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<p>Depression was already a leading cause of disability worldwide before the COVID-19 pandemic. In 2020, global estimates suggested 3153 cases of major depressive disorder per 100,000 people, deepening the gap between treatment demand and available resources. Blended therapy, which combines face-to-face sessions with online Cognitive Behavioral Therapy (CBT) modules, may help address this gap by shortening treatment while maintaining effectiveness. This study examines symptom change and the client’s perspective on therapeutic progress during blended CBT for depression. Using a single-case study, we analyzed a case of a client treated in primary care. Symptoms of depression, anxiety, and general mental health were monitored throughout therapy and at follow-up, while perceived changes were assessed using the Change Interview. Results showed a clinically significant reduction in depressive symptoms (PHQ-9: from 16 to 6) and anxiety symptoms (GAD-7: from 14 to 5), with improvements maintained at follow-ups (16, 26 and 52 weeks). The client attributed these changes to the blended therapy process, reporting that online modules complemented face-to-face sessions and supported continued progress during the pandemic. This study contributes to the growing evidence on blended CBT by highlighting how clients experience change and by demonstrating its potential utility in resource-limited contexts.</p>

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What Works in Blended Therapy? A Client Change Perspective in CBT Blended Therapy Intervention for Depression in Primary Care

  • 期刊论文

  • 发表日期：

    2025年12月2日

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  • Sara Silva,
  • Nuno Magalhães,
  • João Salgado,
  • Carla Cunha

摘要

Depression was already a leading cause of disability worldwide before the COVID-19 pandemic. In 2020, global estimates suggested 3153 cases of major depressive disorder per 100,000 people, deepening the gap between treatment demand and available resources. Blended therapy, which combines face-to-face sessions with online Cognitive Behavioral Therapy (CBT) modules, may help address this gap by shortening treatment while maintaining effectiveness. This study examines symptom change and the client’s perspective on therapeutic progress during blended CBT for depression. Using a single-case study, we analyzed a case of a client treated in primary care. Symptoms of depression, anxiety, and general mental health were monitored throughout therapy and at follow-up, while perceived changes were assessed using the Change Interview. Results showed a clinically significant reduction in depressive symptoms (PHQ-9: from 16 to 6) and anxiety symptoms (GAD-7: from 14 to 5), with improvements maintained at follow-ups (16, 26 and 52 weeks). The client attributed these changes to the blended therapy process, reporting that online modules complemented face-to-face sessions and supported continued progress during the pandemic. This study contributes to the growing evidence on blended CBT by highlighting how clients experience change and by demonstrating its potential utility in resource-limited contexts.