Abstract：
UNASSIGNED: The authors examined whether brief cognitive-behavioral therapy (bCBT) for depression, delivered by mental health providers in community-based outpatient clinics (CBOCs) of the Veterans Health Administration, improved depression outcomes and was feasible and acceptable in clinical settings.
UNASSIGNED: The authors used a type-2 hybrid effectiveness-implementation, patient-randomized trial to compare bCBT with enhanced usual care. Participants (N=189) with moderate symptoms of depression (Patient Health Questionnaire-9 [PHQ-9] score ≥10) were enrolled from CBOCs in the southern United States. bCBT (N=109) consisted of three to six sessions, delivered by mental health providers (N=17) as part of routine clinic practices. Providers received comprehensive training and support to facilitate bCBT delivery. Recipients of enhanced usual care (N=80) were given educational materials and encouraged to discuss treatment options with their primary care provider. The primary effectiveness outcome was PHQ-9-assessed depression symptoms posttreatment (4 months after baseline) and at 8- and 12-month follow-ups. Implementation outcomes focused on bCBT dose received, provider fidelity, and satisfaction with bCBT training and support.
UNASSIGNED: bCBT improved depression symptoms (Cohen\'s d=0.55, p<0.01) relative to enhanced usual care posttreatment, and the improvement was maintained at 8- and 12-month follow-ups (p=0.004). bCBT participants received a mean±SD of 3.7±2.7 sessions (range 0-9), and 64% completed treatment (≥3 sessions). Providers delivered bCBT with fidelity and reported that bCBT training and support were feasible and effective.
UNASSIGNED: bCBT had a modest treatment footprint of approximately four sessions, was acceptable to participants and providers, was feasible for delivery in CBOCs, and produced meaningful sustained improvements in depression.
UNASSIGNED: The authors used a type-2 hybrid effectiveness-implementation, patient-randomized trial to compare bCBT with enhanced usual care. Participants (N=189) with moderate symptoms of depression (Patient Health Questionnaire-9 [PHQ-9] score ≥10) were enrolled from CBOCs in the southern United States. bCBT (N=109) consisted of three to six sessions, delivered by mental health providers (N=17) as part of routine clinic practices. Providers received comprehensive training and support to facilitate bCBT delivery. Recipients of enhanced usual care (N=80) were given educational materials and encouraged to discuss treatment options with their primary care provider. The primary effectiveness outcome was PHQ-9-assessed depression symptoms posttreatment (4 months after baseline) and at 8- and 12-month follow-ups. Implementation outcomes focused on bCBT dose received, provider fidelity, and satisfaction with bCBT training and support.
UNASSIGNED: bCBT improved depression symptoms (Cohen\'s d=0.55, p<0.01) relative to enhanced usual care posttreatment, and the improvement was maintained at 8- and 12-month follow-ups (p=0.004). bCBT participants received a mean±SD of 3.7±2.7 sessions (range 0-9), and 64% completed treatment (≥3 sessions). Providers delivered bCBT with fidelity and reported that bCBT training and support were feasible and effective.
UNASSIGNED: bCBT had a modest treatment footprint of approximately four sessions, was acceptable to participants and providers, was feasible for delivery in CBOCs, and produced meaningful sustained improvements in depression.
摘要：
■作者研究了抑郁症的简短认知行为疗法（bCBT）由退伍军人健康管理局社区门诊诊所（CBOCs）的精神卫生提供者提供，改善抑郁结局,在临床环境中是可行和可接受的.
■作者使用了2型混合有效性-实现，患者随机试验比较bCBT与强化常规护理。来自美国南部CBOCs的中度抑郁症状（患者健康问卷-9[PHQ-9]评分≥10）的参与者（N=189）。bCBT(N=109)包括三到六次会议，由精神卫生提供者(N=17)作为常规诊所实践的一部分提供。提供商接受了全面的培训和支持，以促进bCBT交付。接受强化常规护理（N=80）的患者接受了教育材料，并鼓励他们与初级保健提供者讨论治疗方案。主要有效性结果是治疗后（基线后4个月）以及8个月和12个月随访时的PHQ-9评估的抑郁症状。实施成果侧重于收到的bCBT剂量，提供者保真度，以及对bCBT培训和支持的满意度。
■bCBT改善了抑郁症状（Cohen'sd=0.55，p<0.01），并且在8个月和12个月的随访中保持了改善（p=0.04）。bCBT参与者平均±SD为3.7±2.7次（范围0-9），64%完成治疗(≥3次)。提供商向bCBT提供了保真度，并报告说bCBT培训和支持是可行和有效的。
■bCBT的治疗足迹适中，约为四个疗程，参与者和提供者都可以接受，在社区门诊诊所分娩是可行的，并对抑郁症产生了有意义的持续改善。
■作者使用了2型混合有效性-实现，患者随机试验比较bCBT与强化常规护理。来自美国南部CBOCs的中度抑郁症状（患者健康问卷-9[PHQ-9]评分≥10）的参与者（N=189）。bCBT(N=109)包括三到六次会议，由精神卫生提供者(N=17)作为常规诊所实践的一部分提供。提供商接受了全面的培训和支持，以促进bCBT交付。接受强化常规护理（N=80）的患者接受了教育材料，并鼓励他们与初级保健提供者讨论治疗方案。主要有效性结果是治疗后（基线后4个月）以及8个月和12个月随访时的PHQ-9评估的抑郁症状。实施成果侧重于收到的bCBT剂量，提供者保真度，以及对bCBT培训和支持的满意度。
■bCBT改善了抑郁症状（Cohen'sd=0.55，p<0.01），并且在8个月和12个月的随访中保持了改善（p=0.04）。bCBT参与者平均±SD为3.7±2.7次（范围0-9），64%完成治疗(≥3次)。提供商向bCBT提供了保真度，并报告说bCBT培训和支持是可行和有效的。
■bCBT的治疗足迹适中，约为四个疗程，参与者和提供者都可以接受，在社区门诊诊所分娩是可行的，并对抑郁症产生了有意义的持续改善。
