National Collaborating Centre for Mental Health
Veale, D. M. (2006) · Research Portal (King's College London) · Cited by 941
Design Sensitivity: Statistical Power for Experimental Research.
Lachenbruch, P. A., & Lipsey, M. W. (1990) · Journal of the American Statistical Association · doi:10.2307/2289636 · Cited by 781
Gilbody, S., Whitty, P., Grimshaw, J., & Thomas, R. (2003) · JAMA · doi:10.1001/jama.289.23.3145 · Cited by 749
Self-citationStepped Collaborative Care for Primary Care Patients With Persistent Symptoms of Depression
Katon, W. J., Korff, M. V., Lin, E., Simon, G., Walker, E., Unützer, J., Bush, T. M., Russo, J. E., & Ludman, E. J. (1999) · Archives of General Psychiatry · doi:10.1001/archpsyc.56.12.1109 · Cited by 658
Using significance tests to evaluate equivalence between two experimental groups.
Rogers, J. L., Howard, K. I., & Vessey, J. T. (1993) · Psychological Bulletin · doi:10.1037/0033-2909.113.3.553 · Cited by 568
Proudfoot, J., Ryden, C., Everitt, B., Shapiro, D. A., Goldberg, D., Mann, A., Tylee, A., Marks, I., & Gray, J. A. (2004) · British Journal of Psychiatry · doi:10.1192/bjp.185.1.46 · Cited by 516 · cited 1×
“…where a number of less intensive treatments (or ‘minimal interventions’) have been developed, for example brief therapies (Scott et al, 1997), group treatments (Dowrick et al, 2000) and self-help approaches such as bibliotherapy (Cuijpers, 1997) and computerised treatments (Proudfoot et al, 2004).”
BackgroundAraya, R., Rojas, G., Fritsch, R., Gaete, J., Rojas, M., Simon, G., & Peters, T. J. (2003) · The Lancet · doi:10.1016/s0140-6736(03)12825-5 · Cited by 450
Treating Major Depression in Primary Care Practice
Schulberg, H. C. (1996) · Archives of General Psychiatry · doi:10.1001/archpsyc.1996.01830100061008 · Cited by 425
Priest, R. G., Vize, C., Roberts, A., Roberts, M., & Tylee, A. (1996) · BMJ · doi:10.1136/bmj.313.7061.858 · Cited by 385
Bower, P., Byford, S., Sibbald, B., Ward, E. S., King, M., Lloyd, M., & Gabbay, M. (2000) · BMJ · doi:10.1136/bmj.321.7273.1389 · Cited by 350
Self-citationStepped care as a heuristic approach to the treatment of alcohol problems.
Sobell, M. B., & Sobell, L. C. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.4.573 · Cited by 345
Bibliotherapy in unipolar depression: A meta-analysis
Cuijpers, P. (1997) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(97)00005-0 · Cited by 339 · cited 4×
“…where a number of less intensive treatments (or ‘minimal interventions’) have been developed, for example brief therapies (Scott et al, 1997), group treatments (Dowrick et al, 2000) and self-help approaches such as bibliotherapy (Cuijpers, 1997) and computerised treatments (Proudfoot et al, 2004).”
BackgroundInfluentialTreatment of early Parkinson's disease
Marsh, L., & Dawson, T. M. (2000) · BMJ · doi:10.1136/bmj.321.7252.1 · Cited by 337
Simon, G. E., Katon, W. J., VonKorff, M., Unützer, J., Lin, E. H. B., Walker, E. A., Bush, T. M., Rutter, C. M., & Ludman, E. J. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.10.1638 · Cited by 326
Who (or What) Can Do Psychotherapy: The Status and Challenge of Nonprofessional Therapies
Christensen, A., & Jacobson, N. S. (1994) · Psychological Science · doi:10.1111/j.1467-9280.1994.tb00606.x · Cited by 318
Abrams, D. B., Orleans, C. T., NIAURA, R. S., Goldstein, M. G., Prochaska, J. O., & Velicer, W. F. (1996) · Annals of Behavioral Medicine · doi:10.1007/bf02895291 · Cited by 287
Ward, E. S., King, M., Lloyd, M., Bower, P., Sibbald, B., Farrelly, S., Gabbay, M., Tarrier, N., & Addington-Hall, J. M. (2000) · BMJ · doi:10.1136/bmj.321.7273.1383 · Cited by 271
Self-citationThe Cost–Utility of Screening for Depression in Primary Care
Valenstein, M., Vijan, S., Zeber, J. E., Boehm, K., & Buttar, A. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-134-5-200103060-00007 · Cited by 268
Introduction to the special section on stepped care models in psychotherapy.
