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Research and Projects

Evaluating Stepped Care for Depression

Who is involved?

Theme: CLAHRC - Mental Health & Dementia
Status: Complete


NICE recommend that further research is needed to address the issues of efficacy, efficiency and acceptability of stepped care for depression by using the Stepped Care model. These systems aim to streamline the processes of treating individuals with depression by providing less intense interventions to patients in the first instance, before stepping patients up to more intensive treatments if required.

The available evidence is sparse and conflates stepped care within complex systems of case management and consultation-liaison in health systems which differ significantly from the UK (Chile, US, Netherlands), in specialist populations (e.g. older people, patients with concurrent diabetes) and include little high-intensity psychological treatment.

Aims and objectives

The overall aim of the project was to develop, refine and test stepped care psychological therapy for depression. The objectives of the project were:

  • To write a report and publication based on information extracted from protocols from primary studies of Stepped Care and component interventions.
  • To consult with national and international experts and service users and collate accepted protocols into a report.
  • To develop protocols for supervision and training of experts and identify measures for adherence and competence.
  • To identify a second base for the research.
  • To design the study and programme strategy.
  • To submit a grant application for the trial.

Current position

The final report has now been completed and provides a review of the data on stepped care for depression including satisfaction, acceptability, feasibility, adherence, clinical and cost effectiveness and the relationship between clinical outcomes, patient and treatment characteristics.

A paper has recently been published on the study protocol.

Others Involved

Other staff in the Mood Disorders Centre.