Date Added: 14/09/2017

Date Updated: 14/09/2017

Behavioural activation versus cognitive behavioural therapy for depression

Stage of development: Investigational - phase III

Stage of EAA: Assessment Complete

Description, patients and keywords:

The included available evidence, limited to one randomised controlled trial, suggests that BA may be no worse than CBT for the treatment of clinically diagnosed major depressive disorder, often referred to simply as depression. This finding is likely to be attractive to policymakers, given that BA is a low intensity therapy that may be delivered by junior mental health workers and could potentially streamline access to timely treatment for depression by removing bottlenecks that exist in current clinical practice pathways. CBT, by contrast, is intensive and more expensive, requiring the training of expert psychotherapy practitioners. The trial that found BA to be no worse than full CBT is not without limitations, however, and a one-trial evidence base for BA, as it may be applied in contemporary clinical practice, versus CBT is small in comparison to the plethora of trial data confirming the effectiveness of CBT versus a range of comparators to treat depression. The early results directly comparing BA and CBT are encouraging, but careful evaluation of further data is likely to be warranted.

HealthPACT recommends that behavioural activation should be embedded as an essential component of general practice in conjunction with the appropriate use of medications.