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The comparative effectiveness and efficiency of cognitive behaviour therapy and generic counselling in the treatment of depression: evidence from the 2nd UK National Audit of psychological therapies

Overview of attention for article published in BMC Psychiatry, June 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#8 of 3,511)
  • High Attention Score compared to outputs of the same age (99th percentile)

Mentioned by

news
4 news outlets
blogs
1 blog
twitter
388 tweeters
facebook
7 Facebook pages
googleplus
1 Google+ user

Citations

dimensions_citation
27 Dimensions

Readers on

mendeley
113 Mendeley
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Title
The comparative effectiveness and efficiency of cognitive behaviour therapy and generic counselling in the treatment of depression: evidence from the 2nd UK National Audit of psychological therapies
Published in
BMC Psychiatry, June 2017
DOI 10.1186/s12888-017-1370-7
Pubmed ID
Authors

Jo Pybis, David Saxon, Andy Hill, Michael Barkham

Abstract

Cognitive Behaviour Therapy (CBT) is the front-line psychological intervention for step 3 within UK psychological therapy services. Counselling is recommended only when other interventions have failed and its effectiveness has been questioned. A secondary data analysis was conducted of data collected from 33,243 patients across 103 Improving Access to Psychological Therapies (IAPT) services as part of the second round of the National Audit of Psychological Therapies (NAPT). Initial analysis considered levels of pre-post therapy effect sizes (ESs) and reliable improvement (RI) and reliable and clinically significant improvement (RCSI). Multilevel modelling was used to model predictors of outcome, namely patient pre-post change on PHQ-9 scores at last therapy session. Counselling received more referrals from patients experiencing moderate to severe depression than CBT. For patients scoring above the clinical cut-off on the PHQ-9 at intake, the pre-post ES (95% CI) for CBT was 1.59 (1.58, 1.62) with 46.6% making RCSI criteria and for counselling the pre-post ES was 1.55 (1.52, 1.59) with 44.3% of patients meeting RCSI criteria. Multilevel modelling revealed a significant site effect of 1.8%, while therapy type was not a predictor of outcome. A significant interaction was found between the number of sessions attended and therapy type, with patients attending fewer sessions on average for counselling [M = 7.5 (5.54) sessions and a median (IQR) of 6 (3-10)] than CBT [M = 8.9 (6.34) sessions and a median (IQR) of 7 (4-12)]. Only where patients had 18 or 20 sessions was CBT significantly more effective than counselling, with recovery rates (95% CIs) of 62.2% (57.1, 66.9) and 62.4% (56.5, 68.0) respectively, compared with 44.4% (32.7, 56.6) and 42.6% (30.0, 55.9) for counselling. Counselling was significantly more effective at two sessions with a recovery rate of 34.9% (31.9, 37.9) compared with 22.2% (20.5, 24.0) for CBT. Outcomes for counselling and CBT in the treatment of depression were comparable. Research efforts should focus on factors other than therapy type that may influence outcomes, namely the inherent variability between services, and adopt multilevel modelling as the given analytic approach in order to capture the naturally nested nature of the implementation and delivery of psychological therapies. It is of concern that half of all patients, regardless of type of intervention, did not show reliable improvement.

Twitter Demographics

The data shown below were collected from the profiles of 388 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 113 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 113 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 20 18%
Student > Bachelor 16 14%
Researcher 14 12%
Student > Ph. D. Student 11 10%
Student > Postgraduate 9 8%
Other 25 22%
Unknown 18 16%
Readers by discipline Count As %
Psychology 55 49%
Medicine and Dentistry 12 11%
Nursing and Health Professions 6 5%
Agricultural and Biological Sciences 5 4%
Social Sciences 5 4%
Other 5 4%
Unknown 25 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 337. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 May 2020.
All research outputs
#44,412
of 15,640,100 outputs
Outputs from BMC Psychiatry
#8
of 3,511 outputs
Outputs of similar age
#1,734
of 271,945 outputs
Outputs of similar age from BMC Psychiatry
#1
of 1 outputs
Altmetric has tracked 15,640,100 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,511 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.3. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 271,945 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them