University of Zürich, Zürich, Switzerland.
Department of Psychology, University of Zürich, Binzmühlestr. 14/04, -8050, Zürich, CH, Switzerland.
BMC Psychiatry. 2018 Apr 3;18(1):86. doi: 10.1186/s12888-018-1666-2.
Bona fide psychotherapy approaches are effective treatments for generalized anxiety disorder (GAD) compared to no-treatment conditions. Treatment manuals and protocols allow a relatively high degree of freedom for the way therapists implement these overall treatment packages and there is a systematic lack of knowledge on how therapists should customize these treatments. The present study experimentally examines two implementation strategies of customizing a bona fide psychotherapy approach based on a 16 session time-limited cognitive-behavioral therapy (CBT) protocol and their relation to the post-session and ultimate treatment outcomes.
This trial contrasts two different implementation strategies of how to customize the in-session structure of a manual-based CBT-protocol for GAD. The patients will be randomly assigned to two implementation conditions: (1) a systematic focus on subtle changes lasting from 7 to 20 min at the check-in phase of every psychotherapy session and (2) a state-of-the-art (SOTA) check-in phase lasting several minutes mainly focused on the session goals. Potential therapist effects will be examined based on an ABAB crossed-therapist design. Treatment outcomes will be assessed at the following times: post-session outcomes, treatment outcome at post assessment and 6- as well as 12-month follow-up.
The proposed randomized clinical implementation trial addresses the clinically relevant question of how to customize a bona fide psychotherapy protocol experimentally contrasting two implementation strategies. Through the development and testing of the proposed implementation design, this trial has the potential to inform therapists about efficacious implementation strategies of how to customize a manual-based treatment protocol in respect to the timing of the in-session structure.
This trial was registered at ClinicalTrials.gov ( NCT03079336 ) at March 14, 2017.
与无治疗条件相比，真诚的心理治疗方法对广泛性焦虑症（GAD）是有效的治疗方法。治疗手册和方案允许治疗师在实施这些总体治疗方案方面有相当大的自由度，并且系统地缺乏关于治疗师应该如何定制这些治疗方法的知识。本研究通过实验检验了基于 16 节限时认知行为疗法（CBT）方案的真诚心理治疗方法的两种定制实施策略，以及它们与治疗后和最终治疗结果的关系。
本试验对比了两种不同的定制基于手册的 CBT 方案治疗 GAD 的会话结构的实施策略。患者将被随机分配到两种实施条件：（1）系统关注从每次心理治疗会话的签到阶段持续 7 至 20 分钟的微妙变化；（2）主要集中在会话目标上的现代（SOTA）签到阶段，持续几分钟。将根据 ABAB 交叉治疗师设计检查潜在的治疗师效应。治疗结果将在以下时间进行评估：治疗后结果、治疗后评估时的治疗结果以及 6 个月和 12 个月的随访。
拟议的随机临床实施试验解决了如何通过实验对比两种实施策略来定制真诚心理治疗方案的临床相关问题。通过开发和测试拟议的实施设计，本试验有可能告知治疗师有关如何针对会话结构的时间定制基于手册的治疗方案的有效实施策略。
该试验于 2017 年 3 月 14 日在 ClinicalTrials.gov（NCT03079336）注册。