Haaga, D. A. F. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.4.547 · Cited by 259
Effectiveness of Disease Management Programs in Depression: A Systematic Review
Badamgarav, E., Weingarten, S. R., Henning, J. M., Knight, K. K., Hasselblad, V., Gano, A. D., & Ofman, J. J. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.12.2080 · Cited by 245
Dowrick, C., Dunn, G., Ayuso-Mateos, J. L., Dalgard, O. S., Page, H., Lehtinen, V., Casey, P., Wilkinson, C., Vazquez-Barquero, J. L., & Wilkinson, G. (2000) · BMJ · doi:10.1136/bmj.321.7274.1450 · Cited by 228
Lovell, K., & Richards, D. (2000) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465800004070 · Cited by 216 · cited 6×
“There is a general perception that minimal interventions are best restricted to less severe disorders, although the evidence for this is not definitive (Lovell & Richards, 2000).”
BackgroundInfluentialStepped care: Doing more with less?
Davison, G. C. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.4.580 · Cited by 204
Bower, P., Richards, D. A., & Lovell, K. (2001) · Europe PMC (PubMed Central) · Cited by 187
Self-citationSelf‐administered treatment in stepped‐care models of depression treatment
Scogin, F. R., Hanson, A., & Welsh, D. (2003) · Journal of Clinical Psychology · doi:10.1002/jclp.10133 · Cited by 186 · cited 8×
“…back pain (Von Korff & Moore, 2001), alcohol treatment (Breslin et al, 1997; Sobell & Sobell, 2000), migraine (Sculpher et al, 2002), anxiety (Newman, 2000), eating disorders (Wilson et al, 2000), methadone maintenance (King et al, 2002) and depression (Simon et al, 2001; Scogin et al, 2003).”
BackgroundMethodInfluentialPragmatic evaluation of computer-aided self-help for anxiety and depression
Marks, I. M., Mataix-Cols, D., Kenwright, M., Cameron, R., Hirsch, S., & Gega, L. (2003) · British Journal of Psychiatry · doi:10.1192/bjp.183.1.57 · Cited by 185
Stepped care treatment for eating disorders.
Wilson, G. T., Vitousek, K. M., & Loeb, K. L. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.4.564 · Cited by 175
Newman, M. G. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.4.549 · Cited by 167 · cited 9×
“…back pain (Von Korff & Moore, 2001), alcohol treatment (Breslin et al, 1997; Sobell & Sobell, 2000), migraine (Sculpher et al, 2002), anxiety (Newman, 2000), eating disorders (Wilson et al, 2000), methadone maintenance (King et al, 2002) and depression (Simon et al, 2001; Scogin et al, 2003).”
