Date: 15 March 2017
Category: Collaborative care
I am a Cognitive Behavioural Therapist employed in a local mental health service. I deliver CBT and other psychological interventions to clients who refer themselves or are referred to us.
We see the whole range of anxiety disorders: social, health, phobia, OCD or any generalised anxiety disorder. Some people experience depression alongside this, or they may present with a standalone depression. We also see people who have experienced trauma earlier in their life and need help with the impact now.
My service was one centre in the COBRA trial. Patients were randomised to receive either CBT or behavioural activation. I provided CBT and a colleague saw the patients who were received behavioural activation.
The practicalities of establishing a new patient in the study were dealt with by the research team. My responsibility wasn’t very different from usual practice because I deliver CBT for depression as part of my job anyway. We recorded every session, with the patient's consent of course, but the face-to-face therapy was similar to our usual practice.
We usually provide patients with sixteen 50-minute sessions. For the COBRA trial, twenty such sessions were available, plus the option of four ‘booster’ sessions, which patients were keen to take up.
The COBRA trial was the first piece of research I had been involved in. It was well-organised and I really appreciated being part of it. There was always support on hand and we therapists were never left floundering with any dilemmas.
Both the CBT and the behavioural activation inputs were high-intensity treatments. The results were incredibly pleasing, supporting the hypothesis that BA was not inferior to CBT.
Now the trial is over and the evidence is being considered by NICE, I am keen to see how this will be taken forward. If NICE recommends behavioural activation in their revised guidelines, there may be a surge of demand for us to implement it – and I hope we do.
Therapist Sarah Goff talks about her involvement in the COBRA study evaluating behavioural activation for depression.
Cognitive Behavioural Therapist