The Yomiuri Shimbun A study by the health ministry has shown that cognitive behavioral therapy (CBT) is nearly as effective when administered by experienced nurses or nonphysician psychotherapists as it is when given by doctors.
CBT is considered effective for the treatment of psychological disorders such as depression. It relies on a psychotherapeutic approach using counseling to modify a patient’s way of thinking and behavioral idiosyncrasies that are believed to induce excessive stress.
Currently, under the national health insurance program, medical institutions cannot receive reimbursement for CBT treatment unless it is administered by a doctor for at least 30 minutes. Because of such limitations, CBT has not been widely practiced, prompting calls for expanding reliance on the skills of practitioners other than doctors.
For the study by the Health, Labor and Welfare Ministry, a research team divided 36 patients into two groups. Each patient was suffering from moderate to severe depression even after receiving medical treatment such as antidepressants for at least two months.
Of them, 14 patients were given CBT combined with drug treatment by doctors, while the other 22 were administered CBT and drug therapy by a nurse and a psychologist. The nurse and psychologist had 10 to 16 years clinical experience and had handled 17 to 25 cases using CBT.
On a scale of 27, the severity level of the two groups’ depression was about equal, around 14 on average, at the start of the examination.
Both groups received 50 minutes of CBT each week over a 16-week period, after which the severity levels of their cases were reevaluated and compared. The level of the group treated by doctors declined to 7.2, while that of the group treated by a nurse and psychologist fell to 9. Both final figures are considered mild depression, and the outcomes were judged nearly equal in statistical terms, according to the study team.
“To promote wider use of CBT, we must urgenty study the possibility of utilizing experienced nurses and psychologists. It’s also essential to build a framework for training and fostering manpower,” said Yutaka Ono, head of the National Center for Cognitive Behavior Therapy and Research at the National Center of Neurology and Psychiatry.
