Outcomes following a physician-led CBT skills group for anxiety and depression in primary care: a longitudinal cohort study

Background Cognitive Behavioural Therapy (CBT) is an evidence-based psychotherapy used to treat a range of mental health disorders. This study aimed to evaluate the long-term impact of a novel primary care-based Cognitive Behavioural Therapy (CBT) Skills Group program on symptoms of anxiety and depression, using patient-reported outcomes at 3, 6, and 12 months post-intervention. Methods This study was an observational cohort study evaluating real-world outcomes of a primary-care-based CBT Skills Group program. The study followed adult patients with mild to moderate anxiety and/or depression who completed an 8-week CBT Skills Group. Participants were assessed using validated self-report measures (PHQ-8 and GAD-7) at baseline, program completion, and 3, 6, and 12-month follow-up intervals. This study is reported in accordance with the STROBE guidelines for observational studies. Results Symptoms of depression and anxiety (PHQ-8 and GAD-7) improved significantly between baseline and program completion and remained significantly lower at 3-month follow-up. Improvements appeared to persist to 12 months, although precision decreased because of participant attrition. Of 206 invited participants, 67 enrolled and 17 completed 12-month follow-up (25% of enrolled participants). Sensitivity analyses using multiple imputation approaches produced broadly consistent findings. Qualitative data indicated that most participants continued to apply CBT tools in their daily lives well after program completion. Conclusions Group-based CBT Skills training delivered in a primary care setting was associated with clinically meaningful reductions in depression and anxiety symptoms. Participants who completed the CBT Skills Group demonstrated clinically meaningful reductions in depression and anxiety scores that persisted for at least three months, with trends suggesting continued benefit up to 12 months. This model offers a scalable, accessible option for mental health support in publicly funded healthcare systems.