An expert consensus on the most effective components of cognitive behavioural therapy for adults with depression: a modified Delphi study

Taylor, A., Tallon, D., Kessler, D., Peters, T. J., Shafran, R., Williams, C. and Wiles, N. (2020) An expert consensus on the most effective components of cognitive behavioural therapy for adults with depression: a modified Delphi study. Cognitive Behaviour Therapy, 49(3), pp. 242-255. (doi: 10.1080/16506073.2019.1641146) (PMID:31429639)

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Abstract

Designing new approaches to delivering cognitive behavioural therapy (CBT) requires an understanding of the key components. This study aimed to establish an expert consensus on the effective components of CBT for depressed adults. An international panel of 120 CBT experts was invited to participate in a modified Delphi study. Thirty-two experts participated in round 1; 21 also provided data in round 2. In round 1, experts rated the effectiveness of 35 content and process components. A priori rules identified components carried forward to round 2, in which experts re-rated items and final consensus items were identified. Consensus was achieved for nine content components (ensuring understanding; developing and maintaining a good therapeutic alliance; explaining the rationale for CBT; eliciting feedback; identifying and challenging avoidant behaviour; activity monitoring; undertaking an initial assessment; relapse prevention methods; homework assignments); and three process components (ensuring therapist competence; scheduling sessions flexibly; scheduling sessions for 45–60 mins). Five of the twelve components identified were generic therapeutic competences rather than specific CBT items. There was less agreement about the effectiveness of cognitive components of CBT. This is an important first step in the development of novel approaches to delivering CBT that may increase access to treatment for patients.

Item Type:Articles
Additional Information:This study is funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research (Integrated therapist and online CBT for depression in primary care, RP- PG-0514-20012). All research at Great Ormond Street Hospital NHS Foundation Trust and UCL Great Ormond Street Institute of Child Health is made possible by the NIHR Great Ormond Street Hospital Biomedical Research Centre. This study was also supported by the NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the COGNITIVE BEHAVIOUR THERAPY 11 University of Bristol.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Williams, Professor Christopher
Authors: Taylor, A., Tallon, D., Kessler, D., Peters, T. J., Shafran, R., Williams, C., and Wiles, N.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
Journal Name:Cognitive Behaviour Therapy
Publisher:Taylor & Francis
ISSN:1650-6073
Published Online:20 August 2019

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
665291Integrated therapist and online CBT for depression in primary careChristopher WilliamsNational Institute for Health Research (NIHR)RP-PG-0514-20012IHW - MENTAL HEALTH & WELLBEING