National Dissemination and Implementation of CBT for Depression in the Department of Veterans Affairs Health Care System Improves Patient Outcomes

According to a recent study published in the Journal of Consulting and Clinical Psychology, the implementation of CBT training for depression (CBT-D) significantly improves patient outcomes in the Veterans Affairs (VA) health care system. In the current study, 211 therapists participated in a VA CBT-D Training Program and delivered therapy to 356 patients. Therapist training included a 3-day CBT workshop followed by a 6-month consultation phase (weekly, 90-minute telephone-based consultation sessions led by an expert CBT-D clinician). Therapist competencies were assessed using the Cognitive Therapy Rating Scale (CTRS) and patient outcomes were assessed using the Beck Depression Inventory-II and World Health Organization Quality of Life-BREF. At the conclusion of the program, all of the therapists who completed training (82%) demonstrated competency in administering CBT-D, as well as higher levels of confidence, self-efficacy, and positive attitudes toward treatment. Furthermore, the implementation of CBT-D resulted in highly significant reductions in depressive symptoms and improvements in quality of life among patients treated. In fact, patient assessments revealed a 40% average decline in mean BDI-II scores recorded during the initial and later phases of treatment. This study has important implications for both therapists and veterans suffering from depression: A comprehensive CBT training program, when implemented in a realistic time-frame with follow-up consultation, significantly increases therapists’ ability to deliver effective treatment to depressed VA patients.

Karlin, B.E., Brown, G.K., Trockel, M., Cunning, D., Zeiss, A.M., & Taylor, C.B. (2012, July23). National dissemination of cognitive behavioral therapy for depression in the department of veteran affairs health care system: therapist and patient-level outcomes. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0029328

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