COGNITIVE-BEHAVIORAL THERAPY FOR DEPRESSION IN LOW-INCOME AND MINORITY MEDICAL OUTPATIENTS - DESCRIPTION OF A PROGRAM AND EXPLORATORY ANALYSES

This article describes the treatment of depression in low-income and ethnic minority medical outpatients with cognitive-behavioral therapy and also reports on preliminary analyses of effectiveness as well as predictors of treatment outcome and dropout. One hundred and seventy-five patients were treated and showed significant pre- to posttreatment reductions in Beck Depression Inventory scores but not to the same extent as results reported in the treatment outcome literature. Patients with the poorest outcome were those with initially high symptoms of depression and not living with spouses/partners. Dropout was most likely in patients who were younger, minority, and treated with group therapy. Clinic procedures designed to reduce traditional barriers to mental health service utilization encountered by ethnic minorities resulted in 14% of referrals coming to one session of evaluation, 29% starting therapy, and 12% completing treatment, for a total service utilization rate of 55%.