(PS3-A24) Group Therapy for Depression: Assessing Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy for Depression (CBT-D) in an Intensive Outpatient Sample

Background: The efficacy of group therapies aimed at treating adults with depression should be re-examined in light of two recent, COVID-19 related phenomena: the rise of teletherapy and an increase in adults experiencing acute depression. Previous studies investigating the efficacy of ACT and CBT group therapies indicate that they are similarly effective in treating depression (Samaan et al., 2019), however others suggest that ACT is more effective in treating acute symptoms (Losada et al., 2015; Karami et al., 2018). Recent studies have produced mixed results regarding the effectiveness of teletherapy vs. in-person treatment delivery modes (Puspitasari et al., 2021; Heckman et al., 2021). Few studies have investigated the efficacy of  CBT and ACT group therapies for a diagnostically diverse adult population in an intensive outpatient program (IOP), and none have examined teletherapy as a delivery mode of these treatments for this population. This study aims to investigate the effect of treatment type (ACT or CBT-D) and delivery mode (in-person or teletherapy) on depression symptoms in adults receiving intensive treatment for severe symptomology.

Methods: Patients included 265 adults (M age= 30.47, SD=9.175; 51.9% female; 87% White) enrolled in an intensive outpatient (IOP) treatment at the Columbia University Irving Medical Center Day Treatment Program. Patients received one of two group treatments: ACT (N=67) or CBT-D (N=198). Treatment delivery mode was mixed within these groups (in-person N=58, teletherapy N=207). Depression symptoms were assessed at session 1 (pre-treatment) and session 8 (post-treatment) using the PHQ-9.

Results: A repeated measures ANOVA was performed to examine effects of delivery mode and treatment type on pre- and post-treatment depression scores. While the data did demonstrate a significant difference between pre- and post-treatment mean depression scores (F(1,155)=49.93, p< .00; M pre-treatment =20.95, M post-treatment=16.46), mean scores were not significantly affected by treatment type (F(1,155)=1.32, p=.25) or treatment delivery mode (F(1,155)=.92, p=.34).

Discussion: This study indicates that ACT and CBT-D, regardless of whether treatment is delivered in-person or through teletherapy, are similarly effective group treatments for depression in an acute, adult IOP sample. Future studies should explore whether other factors, such as group cohesion, may explain or alter treatment outcomes. Identification of modifiable factors will inform treatment decisions and protocols in IOP settings.