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Self-management support system eases chronic depression

Teaching patients behavior-based coping skills helped symptom management better than traditional care for depression.

By Stephen Feller

SEATTLE, Aug. 31 (UPI) -- A test program pairing self-management techniques with traditional care helped chronic depression patients cope with their symptoms and live "a life worth living" better than therapy or pharmaceuticals alone, according to a new study by researchers in Seattle.

The program added a behavioral and self-management aspect to standard depression treatment methods, finding more it to be more effective -- at least partially because many depression patients have had experiences seeking treatment that offered no help.

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"What makes this program unique is that it combines a traditional mental health model aiming to reduce symptoms with a recovery model focused on achieving life goals despite symptoms," Dr. Evette J. Ludman, a research associate at Group Health Research Institute, said in a press release.

The researchers worked with 300 patients at five clinics in Seattle randomly assigning them to traditional care -- psychotherapy, medication, both or neither -- or to care that included traditional treatment, as well as self-management aspects.

The additional treatment continued for 18 months, and included depression self-management training, recovery coaching in person and via phone and care coordination. Participants in this group also had access to mental health services in a structured group therapy program based on cognitive behavioral therapy and behavioral activation training.

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Researchers found that at 6-, 12- and 18-month intervals, the patients who received the self-management training with traditional care displayed less severe symptoms and had less chance of major depression.

"The care managers, peer specialists and group program focused on coaching participants to achieve self-care goals and larger life goals for a 'life worth living,'" Ludman said. "They emphasized that recovery is possible -- while acknowledging that the participants had had disappointing experiences with treatment. The intervention had to remain flexible and geared to individual goals, because people with chronic depression have such varied experiences."

The study is published in Psychiatric Services.

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