Studies that compared professional versus paraprofessional treatment using cognitive and/or behaviour therapy as the primary treatment for symptoms of anxiety or depression were eligible for inclusion. Outcomes included symptom reduction, quality of life, functionality changes and satisfaction. Studies that used self-help groups or peer-help groups were excluded.
The included studies explored CBT (five to 10 sessions), mutual support groups or group desensitisation given by professionals versus paraprofessionals. Professionals were defined as primarily PhD level psychologists as well as master’s level psychologists. Paraprofessionals were defined as no advanced degree, undergraduate level or no formal mental health training. All studies used manualised group therapies. Most patients did not have severe mood or anxiety disorders. Reported outcomes included personal report of confidence as a speaker (PRCS), S-R inventory of anxiety, Beck depression inventory (BDI), Hamilton rating scale for depression (HRSD), Suinn Test Anxiety Behaviour Score (STABS) and life satisfaction index.
One author initially screened papers and three authors independently undertook study selection at the full paper stage.