Adapted Cognitive Therapy for Women with Depression and Low Literacy

Depression is one of the leading causes of disability worldwide, disproportionately affecting women. Although, Cognitive Behavior Therapy (CBT) is one of the most effective treatments for depression, it requires the use of workbooks and worksheets that are complicated and text-heavy. This alone creates a barrier for those with low literacy may receive from this treatment. The aim of this proposal is to gather pilot data, focusing on major depressive disorder in women with low literacy. Over a one-year period, women with major depressive disorder and low literacy (n = 30, including 25% for potential attrition) will be randomly allocated to Standard CBT or Adapted CBT. They will be assessed at baseline, post-treatment, and 3-months follow-up. First, we will determine the effect size required to detect a between-group change in depressive symptoms between Standard CBT and Adapted CBT (Aim 1). We will compare the benefits of a text-free version of CBT (ACBT) to determine if this adaptation confers improved outcomes for women with low literacy (Aim 2). Finally, we will create a Therapists and Patient Advisory Panel allowing us to refine our ACBT protocol (Aim 3). This research has the potential to enhance outcomes for individuals with depression and low literacy.