Effectiveness of Supplementary Cognitive Behaviour Therapy for Depression: Research Proposal

Running head: RESEARCH PROPOSAL
Research proposal
Name of the student:
Name of the University:
Author’s note:

Introduction:
Depressive disorder is a mental health condition associated with persistent feelings of
low mood, loss of interest in activities, sadness and reduced interest in daily life activities.
Pharmacotherapy is one of the first line of treatment for depression. However, use of anti
depressive treatment is associated with many challenges for clinicians because of
controversies related to efficacy of many anti hypertensive drugs (Popa-Velea et al. 2015). In
case of elderly people, depression is associated with many overlapping symptoms because of
co-morbid illness. Hence, aging related changes in pharmacokinetics and pharmacodynamics
also brings unique challenges in treatment because of the need to adjust dosing and
monitoring requirements for patient after initiation of pharmacological treatment (Rojas-
Fernandez and Mikhail 2012). Current evidence suggests use of cognitive behavioural
therapy as an effective treatment option for patients who do not respond to pharmacotherapy.
It is a skill based intervention that teaches patient to manage their mood and achieve long
term benefit even after discontinuation of therapy (Nielsen 2015). However, the cost
effectiveness of CBT has not been established because of problems related to methodological
limitation in past studies conducted regarding the efficacy of the strategy. In response to these
inconsistencies in research outcome, the main purpose of this research proposal is to
determine whether supplementary CBT is more effective than pharmacotherapy alone for
treatment of depression. The research proposal looks at past research done on the topic to find
answers that are yet to be answered and develops appropriate research methodology to gain
answer to the research question.

Background:
The review of research literature reveals several gap in research literature related to
the effectiveness of supplementary CBT as a treatment option for people with depression in
comparison to pharmacotherapy. Wiles et al. (2016) argues that CBT has not been widely
implemented as a treatment option for people with depression despite advancement of
psychological service because it is limited only for those people who do not respond well to
anti depressive medications. Wiles et al. (2016) investigated about the cost effectiveness of
CBT compared to usual treatment in addressing depressive symptoms and improving quality
of life. By the use of randomized controlled trial, the study revealed CBT as a useful
replacement compared to usual care for treatment of patients with long term depression. The
study also revealed effectiveness of CBT in preventing remission of symptoms in the future.
The significance of the study was that it evaluated long term effectiveness of the therapy too.
However, one limitation of the research design was collection of long term follow up data
using postal questionnaire instead of face to face questionnaire which limited the validity of
long term clinical outcomes. Direct interview and survey with patient might have helped to
gain more knowledge related to the barriers faced in using CBT as a treatment choices. The
mode of implementation of the therapy also needs to be considered as Mohr et al. (2012)
revealed that providing CBT over the telephone or face-to-face interaction provides
equivalent improvement in depression. However, in case of telephone based CBT, treatment
adherence comes at the cost poor maintenance after treatment cessation.
Research has also been done on smart phone CBT as an alternative treatment option
for depression. Mantani et al. (2017) conducted such study because of ineffectiveness of
antidepressants as a treatment option for patients with depression. By the use of randomized
controlled trial method, the study used an app to implement CBT and encourage participants
to switch to the app in the smart phone. The control group received only antidepressant