Kellett Stephen, Simmonds-Buckley Mel, Bliss Paul, Waller Glenn
Centre for Psychological Services Research,University of Sheffield,UKandSheffield Health and Social Care NHS Foundation Trust,UK.
University of Sheffield,UK.
Behav Cogn Psychother. 2017 Jul;45(4):401-418. doi: 10.1017/S1352465816000540. Epub 2017 Mar 13.
The evidence base for behavioural activation (BA) is mainly grounded in the individual delivery method, with much less known about the impact of group delivery.
To conduct a pilot study of behavioural activation in groups (BAG) for depression delivered in a routine service setting, in order to explore acceptability, effectiveness and predictors of outcome.
The manualized group treatment format was delivered in a Primary Care mental health setting, at step three of an Improving Access to Psychological Therapies (IAPT) service. BAG was facilitated by cognitive behavioural psychotherapists, and outcome measures (depression, anxiety and functional impairment) were taken at each session. Seventy-three participants were referred and treated within nine groups.
BAG was an acceptable treatment generating a low drop-out rate (7%). Significant pre-post differences were found across all measures. There was a moderate to large depression effect size (d + = 0.74), and 20% met the criteria for a reliable recovery in depression. Greater severity of initial depression and attendance of at least four BAG sessions predicted better outcomes.
BAG appears to be an effective depression treatment option that shows some clinical promise. Further larger and more controlled studies are nevertheless required.
行为激活（BA）的证据基础主要基于个体治疗方式，对于团体治疗的影响了解较少。
在常规服务环境中对团体行为激活（BAG）治疗抑郁症进行一项试点研究，以探索其可接受性、有效性及结果预测因素。
在改善心理治疗可及性（IAPT）服务的第三步，即在初级保健心理健康环境中采用手册化的团体治疗形式。BAG由认知行为心理治疗师实施，每次治疗时进行结果测量（抑郁、焦虑和功能损害）。73名参与者被转介并分入9个治疗组接受治疗。
BAG是一种可接受的治疗方法，脱落率较低（7%）。所有测量指标在治疗前后均有显著差异。抑郁效应量为中度至较大（d += 0.74），20%的参与者达到了抑郁症可靠康复的标准。初始抑郁程度较重且至少参加四次BAG治疗的参与者预后较好。
BAG似乎是一种有效的抑郁症治疗选择，显示出一定的临床前景。然而，仍需要进一步开展更大规模、更具对照性的研究。
