Group treatments for depression: A comparison of cognitive-behavioral and mutual support interventions

In view of the increasing utilization of cognitive behavioral and mutual support therapy by community-based programs, the relative effectiveness of professional and paraprofessional therapists in providing both types of treatment was examined. Depressed outpatients (N = 98) were randomly assigned to either a cognitive behavioral or mutual support group led by either a pair of professional or paraprofessional therapists. Clinically significant improvement was demonstrated for all conditions. However, greater percentages of patients in the professionally led cognitive behavioral groups were classified as "nondepressed" and "alleviated" at treatment termination as compared to those in the paraprofessionally led cognitive behavioural groups. Conversely, a larger percentage of patients in the paraprofessionally led mutual support groups were classified as "nondepressed" and "alleviated" at treatment termination as compared to those in the professionally led mutual support groups. Further analyses suggested that nonprofessionals were considerably less effective in the cognitive behavioral groups as compared to the mutual support condition. Additionally, adequacy of therapy delivery and receipt were associated with improvement in depressive symptomatology as rated by independent clinicians.