Inpatient behavioural therapy program for depression: a first effect measurement
Background: Behavioural activation is more and more seen as an independent therapy for depression, because of its feasibility and effectiveness. The Dutch Guideline Depression recommends behavioural therapeutic interventions during (clinical) treatment for depression.
Objective: To present the design of a 12-day clinical and integrated, multimodal treatment program based on intensive behavioural activation for depression. Furthermore, to examine the effect of the program on the level of depressive symptoms, total psychological symptoms and vitality over time, and to evaluate the efficacy of the programme in treating therapy-resistant cases.
Methods: A retrospective analysis of files of patients who participated in the program between 2019 and 2022. To examine the change over time (time + time2) of perceived depressive symptoms (Beck Depression Inventory, BDI), total psychological complaints and vitality (Symptom Questionnaire – 48), linear mixed model analyses were conducted.
Results: Out of 107 patients, 54 retrospectively provided informed consent. Eventually, we included the data of 50 patients for this study. The results revealed a significant reduction in depressive symptoms and overall psychological symptoms over time, which receded slightly at follow-up. The adjusted mean BDI score decreased from 32.96 at the start of the clinical programme to 28.96 upon completion and to 28.20 one to three months later. No significant time effect was observed for vitality. Furthermore, there was no interaction effect of therapy resistance*time on treatment effect.
Conclusions: Intensive behavioural activation in a multimodal program, including involving significant others, meaning-making, values and physical activation, seems to have the potential to break the vicious circle of major depressive symptoms, making it possible to continue treatment on an outpatient basis. However, the limitations of this study call for replication of the aims in further research with a larger sample and inclusion of context factors.