BackgroundInfluentialNeurotic disorders and the receipt of psychiatric treatment
Bebbington, P., Brugha, T. S., Meltzer, H., Jenkins, R., Ceresa, C., Farrell, M., & Lewis, G. (2000) · Psychological Medicine · doi:10.1017/s0033291799002974 · Cited by 166
Modelling in Health Economic Evaluation
Brennan, A., & Akehurst, R. L. (2000) · PharmacoEconomics · doi:10.2165/00019053-200017050-00004 · Cited by 165
Population-based care of depression: Effective disease management strategies to decrease prevalence
Katon, W. J., Korff, M. V., Lin, E. H. B., Unützer, J., Simon, G., Walker, E., Ludman, E. J., & Bush, T. M. (1997) · General Hospital Psychiatry · doi:10.1016/s0163-8343(97)00016-9 · Cited by 164
Sequential Treatment for Bulimia Nervosa Incorporating A Self-Care Manual
Treasure, J. L., Schmidt, U. H., Troop, N. A., Tiller, J., Todd, G., & Turnbull, S. (1996) · The British Journal of Psychiatry · doi:10.1192/bjp.168.1.94 · Cited by 144
Stepped Care for Back Pain: Activating Approaches for Primary Care
Korff, M. V., & Moore, J. C. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-134-9_part_2-200105011-00016 · Cited by 140
Scott, C., Tacchi, M. J., Jones, R. H., & Scott, J. L. (1997) · The British Journal of Psychiatry · doi:10.1192/bjp.171.2.131 · Cited by 137
Cost effectiveness analysis in health care: contraindications
Donaldson, C. (2002) · BMJ · doi:10.1136/bmj.325.7369.891 · Cited by 135
Older adults' acceptance of psychological and pharmacological treatments for depression
Landreville, P., Landry, J., Baillargeon, L., Guerette, A., & Matteau, E. (2001) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/56.5.p285 · Cited by 118
Cost-Effectiveness of Psychotherapy: A Guide for Practitioners, Researchers, and Policymakers
Miller, N. E., & Magruder, K. M. (1999) · Cited by 116
Demanding patients? Analysing the use of primary care.
Stott, N. (2000) · Family Practice · doi:10.1093/fampra/17.3.277 · Cited by 111
Kaltenthaler, E., Shackley, P., Stevens, K., Beverley, C., Parry, G., & Chilcott, J. (2002) · Health Technology Assessment · doi:10.3310/hta6220 · Cited by 109
The reluctance to seek treatment for neurotic disorders
Meltzer, H., Bebbington, P., Brugha, T., Farrell, M., Jenkins, R., & Lewis, G. (2003) · International Review of Psychiatry · doi:10.1080/0954026021000046038 · Cited by 109
(1999) · Research Explorer (The University of Manchester) · Cited by 103
BRESLIN, F. C., SOBELL, M. B., SOBELL, L. C., BUCHAN, G., & CUNNINGHAM, J. A. (1997) · Addiction · doi:10.1111/j.1360-0443.1997.tb02869.x · Cited by 102
Guided Self-Change for Bulimia Nervosa Incorporating Use of a Self-Care Manual
Thiels, C., Schmidt, U. H., Treasure, J. L., Garthe, R., & Troop, N. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.7.947 · Cited by 100
The role of modelling in prioritising and planning clinical trials
Chilcott, J. B., Brennan, A., Booth, A., Karnon, J. D., & Tappenden, P. (2003) · Health Technology Assessment · doi:10.3310/hta7230 · Cited by 99
Will managed care change our way of being?
Cushman, P., & Gilford, P. (2000) · American Psychologist · doi:10.1037/0003-066x.55.9.985 · Cited by 96
Palmer, R. L., Birchall, H. M., McGrain, L., & Sullivan, V. (2002) · The British Journal of Psychiatry · doi:10.1192/bjp.181.3.230 · Cited by 96
Strike while the iron is hot: Can stepped-care treatments resurrect relapsing smokers?
Smith, S. S., Jorenby, D. E., Fiore, M. C., Anderson, J. E., Mielke, M. M., Chiasson, K. B., Piasecki, T. M., & Baker, T. B. (2001) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.69.3.429 · Cited by 88
Problem drinkers: evaluation of a stepped-care approach
Breslin, F. C., Sobell, M. B., Sobell, L. C., Cunningham, J. A., Sdao‐Jarvie, K., & Borsoi, D. (1998) · Journal of Substance Abuse · doi:10.1016/s0899-3289(99)00008-5 · Cited by 69
Sculpher, M. J., Millson, D. S., MEDDIS, D., & Poole, L. (2002) · PharmacoEconomics · doi:10.2165/00019053-200220020-00002 · Cited by 65
A multicenter randomized evaluation of methadone medical maintenance.
King, V., Stoller, K. B., Hayes, M., Umbricht, A., Currens, M., Kidorf, M., Carter, J., Schwartz, R., & Brooner, R. (2002) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(01)00155-7 · Cited by 65
The reluctance to seek treatment for neurotic disorders
Meltzer, H., Bebbington, P., Brugha, T. S., Farrell, M., Jenkins, R., & Lewis, G. (2000) · Journal of Mental Health · doi:10.1080/713680243 · Cited by 62
Primary care mental health workers: models of working and evidence of effectiveness.
