Emotion GPS: The Effectiveness of the Stepped-care model in a Mental Health Community Setting in Hong Kong

This study will investigate the effectiveness of LICBT in order to provide insights into the development and application of LICBT for mild to moderate mood disorders. Results of this study will shed light on whether LICBT could improve depression and anxiety symptoms. This study will specifically target individuals with mild to moderate depression or anxiety due to the high prevalence of these disorders in Hong Kong. Individual guided self-help service and high intensity psychoeducational groups such as low intensity cognitive behavioural therapy and psychoeducational group (Unified Protocol group therapy) will be implemented in this study to help us understand the effectiveness of the "stepped-care model" in a mental health setting. The "stepped-care model" is used to reduce the burden of high priority services such as clinical psychologists where waiting times can be long. In our current practice, we adopted the stepped-care model in treating common mental disorders such as depression and anxiety with lower intensity therapies such that patients with milder to moderate symptoms are treated with shorter waiting times, while patients with more severe symptoms are "stepped up" to be treated with more high intensity treatments. Our current study would investigate the process of stepping up clients to higher intensity therapy who show no signs of remission after a course of lower intensity therapy compared with extending the duration of the lower intensity therapy to see the effectiveness of these respective mechanisms. Individuals would first receive a course of lower intensity cognitive behavioural therapy. The depression and anxiety levels, work and social adjustment, and psychological well-being of participants will be assessed at pre-treatment, post-treatment (at the end of the last session). We would then investigate the process of stepping up clients to 1.) higher intensity group therapy or 2.) extended low intensity cognitive behavioral therapy who show no signs of remission after a course of lower intensity therapy. We would again test their depression and anxiety levels along with the other measurements and compare them to see the effectiveness of these respective mechanisms. If LICBT is shown to be effective in treating mild to moderate depression and anxiety under an effective stepped care model, this intervention can be adopted widely in the community and the waiting time for psychological treatments can be minimised. Eventually, the development of LICBT could alleviate the burden of mental health professionals and reduce costs in the healthcare system.