|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$7,758||Benefits minus costs||$24,288|
|Participants||$14,317||Benefit to cost ratio||$49.09|
|Others||$1,826||Chance the program will produce|
|Indirect||$892||benefits greater than the costs||100 %|
|Net program cost||($505)|
|Benefits minus cost||$24,288|
|Detailed Monetary Benefit Estimates Per Participant|
|Benefits from changes to:1||Benefits to:|
|Labor market earnings associated with major depression||$6,283||$13,836||$0||$404||$20,523|
|Health care associated with major depression||$1,475||$480||$1,826||$740||$4,522|
|Adjustment for deadweight cost of program||$0||$0||$0||($252)||($252)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$1,231||2014||Present value of net program costs (in 2016 dollars)||($505)|
|Comparison costs||$672||2008||Cost range (+ or -)||10 %|
|Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)|
|The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.|
|Meta-Analysis of Program Effects|
|Outcomes measured||Treatment age||No. of effect sizes||Treatment N||Adjusted effect sizes (ES) and standard errors (SE) used in the benefit-cost analysis||Unadjusted effect size (random effects model)|
|First time ES is estimated||Second time ES is estimated|
|Major depressive disorder||39||64||1489||-0.481||0.044||40||-0.250||0.053||42||-0.733||0.001|
Ammerman, R.T., Putnam, F.W., Altaye, M., Stevens, J., Teeters, A.R., & Van, G.J.B. (2013). A clinical trial of in-home CBT for depressed mothers in home visitation. Behavior Therapy, 44(3), 359-72.
Barnhofer, T., Crane, C., Hargus, E., Amarasinghe, M., Winder, R., & Williams, J.M. ( 2009). Mindfulness-based cognitive therapy as a treatment for chronic depression: A preliminary study. Behaviour Research and Therapy, 47(5), 366-373.
Barrera, M.J. (1979). An evaluation of a brief group therapy for depression. Journal of Consulting and Clinical Psychology, 47(2), 413-415.
Beach, S.R.H., & Daniel, K.D. O'Leary (1992). Treating depression in the context of marital discord: Outcome and predictors of response of marital therapy versus cognitive therapy. Behavior Therapy, 23(4), 507-528.
Beutler, L.E., Engle, D., Mohr, D., Daldrup, R.J., Bergan, J., Meredith, K., & Merry, W. (1991). Predictors of differential response to cognitive, experiential, and self-directed psychotherapeutic procedures. Journal of Consulting and Clinical Psychology, 59(2), 333-340.
Blackburn, I.M., Bishop, S., Glen, A.I., Whalley, L.J., & Christie, J.E. (1981). The efficacy of cognitive therapy in depression: A treatment trial using cognitive therapy and pharmacotherapy, each alone and in combination. The British Journal of Psychiatry, 139(3), 181-189.
Bockting, C.L., Schene, A.H., Spinhoven, P., Koeter, M.W., Wouters, L.F., Huyser, J., & Kamphuis, J.H. (2005). Preventing relapse/recurrence in recurrent depression with cognitive therapy: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 73(4), 647-657.
Bondolfi, G., Jermann, F., Bizzini, L., Gonzalez, C., der, L.M.V., Gex-Fabry, M., Myers-Arrazola, L., . . . Segal, Z. (2010). Depression relapse prophylaxis with Mindfulness-Based Cognitive Therapy: Replication and extension in the Swiss health care system. Journal of Affective Disorders, 122(3), 224-231.
Bowers, W.A. (1990). Treatment of depressed in-patients. Cognitive therapy plus medication, relaxation plus medication, and medication alone. The British Journal of Psychiatry, 156(1), 73-78.
Carrington, C.H. (1979). A comparison of cognitive and analytically oriented brief treatment approaches to depression in black women. Dissertation Abstracts.
Castonguay, L.G., Schut, A.J., Aikins, D.E., Constantino, M. ., Laurenceau, J.-P., Bologh, L., & Burns, D.D. (2004). Integrative cognitive therapy for depression: A preliminary investigation. Journal of Psychotherapy Integration, 14, 4-20.
Cho, H.J., Kwon, J.H., & Lee, J.J. (2008). Antenatal cognitive-behavioral therapy for prevention of postpartum depression: A pilot study. Yonsei University College of Medicine.
Comas-Diaz, L. (1981). Effects of cognitive and behavioral group treatment on the depressive symptomatology of Puerto Rican women. Journal of Consulting and Clinical Psychology, 49(5), 627-632.
Cooper, P.J., Murray, L., Wilson, A., & Romaniuk, H. (2003). Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression: 1. Impact on maternal mood. The British Journal of Psychiatry, 182(5), 412-419.