Bower, P. (2002) · Europe PMC (PubMed Central) · Cited by 60
Self-citationEfficacy, effectiveness, and expected treatment response in psychotherapy
Lutz, W. (2003) · Journal of Clinical Psychology · doi:10.1002/jclp.10169 · Cited by 54
Gilbody, S. M., & Whitty, P. (2002) · The British Journal of Psychiatry · doi:10.1192/bjp.180.1.13 · Cited by 52
Self-citationDurand, M. A., & King, M. (2003) · Europe PMC (PubMed Central) · Cited by 45
Whitfield, G., Williams, C., & Shapiro, D. A. (2001) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s135246580100306x · Cited by 22
PHASE: a 'health technology' approach to psychological treatment in primary mental health care
Richards, D. A., Richards, A., Barkham, M., Cahill, J., & Williams, C. (2002) · Primary Health Care Research & Development · doi:10.1191/1463423602pc103oa · Cited by 20
Economic modelling before clinical trials
Torgerson, D. J., & Byford, S. (2002) · BMJ · doi:10.1136/bmj.325.7355.98 · Cited by 17
Personal paper: how to get the best health outcome for a given amount of money
Sutton, M. (1997) · BMJ · doi:10.1136/bmj.315.7099.47 · Cited by 12
Entering psychological treatment: Decision-making factors for GPs and service users
Pilgrim, D. M., Rogers, A. E., Clarke, S. E., & Clark, W. D. (1997) · Journal of Interprofessional Care · doi:10.3109/13561829709034128 · Cited by 11
Schulz, J. D. (2006) · Logistics management · Cited by 8
Flagged first, then by citations
1 of the 66 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- 2003, Depression – Core Interventions in the Management of Depression in Primary and Secondary Care (National Clinical Practice Guideline – Draft for Consultation)
- 2001, Treatment Choice in Psychological Therapies and Counselling: Evidence Based Clinical Practice Guideline
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Cognitive behavioural therapy for anxiety disorders in children and adolescents
James, A. C., James, G., Cowdrey, F. A., Soler, A., & Choke, A. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004690.pub4 · Cited by 876
Cleare, A., Pariante, C., Young, A., Anderson, I., Christmas, D., Cowen, P., Dickens, C., Ferrier, I., Geddes, J., Gilbody, S., et al. (2015) · Journal of Psychopharmacology · doi:10.1177/0269881115581093 · Cited by 759
“Overall, the effects for psychological therapies is small, with most evidence for CBT from trials in coronary heart disease (Baumeister et al., 2011; Bower and Gilbody, 2005; Dickens et al., 2013; Welton et al., 2009; Whalley et al., 2011) and exercise in trials in chronic obstructive pulmonary disease (Coventry et al.”
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The Lancet Psychiatry Commission on psychological treatments research in tomorrow's science
Holmes, E. A., Ghaderi, A., Harmer, C. J., Ramchandani, P. G., Cuijpers, P., Morrison, A. P., Roiser, J. P., Bockting, C. L. H., O'Connor, R. C., Shafran, R., et al. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30513-8 · Cited by 624
Metadata
- Authors
- Bower, P., & Gilbody, S.
- Affiliations
- University of Manchester (GB)
- University of Leeds (GB)
- Corresponding author
- Bower, Peter
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2005-01
- Volume
- 186
- Issue
- 1
- Pages
- 11-17
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2160548159
- Cited by
- 1,084
- References
- 66
- Citations by year
- 2026: 76 · 2025: 61 · 2024: 71 · 2023: 72 · 2022: 73 · 2021: 62 · 2020: 68 · 2019: 63 · 2018: 65 · 2017: 51 · 2016: 62 · 2015: 55 · 2014: 48 · 2013: 45 · 2012: 54
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- stepped care, psychotherapy, minimal intervention, brief intervention, access to mental health care, service supply and demand, treatment efficiency, cost-effectiveness, treatment acceptability, resource utilization (health care)
- MeSH terms
- Mental Disorders, Humans, Patient Acceptance of Health Care, Psychotherapy, Treatment Outcome
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