Addressing Depression and Comorbid Health Conditions through Solution-Focused Brief Therapy in an Integrated Care Setting: A Randomized Clinical Trial

Abstract Background: Co-occurring physical and mental health conditions are common, but effective and sustainable interventions are needed for primary care settings. Purpose: Our paper analyzes the effectiveness of a Solution-Focused Brief Therapy (SFBT) Intervention for treating depression and co-occurring health conditions in primary care. Methods: A Randomized Clinical Trial was conducted at a rural federally qualified health center. Eligible participants scored ≥10 on the Patient Health Questionnaire (PHQ-9) and met criteria for co-occurring health conditions (hypertension, obesity, diabetes) evidenced by chart review. SFBT participants (n=40) received three SFBT interventions over three weeks in addition to treatment as usual (TAU). The control group (n=40) received TAU over three weeks. Measures included depression (PHQ-9) and anxiety (GAD-7), well-being (Human Flourishing Index), and SFBT scores, along with physical health outcomes. Results: Of 80 consented participants, 69 completed all measures and were included in the final analysis. 80% identified as female and the mean age was 38.1 (SD 14.5). Most participants were White (72%) followed by Hispanic (15%) and Black (13%). When compared to TAU, SFBI participants had significant reductions in depression (baseline: M=18.17, SD=3.97, outcome: (M=9.71, SD=3.71) and anxiety (baseline: M=14.69, SD=4.9, outcome: M=8.43, SD= 3.79). SFBI participants also had significantly increased flourishing scores (baseline: M=58.37, SD= 16.36, outcome: M=73.43, SD= 14.70) when compared to TAU. Changes in BMI and blood pressure were not statistically significant. Conclusions: SFBI demonstrated efficacy in reducing depressive and anxiety symptoms and increasing well-being. Trial Registration: The study was pre-registered at ClinicalTrials.gov Identifier: NCT05838222 on 4/20/2023.