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How to customize a bona fide psychotherapy for generalized anxiety disorder? A two-arms, patient blinded, ABAB crossed-therapist randomized clinical implementation trial design [IMPLEMENT 2.0]

Flückiger, Christoph, Wolfer, Christine, Held, Judith, Hilpert, Peter, Rubel, Julian, Allemand, Mathias, Zinbarg, Richard E. and Vîslă, Andreea (2018) How to customize a bona fide psychotherapy for generalized anxiety disorder? A two-arms, patient blinded, ABAB crossed-therapist randomized clinical implementation trial design [IMPLEMENT 2.0] BMC Psychiatry, 18 (86). pp. 1-11.

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Abstract

Background

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.

Methods

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.

Discussion

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.

Trial registration

This trial was registered at ClinicalTrials.gov (NCT03079336) at March 14, 2017.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Psychology
Authors :
NameEmailORCID
Flückiger, Christoph
Wolfer, Christine
Held, Judith
Hilpert, Peterp.hilpert@surrey.ac.uk
Rubel, Julian
Allemand, Mathias
Zinbarg, Richard E.
Vîslă, Andreea
Date : 3 April 2018
DOI : 10.1186/s12888-018-1666-2
Copyright Disclaimer : © The Author(s). 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Uncontrolled Keywords : Generalized anxiety disorder; Cognitive behavior therapy; Sudden gains; Early change; Responsiveness; Therapist effects; Personalized medicine; Randomized clinical trial; Evidence-based practice; Translational science
Depositing User : Clive Harris
Date Deposited : 24 Aug 2018 12:47
Last Modified : 16 Nov 2018 14:40
URI: http://epubs.surrey.ac.uk/id/eprint/849094

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