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Effectiveness of teaching general practitioners skills in brief cognitive behaviour therapy to treat patients with depression: randomised controlled trial

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7343.947 (Published 20 April 2002) Cite this as: BMJ 2002;324:947
  1. Michael King, head (m.king{at}rfc.ucl.ac.uk)a,
  2. Oliver Davidson, honorary senior lecturera,
  3. Fiona Taylor, research fellowa,
  4. Andrew Haines, headb,
  5. Deborah Sharp, headc,
  6. Rebecca Turner, research associated
  1. a Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, Royal Free Campus, London NW3 2PF
  2. b Department of Primary Care and Population Sciences, Royal Free and University College Medical School
  3. c Division of Primary Health Care, Department of Clinical Medicine, University of Bristol, Bristol BS8 2PR
  4. d Medical Research Council Clinical Trials Unit, London NW1 2DA
  1. Correspondence to: M King
  • Accepted 2 January 2002

Abstract

Objective: To assess the effectiveness of teaching general practitioners skills in brief cognitive behaviour therapy.

Design: Parallel group, cluster randomised, controlled trial of an educational package on cognitive behaviour therapy.

Setting: General practices in north London.

Participants: 84 general practitioner principals and 272 patients attending their practices who scored above the threshold for psychological distress on the hospital anxiety and depression scale.

Intervention: A training package of four half days on brief cognitive behaviour therapy.

Main outcome measures: Scores on the depression attitude questionnaire (general practitioners) and the Beck depression inventory (patients).

Results: Doctors' knowledge of depression and attitudes towards its treatment showed no major difference between intervention and control groups after 6 months. The training had no discernible impact on patients' outcomes.

Conclusion: General practitioners may require more training and support than a basic educational package on brief cognitive behaviour therapy to acquire skills to help patients with depression.

What is already known on this topic

What is already known on this topic Trained professionals can deliver effective cognitive behaviour therapy to depressed patients presenting to general practitioners

Limited evidence shows that cognitive behaviour therapy is effective when delivered by general practitioners who have received extensive instruction

Most doctors do not have the time or inclination to carry out such comprehensive training

What this study adds

What this study adds Basic training in brief cognitive behaviour therapy has little effect on general practitioners' attitudes to the identification and treatment of depression or the outcome of their patients with emotional problems

General practitioners may require more extensive training and support if they are to acquire skills in brief cognitive behaviour therapy that will have a positive impact on their patients

Footnotes

  • Funding MK received funding from the NHS research and development programme. The views expressed are those of the authors' and not necessarily those of the NHS Executive or the Department of Health.

  • Competing interests None declared

  • Accepted 2 January 2002
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