Researchers from the University of Washington using the alcohol abuse treatment as their guidelines, have used it to successfully test a low-cost yet brief intervention to help deal with depression, which has become the No. 1 mental health problem in the United States.
Students with mild depression who received the intervention through the mail reported a 20 percent reduction in the severity of their symptoms one month later, compared with an 8 percent drop for another group that was not treated. In addition, feelings of hopelessness among the students who received the brief intervention dropped 31 percent, while those emotions only fell 7 percent for the other students.
Brief interventions have been utilized effectively in alcohol treatment for a number of years, and the concept transferred to depression, said Irene Markman Geisner, lead author of a study appearing in the current issue of the Journal of Consulting and Clinical Psychology and a psychology doctoral student at the University of Washington.
"There is a tendency to think that college students are a privileged group with no real problems. But depression is a serious concern among college students," said Mary Larimer, a study co-author and UW associate professor of psychiatry and behavior sciences. "Our counseling centers are overrun with depression, as well as other problems."
"At any given time, up to 35 percent of college students have depressed moods," said Geisner. "They are not clinically depressed, per se, but their mood clouds their academic and social lives and puts them at much greater risk for future clinical depression."
For the study, nearly 1,200 students were screened for symptoms of depression. More than 200 met the criteria for depression, and 177 were recruited and completed a more-detailed baseline assessment for depression and how they cope with it.
A week after this assessment, half of the students received the intervention that consisted of a personalized feedback letter and a brochure. The letter began with a paragraph that told the students the concerns they reported during the assessment were consistent with depression and that this is a common experience for college students. The letter then reflected the personal concerns students expressed. It also listed the various coping strategies each was already using to deal with his or her depression, and indicated that there were many things the students could do to reduce depression.
The brochure, prepared for the study, listed six types of strategies students could use - social support, pleasant activities, exercise, self-help literature, meditation and spirituality, and medication - to help relieve their depression. The brochure also gave the students examples of problem solving and how to change their thought processes. Finally, it provided a list of on- and off-campus treatment resources
The other group of students received thank-you letters for participating in the study. These letters listed common depression symptoms and provided a list of on- and off-campus telephone numbers students could call for help.
One month later, both groups were reevaluated to look at the impact of the feedback.
Geisner and Larimer said the idea of brief intervention treatment for depression needs more refinement and study but is promising, particularly because of its low cost. They estimate it cost less than $2 per person to deliver the treatment in this study. Other low-cost strategies that could be tested include weekly boosters delivered by e-mail and an Internet version of the treatment.
"The beauty of this study is that these people were not seeking help when they were sitting in a classroom, but help was brought to them," said Larimer. "People who received this brief intervention felt less hopeless and depressed, both physically and emotionally. Depression is a very costly problem and we should not wait for people to develop a more serious form of it before treatment is available."
Clayton Neighbors, a UW assistant professor of psychiatry and behavior sciences, was a co-author of the study funded by the National Institute on Alcohol Abuse and Alcoholism and the Stanley Foundation.