Using the Transtheoretical Model / Stages of Change Model to Prevent Depression

Image Source: Leesque, D. A., Van Marter, D. F., Schneider, R. J., Bauer, M. R., Goldberg, D. N., Prochaska, J. O., & Prochaska, J. M. (2011). Randomized Trial of a Computer-Tailored Intervention for Patients With Depression. American Journal Of Health Promotion, 26(2), 77-89.

Leesque and colleagues recently applied the Transtheoretical Model to treating depression in a way that used both the computer and a workbook. According to the article, 5% of people in the United States struggle with depression, which is not only a terrible thing to have to fight on its own, but is also a risk factor for various other diseases, such as type 2 diabetes and cardiovascular disease. Depression is also responsible for loss of productivity due to people missing work because of their depression. Even though depression is related to so many negative outcomes, only 15%-30% of patients receive adequate care. There is definitely a treatment gap that needs to be addressed.

This study aimed fill in some of that gap by targeting the population of people who are not ideal candidates for traditional treatment due to either not being receptive to traditional treatment or not displaying symptoms strong enough to warrant traditional treatment. The intervention was home based. Participants were first separated into stages depending on if they were engaging in behaviors found to prevent depression, such as daily exercise or stress management, or when, if ever, they were planning on beginning to engage in these behaviors. Based on their responses to a series of questions, participants in the intervention group were presented with their stage and also with an individualized report which told them their stage-matched options for change. They also received a stage-matched workbook designed to bring them into the next stage.

As demonstrated by the table, the intervention was successful in reducing scores according to the Beck Depression inventory and increasing physical functioning. It was not as successful in bringing people into the next stage of change.

While the intervention was not so successful in bringing people into the next stage, using a stage-matched workbook did manage to decrease depressive symptoms and increase physical functioning, which is spectacular. Using this method to treat depression in patients who either can't afford treatment or who aren't responsive to regular treatment could definitely be a great way to address the treatment gap. So many people who are depressed don't receive treatment, and this could be an inexpensive way to address that. This intervention could also help to prevent depression in people who are more vulnerable to depression, such as those who have been depressed in the past or who have risk factors for depression. By giving them a workbook based on the managing stage, the arrival of symptoms could be reduced.

I feel like this is a very promising style of intervention, and even if it doesn't actually bring people into the next stage of change, if it is able to decrease depressive symptoms through matching the intervention to the stage that a person is in, then it does deserve to be further examined.