Tiller Community Mental Health Centre, Department of Mental Health, Tiller DPS, St. Olavs Hospital HF, Postboks 3250, Torgarden, 7006, Trondheim, Norway.
Department of Mental Health (IPH), Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway.
Trials. 2020 May 27;21(1):432. doi: 10.1186/s13063-020-04297-z.
Suffering linked to previous interpersonal trauma is common among patients in mental health care. Diagnostic labels may vary, but the clinical picture is often characterized by long-lasting and complex psychological and somatic symptoms, subjective distress and reduced quality of health and life. A substantial proportion of patients do not recover after individual treatment in ordinary specialized mental healthcare settings, despite the proven usefulness of individual trauma-specific treatments. The therapeutic factors that arise in group settings, such as normalization, shame reduction and corrective relational experiences, may be particularly useful for trauma survivors. However, evidence in support of group treatment for trauma survivors is scarce. This study aims to test whether combining a novel group intervention to individual treatment is superior to conventional individual out-patient treatment in an ordinary community mental health hospital.
In a single-site, non-blinded, randomized controlled trial (RCT), the effect of a combined group-based stabilization and skill-training (SST) intervention added to individual treatment will be compared to conventional treatment (treatment as usual, TAU) alone. Participants (N = 160) with ongoing and long-lasting reactions related to known adverse life events from the past will be recruited among patients at general outpatient clinics in a community mental health centre at St. Olav's University Hospital, Trondheim, Norway. Following baseline assessment and randomization, participants will complete follow-up measures at 4, 8, 13 and 19 months post-baseline. The primary outcome is personal recovery (The questionnaire about the process of recovery , QPR). Secondary outcomes include (1) self-reported symptoms of posttraumatic stress, general mental and somatic health symptoms, well-being, functional impairment and client satisfaction, (2) immunological and endocrine response measured in blood samples and (3) national registry data on occupational status, use of mental health services and pharmacological treatment. Additionally, mechanisms of change via posttraumatic cognitions will be examined.
The addition of a group-based intervention to individual treatment for trauma survivors might prove to be an efficient way to meet the need of long-lasting high-intensity treatment in a large group of patients in mental health care, thereby reducing their suffering and increasing their psychosocial functioning.
ClinicalTrials.gov: NCT03887559. Registered on 25 March 2019.
在精神卫生保健机构的患者中，与先前人际创伤相关的痛苦较为常见。诊断标签可能有所不同，但临床特征通常是持久且复杂的心理和躯体症状、主观痛苦以及健康和生活质量下降。尽管个体创伤特异性治疗已被证明有效，但相当一部分患者在普通专科精神卫生保健机构接受个体治疗后并未康复。在群体环境中产生的治疗因素，如正常化、羞耻感减轻和矫正的关系体验，对于创伤幸存者可能特别有用。然而，支持创伤幸存者群体治疗的证据很少。本研究旨在检验在普通社区精神卫生医院，将一种新的基于群体的稳定和技能训练（SST）干预措施与常规个体门诊治疗相结合是否优于常规个体门诊治疗。
在一项单站点、非盲、随机对照试验（RCT）中，将比较添加基于群体的稳定和技能训练（SST）干预措施的联合治疗与单独常规治疗（常规治疗，TAU）的效果。参与者（N=160）来自挪威特隆赫姆圣奥拉夫大学医院社区精神卫生中心的普通门诊患者，他们正在经历与过去已知不良生活事件相关的持续和长期反应。在基线评估和随机分组后，参与者将在基线后 4、8、13 和 19 个月完成随访测量。主要结局是个人康复（康复过程问卷，QPR）。次要结局包括（1）自我报告的创伤后应激症状、一般心理健康和躯体健康症状、幸福感、功能障碍和客户满意度，（2）血液样本中测量的免疫和内分泌反应，以及（3）国家登记数据显示的职业状况、精神卫生服务使用情况和药物治疗情况。此外，还将通过创伤后认知来检查变化的机制。
为创伤幸存者提供的个体治疗加上基于群体的干预可能被证明是一种有效的方法，可以满足精神卫生保健中大量患者长期高强度治疗的需求，从而减轻他们的痛苦，提高他们的社会心理功能。
ClinicalTrials.gov：NCT03887559。于 2019 年 3 月 25 日注册。
