The DOI matches its Crossref record; 51 of the 52 references it cites were found in a registry or an index.
Improving access to psychological therapies: Phase IV prospective cohort study
Abstract
Objectives. To determine the effects of implementing stepped care evidence‐based psychological treatments for anxiety and depression in routine practice using a collaborative care implementation model. Design. Observational prospective cohort study/Phase IV field trial. Methods. We collected data on depression and anxiety from a prospective cohort of 3,994 consecutive patients referred to the UK Improving Access to Psychological Therapies demonstration site in Doncaster for 12 months from August 2006 using PHQ‐9 and GAD‐7. We collected demographic and process information including the type and methods of treatments received. We calculated effect sizes, remission, and recovery rates for patients competing treatment and those who dropped out or were considered to be unsuitable. Results. Two thousand seven hundred and ninety‐five patients received an assessment, out of which 2,017 received two or more appointments. Out of these, 869 had completed treatment by the census date, 743 remained in treatment, 319 had dropped out, and 85 had been found to be unsuitable. Pre–post treatment effect sizes for anxiety and depression in those patients completing treatment were 1.39 and 1.41, respectively, with post‐treatment relative risks of depression and anxiety 0.29 and 0.34. The combined remission and recovery rates were 76% for depression and 74% for anxiety. The mean number of treatment sessions was 5.15 in a mean time of 2 h and 45 min. On an average, patients received at least three of these contacts by telephone. Outcomes are comparable with benchmarked trials, reviews, and routine datasets. Conclusions. Combining low‐intensity stepped care psychological treatment with a telephony‐based collaborative care organizational system can deliver good clinical outcomes in routine practice.
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“The GAD-7 is increasingly used in large-scale studies as a generic measure of changes in anxiety symptomatology, using a cut-off score of 8 [31,58].”
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“These will allow us to compare our study findings with published national outcomes on cCBT and related interventions [44,45].”
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“The ‘Doing Well by People with Depression’ programme therefore had similar objectives to the improving access to psychological therapies programme in England (which began in 2006), though the two approaches developed independently.”
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“With regard to clinical significance, we used the percentage change method, which has been utilized in previous research (Richards & Suckling, 2009; Titov et al., 2010).”
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“2008; Richards & Suckling 2009), and to treat a broad range of mental illnesses (Brenes et al .”
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Pluralism as the forerunner of integration? A reflective account
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“Including a follow-up assessment would help distinguish intervention effects from spontaneous remission [102] and provide insight into the sustainability of treatment effects.”
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Version of file: Published Peer Review Status: Peer reviewed Citation for item:
Richards, D. A., Bower, P., Pagel, C., Weaver, A. N., Utley, M., Cape, J. D., Pilling, S., Lovell, K., Gilbody, S. M., Leibowitz, J., et al. (2012)
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Metadata
- Authors
- Richards, D. A., & Suckling, R.
- Affiliations
- University of Exeter (GB)
- Corresponding author
- Richards, David A.
- Venue
- British Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2009-11
- Volume
- 48
- Issue
- 4
- Pages
- 377-396
- ISSN
- 0144-6657 (ISSN-L)
- 2044-8260
- OpenAlex
- W2033901652
- Cited by
- 154
- References
- 52
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 4 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 4 · 2018: 12 · 2017: 7 · 2016: 16 · 2015: 13 · 2014: 16 · 2013: 14 · 2012: 18
- FWCI
- 22.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- Improving Access to Psychological Therapies, stepped care, collaborative care, anxiety, depression, psychotherapy, telemedicine, telephone-delivered therapy, treatment discontinuation
- MeSH terms
- Adult, Anxiety Disorders, Counseling, Depressive Disorder, Female, United Kingdom, Humans, Male, Prospective Studies, Telephone, Cohort Studies, Cognitive Behavioral Therapy, Treatment Outcome, Evidence-Based Medicine
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