COBRA

In the study, the team directly compared CBT with BA, allocating the 440 research participants by chance to receive either BA or CBT, to see if people receiving BA were no worse off than those treated with CBT. The team also analysed cost-effectiveness – the differences in the costs of both treatments related to their effectiveness – and interviewed participants and therapists for their views on treatment.

The team found that the people in both groups improved. They found that at 6, 12 and 18 months after people were allocated to either treatment, those receiving BA were not worse off in terms of symptoms of depression than those receiving CBT, as measured by any questionnaires that were used. They also found that the total costs of health and social care were lower for people treated with BA and that it was more likely that BA was cost-effective compared with CBT. Patients and therapists identified some challenges receiving and delivering treatment but found BA and CBT to be acceptable overall.

In conclusion, this trial showed that BA is a clinically effective and cost-effective alternative psychological therapy to CBT for the treatment of patients with depression.

Read the study report

Read the Lancet paper