Primary care-based guided self-help for depression provided by a nurse practitioner: a pilot evaluation

National Institute for Health and Clinical Excellence (NICE) guidelines for depression and anxiety recommend the provision of cognitive behaviour therapy (CBT)-based guided self-help interventions in primary care as part of a stepped care model. Despite such guidance some important questions remain, such as the nature of the guidance, who should provide the guidance within primary care and the application of service delivery models in practice. This paper describes and evaluates a pilot project involving guided self-help for depression provided by a nurse practitioner within primary care. Clinical outcome measures showed statistical and clinically significant improvements in both anxiety and depression, although, as this was not a controlled study, one cannot definitely attribute improvements to the intervention. Issues about the provision of guided self-help in primary care and the implications for implementing NICE guidance and the role of nurse practitioners and other primary care staff are discussed