Covi, L., & Lipman, R.S. (1987). Cognitive behavioral group psychotherapy combined with imipramine in major depression. Psychopharmacology Bulletin, 23(1), 173-176.
Cullen, J.M., Spates, C.R., Pagoto, S.L., & Doran, N. (2006). Behavioral activation treatment for major depressive disorder: A pilot investigation. Behavior Analyst Today, 7(1), 151-166.
Dobkin, R.D., Menza, M., Allen, L.A., Gara, M.A., Mark, M.H., Tiu, J., Bienfait, K. L., . . . Friedman, J. (2011). Cognitive-behavioral therapy for depression in Parkinson's disease: a randomized, controlled trial. The American Journal of Psychiatry, 168(10), 1066-74.
Dozois, D.J.A., Bieling, P.J., Patelis-Siotis, I., Hoar, L., Chudzik, S., McCabe, K., & Westra, H. A. (2009). Changes in self-schema structure in cognitive therapy for major depressive disorder: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 77(6), 1078-1088.
Dunn, R.J. (1979). Cognitive modification with depression-prone psychiatric patients. Cognitive Therapy and Research, 3(3), 307-317.
Elkin, I., Shea, M.T., Watkins, J.T., Imber, S.D., Sotsky, S.M., Collins, J.F., . . . Parloff, M.B. (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program: General effectiveness of treatments. Archives of General Psychiatry, 46(11), 971-982.
Hogg, J.A., & Deffenbacher, J.L. (1988). A comparison of cognitive and interpersonal-process group therapies in the treatment of depression among college students. Journal of Counseling Psychology, 35(3), 304-310.
Hollon, S.D., DeRubeis, R.J., Evans, M.D., Wiemer, M.J., Garvey, M.J., Grove, W.M., & Tuason, V.B. (1992). Cognitive therapy and pharmacotherapy for depression: Singly and in combination. Archives of General Psychiatry, 49(10), 774-781.
Hopko, D.R., Lejuez, C.W., LePage, J.P., Hopko, S.D., & McNeil, D.W. (2003). A brief behavioral activation treatment for depression: A randomized pilot trial within an inpatient psychiatric hospital. Behavior Modification, 27(4), 458-469.
Laidlaw, K., Davidson, K., Toner, H., Jackson, G., Clark, S., Law, J., Howley, M., . . . Cross, S. (2008). A randomised controlled trial of cognitive behaviour therapy vs treatment as usual in the treatment of mild to moderate late life depression. International Journal of Geriatric Psychiatry, 23(8), 843-50.
Ma, S.H., & Teasdale, J.D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72(1), 31-40.
Macaskill, N.D., & Macaskill, A. (1996). Rational-Emotive Therapy Plus Pharmacotherapy Versus Pharmacotherapy Alone in the Treatment of High Cognitive Dysfunction Depression. Cognitive Therapy and Research, 20(6), 575-592.
Markowitz, J.C., Kocsis, J.H., Fishman, B., Spielman, L.A., Jacobsberg, L.B., Frances, A.J., Klerman, G.L., . . . Perry, S.W. (1998). Treatment of depressive symptoms in human immunodeficiency virus-positive patients. Archives of General Psychiatry, 55(5), 452-7.
McNamara, K., & Horan, J.J. (1986). Experimental construct validity in the evaluation of cognitive and behavioral treatments for depression. Journal of Counseling Psychology, 33(1), 23-30.
Miller, I.W., Norman, W.H., Keitner, G.I., Bishop, S.B., & Dow, M.G. (1989). Cognitive-behavioral treatment of depressed inpatients. Behavior Therapy, 20(1), 25-47.
Miranda, J., Chung, J.Y., Green, B. L., Krupnick, J., Siddique, J., Revicki, D.A., & Belin, T. (2003). Treating depression in predominantly low-income young minority women: A randomized controlled trial. JAMA : The Journal of the American Medical Association, 290(1), 57-65.
Mohr, D.C., Boudewyn, A.C., Goodkin, D.E., Bostrom, A., & Epstein, L. (2001). Comparative outcomes for individual cognitive-behavior therapy, supportive-expressive group psychotherapy, and sertraline for the treatment of depression in multiple sclerosis. Journal of Consulting and Clinical Psychology, 69(6), 942-949.
Murphy, G.E., Simons, A.D., Wetzel, R.D., & Lustman, P.J. (1984). Cognitive therapy and pharmacotherapy. Singly and together in the treatment of depression. Archives of General Psychiatry, 41(1), 33-41.
Murphy, G.E., Carney, R.M., Knesevich, M.A., Wetzel, R.D., & Whitworth, P. (1995). Cognitive behavior therapy, relaxation training, and tricyclic antidepressant medication in the treatment of depression. Psychological Reports, 77(2), 403-420.
