There's been quite a bit of work in recent years trying to improve the treatment of depression in medical settings since many depressed individuals either seek treatment from their primary care physician or seek treatment for physical complaints when the main problem is depression. It is great that CT is an effective treatment for depression. Unfortunately, simply publishing treatment guidelines regarding when to prescribe antidepressants and when to refer for therapy has not proven to be an effective way to improve the quality of care that most patients recieve.

A recent Medscape article (http://www.medscape.com/viewarticle/487742) describes an ambitions new project and gives an idea of what is needed to produce system-wide improvement. Links within the article give additional information and include a good bibliography on related topics (http://www.depression-primarycare.or...commended/#top).