Brief Cognitive Behavioral Therapy compared with Pharmacotherapy for treating depression and improving well-being in young adults in Pakistan

Intervention Arms: Arm 1: Brief Cognitive Behavioral Therapy – Individual Module • Manual-based Brief CBT (Cully et al., 2020) • 4–8 weekly sessions (60 minutes each) • Face-to-face delivery • Includes psychoeducation, behavioral activation, cognitive restructuring, homework, relapse prevention • Delivered by trained clinical psychologist Arm 2: Brief Cognitive Behavioral Therapy – Group Module • 4–8 weekly sessions (60 minutes) • 20–22 participants per group • Same therapeutic components as individual module • This study involves a Brief Cognitive Behavioral Therapy (CBT) intervention delivered in two formats: individual and group modules. The intervention is manual based (Cully et al., 2020) and includes core components such as psychoeducation, behavioral activation, cognitive restructuring, and relapse prevention strategies. • The individual module consists of 4–8 weekly face-to-face sessions (60 minutes each) delivered by a trained clinical psychologist. The group module consists of 4–8 weekly sessions (60 minutes each) with approximately 20–22 participants per group, incorporating the same therapeutic components as the individual format. • The intervention will be delivered at a well-established university-based counselling centre with appropriate clinical facilities. • Intervention fidelity and adherence will be monitored using session attendance records, therapist-completed session checklists, and participant homework compliance logs. • Participants will be allocated using a matched allocation procedure based on baseline depression severity scores measured using the Beck Depression Inventory (BDI). Participants with comparable severity levels will be assigned to study arms to ensure baseline equivalence. Allocation will be conducted sequentially following baseline assessment.