The estimated ICERs of active treatments vs. no treatment range from just over A$1,650 for TF-CBT only to under A$2,100 for non-directive counselling.
The results of this two-way sensitivity analysis were 13.27 QALYs at an additional cost of A$1,221 for TF-CBT; 13.34 QALYs at an additional cost of A$1,271 for TF-CBT + SSRI as compared to 12.61 QALYs at an additional cost of A$2,081 for non-directive counselling.
Women with a family history of breast/ovarian cancer who attend the family cancer clinic are either seen by a doctor (a consultant clinical geneticist or a specialist registrar in genetics) or a genetic counsellor (graduate nurses or science graduates with training in genetic counselling) for non-directive counselling.
The estimated ICERs of active treatment vs. no treatment range from A$22,263 for TF-CBT + SSRI to A$34,567 for non-directive counselling, indicating that even in the short term investing in any type of psychotherapy is likely to present a good value for money from the perspective of the Australian mental health system if the threshold of A$50,000 per QALY gained is considered 'affordable' [ 61].
For the collection of data, we first favored the use of non-directive interviews that were later consolidated by semi-directive interviews.
Decision coaching is a process of non-directive support by a trained facilitator to help patients develop skills in preparation for decision making with their physician [ 9].
Furthermore, they did not require the use of evidence based psychotherapy (for example, non-directive supportive counseling was eligible for their analyses), they did not limit studies to those in which patients had not already failed a previous antidepressant treatment (who would be more likely to be seen in primary care).
The ICER values were A$6,513 for TF-CBT and A$6,617 for TF-CBT + SSRI, with non-directive counselling dominated by these treatment options.
Compared with non-directive counselling, it is more focused and goal-directed.
Bower et al (2000) conducted an analysis of the cost-effectiveness of CBT for depression in people of all ages, comparing CBT with non-directive counselling and usual general practitioner care [ 13].
On the basis of available evidence the PTSD Guideline recommended 8-12 individual weekly Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) sessions with the child over non-directive supportive counselling or standard community treatment for treating PTSD in children and adolescents [ 20].
