Research Reports - Comparison of cognitive behavioral therapy and supportive psychotherapy for the treatment of depression following traumatic brain injury

J Head Trauma Rehabil. 2014 Nov-Dec;29(6):467-78

Ashman T(1), Cantor JB, Tsaousides T, Spielman L, Gordon W

OBJECTIVE: To determine the efficacy of 2 different interventions (cognitive
behavioral therapy [CBT] and supportive psychotherapy [SPT]) to treat
post-traumatic brain injury (TBI) depression.
PARTICIPANTS: A sample of 77 community-dwelling individuals with a TBI, and a
diagnosis of depression. Participants were randomized into treatment conditions
either CBT or SPT and received up to 16 sessions of individual psychotherapy.
MEASURES: Participants completed the Structured Clinical Interview for DSM-IV and
self-report measures of depression (Beck Depression Inventory-Second Edition),
anxiety (State-Trait Anxiety Inventory), perceived social support (Interpersonal
Support Evaluation List), stressful life events (Life Experiences Survey), and
quality of life (QOL) before beginning and immediately following treatment.
RESULTS: No significant differences were found at baseline between CBT and SPT
groups on demographic factors (sex, age, education, race, and time since injury)
or baseline measures of depression, anxiety, participation, perceived social
support, stressful life events, or QOL. Analyses of variance revealed significant
time effects for the Beck Depression Inventory-Second Edition, State-Trait
Anxiety Inventory, and QOL outcome measures but no group effects.
Intention-to-treat mixed effects analyses did not find any significant difference
in patterns of scores of the outcome measures between the CBT and SPT
intervention groups.
CONCLUSIONS: Both forms of psychotherapy were efficacious in improving diagnoses
of depression and anxiety and reducing depressive symptoms. These findings
suggest that in this sample of individuals with TBI, CBT was not more effective
in treating depression than SPT, though further research is needed with larger
sample sizes to identify different components of these interventions that may be
effective with different TBI populations.

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