Pace, T.M., & Dixon, D.N. (1993). Changes in depressive self-schemata and depressive symptoms following cognitive therapy. Journal of Counseling Psychology, 40(3), 288-294.
Propst, L.R., Ostrom, R., Watkins, P., Dean, T., & Mashburn, D. (1992). Comparative efficacy of religious and nonreligious cognitive-behavioral therapy for the treatment of clinical depression in religious individuals. Journal of Consulting and Clinical Psychology, 60(1), 94-103.
Rieu, J., Bui, E., Rouch, V., Faure, K., Birmes, P., & Schmitt, L. (2011). Efficacy of Ultrabrief Cognitive and Behavioural Therapy Performed by Psychiatric Residents on Depressed Inpatients. Psychotherapy and Psychosomatics, 80(6), 374-376.
Ross, M. & Scott, M. (1985). An evaluation of the effectiveness of individual and group cognitive therapy in the treatment of depressed patients in an inner city health centre. Journal of the Royal College of General Practitioners, 35(274), 239-242.
Rush, A.J., Beck, A.T., Kovacs, M., & Hollon, S. (1977). Comparative efficacy of cognitive therapy and pharmacotherapy in the treatment of depressed outpatients. Cognitive Therapy and Research, 1(1), 17-37.
Scott, A.I., & Freeman, C.P. (1992). Edinburgh primary care depression study: Treatment outcome, patient satisfaction, and cost after 16 weeks. British Medical Journal, 304(6831), 883-887.
Scott, M.J., & Stradling, S.G. (1990). Group cognitive therapy for depression produces clinically significant reliable change in community-based settings. Behavioural Psychotherapy, 18, 1.
Selmi, P.M., Klein, M.H., Greist, J.H., Sorrell, S.P., & Erdman, H.P. (1990). Computer-administered cognitive-behavioral therapy for depression. The American Journal of Psychiatry, 147(1), 51-56.
Shaw, B.F. (1977). Comparison of cognitive therapy and behavior therapy in the treatment of depression. Journal of Consulting and Clinical Psychology, 45(4), 543-551.
Taylor, F.G., & Marshall, W.L. (1977). Experimental analysis of a cognitive-behavioral therapy for depression. Cognitive Therapy and Research, 1(1), 59-72.
Teasdale, J.D., Fennell, M.J., Hibbert, G.A., & Amies, P.L. (1984). Cognitive therapy for major depressive disorder in primary care. The British Journal of Psychiatry, 144(4), 400-406.
Teasdale, J.D., Segal, Z.V., Williams, J.M., Ridgeway, V.A., Soulsby, J.M., & Lau, M.A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615-623.
Teichman, Y., Bar-el, Z., Shor, H., Sirota, P., & Elizur, A. (1995). A comparison of two modalities of cognitive therapy (individual and marital) in treating depression. Psychiatry, 58(2), 136-48.
Thompson, L.W., Coon, D.W., Gallagher-Thompson, D., Sommer, B.R., & Koin, D. (2001). Comparison of desipramine and cognitive/behavioral therapy in the treatment of elderly outpatients with mild-to-moderate depression. The American Journal of Geriatric Psychiatry, 9(3), 225-40.
Tovote, K.A., Fleer, J., Snippe, E., Peeters, A.C., Emmelkamp, P.M., Sanderman, R., Links, T.P., . . . Schroevers, M.J. (2014). Individual mindfulness-based cognitive therapy and cognitive behavior therapy for treating depressive symptoms in patients with diabetes: results of a randomized controlled trial. Diabetes Care, 37(9), 2427-34.
Ward, E., King, M., Lloyd, M., Bower, P., Sibbald, B., Farrelly, S., . . . Addington-Hall, J. (2000). Randomised controlled trial of non-directive counselling, cognitive behaviour therapy, and usual general practitioner care for patients with depression. I: Clinical effectiveness. British Medical Journal, 321(7273), 1383-1388.
Warren, R., McLellarn, R., & Ponzoha, C. (1988). Rational-emotive therapy vs general cognitive-behavior therapy in the treatment of low self-esteem and related emotional disturbances. Cognitive Therapy and Research, 12(1), 21-37.
Wilson, P.H., Goldin, J.C., & Charbonneau-Powis, M. (1983). Comparative efficacy of behavioral and cognitive treatments of depression. Cognitive Therapy and Research, 7(2), 111-124.
Wilson, P.H. (1982). Combined pharmacological and behavioural treatment of depression. Behaviour Research and Therapy, 20(2), 173-184.
Wright, J.H., Wright, A.S., Albano, A.M., Basco, M.R., Goldsmith, L.J., Raffield, T., & Otto, M.W. (2005). Computer-assisted cognitive therapy for depression: maintaining efficacy while reducing therapist time. The American Journal of Psychiatry, 162(6), 1158-64.