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Keywords:

  • cognitive behavioural therapy;
  • depression;
  • hope;
  • hopelessness;
  • psychiatric rehabilitation

Accessible summary

  • A combination of individual cognitive behavioural therapy and of psychiatric rehabilitation is more effective in reducing hopelessness than group cognitive behavioural therapy combined with psychiatric rehabilitation or psychiatric rehabilitation only.
  • Hopelessness is a cardinal symptom of depression and one of the main risk factors for suicide. Reduction of hopelessness under nine on the Beck Hopelessness Scale reduces the risk of suicide in depressed patients. In this study, the mean scores on the Beck Hopelessness Scale decreased in all groups under nine.
  • Psychiatric rehabilitation with individual cognitive behavioural therapy for depressed patients suffering from hopelessness can be delivered effectively by an interdisciplinary team including advanced psychiatric nurses.

Abstract

The aim of this study is to evaluate the effects of individual and group cognitive behavioural therapy (CBT) and of psychiatric rehabilitation (PR) on hopelessness for depressed patients in a rehabilitation setting. Three groups of patients who underwent PR were allocated to individual CBT combined with PR (n = 43), group CBT combined with PR (n = 52) or PR only (n = 22). Hopelessness was assessed by the Beck Hopelessness Scale (BHS). The majority of the patients (68.4%) suffered from moderate to severe hopelessness before treatment (score ≥ 9–20). Results showed that the pretest mean score on the BHS decreased from 11. 57 (SD = 5.58) to 7.46 (SD = 5.20) at posttest. The mean scores on the BHS decreased in all groups under nine. The combination of individual CBT and PR was significantly more effective in reducing hopelessness than group CBT with PR or PR only. Group CBT combined with PR was not significantly more effective than PR only. It is concluded that individual CBT combined with PR is more effective in alleviating hopelessness among depressed patients than group CBT with PR or PR only. CBT can be delivered by an interdisciplinary team including advanced psychiatric nurses.