Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-26T19:50:58.942Z Has data issue: false hasContentIssue false
  • English
  • Français

A pragmatic patient preference trial of cognitive behavioural versus cognitive analytic guided self-help for anxiety disorders

Published online by Cambridge University Press:  04 August 2020

Stephen Kellett ,
Charlotte Bee ,
Vikki Aadahl ,
Emma Headley  and
Jaime Delgadillo
Stephen Kellett*
Affiliation:
University of Sheffield and Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK
Charlotte Bee
Affiliation:
Pennine Care NHS Foundation Trust, UK
Vikki Aadahl
Affiliation:
Pennine Care NHS Foundation Trust, UK
Emma Headley
Affiliation:
University of Sheffield, Sheffield, UK
Jaime Delgadillo
Affiliation:
University of Sheffield, Sheffield, UK
*
*Corresponding author. Email: s.kellett@sheffield.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims:

To outline the methods of a pragmatic patient preference trial in the Improving Access to Psychological Therapies (IAPT) programme comparing cognitive behavioural therapy guided self-help (CBT-GSH) with cognitive analytic therapy guided self-help (CAT-GSH).

Method:

A partially randomised patient preference trial (PRPPT) methodology. Participants will be assessed with the MINI to ascertain a diagnosis of an anxiety disorder. Treatment will be six to eight 35-minute sessions in each arm. The primary outcome measure is the Beck Anxiety Inventory (BAI), with secondary outcome measures of the IAPT minimum dataset and indices of service utilisation. Participants will be followed up at 8 and 24 weeks.

Planned analyses:

Choice, treatment completion, drop-out and step-up rates will be summarised via a CONSORT diagram. If there are no differences between randomised and preference participants within each form of GSH, then these groups will be collapsed to form a two-arm trial. The primary analysis will compare between-arm standardised effect sizes on the BAI measure, using Cohen’s d+ at 8- and 24-week follow-up. The proportions in each arm achieving reliable and clinical change on the BAI will be established, with interviews exploring the change process with participants achieving a reliable pre–post change on the GAD-7.

Conclusions:

The utility of patient preference trials in mental health services are discussed and the necessary further development of robust evidence concerning low-intensity interventions is highlighted.

Keywords

IAPTlow intensitypatient preference trial
Type
Study Protocol
Information
Behavioural and Cognitive Psychotherapy , Volume 49 , Issue 1 , January 2021 , pp. 104 - 111
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.10.1037/0022-006X.56.6.893CrossRefGoogle ScholarPubMed
Boogar, I. R., Rezaei, A. M., & Yosefi, A. (2013). The effectiveness of cognitive analytic therapy on the severity of symptoms in patients with obsessive-compulsive disorder. Practice in Clinical Psychology, 1, 197–204.Google Scholar
Bower, P., & Gilbody, S. (2005). Stepped care in psychological therapies: access, effectiveness and efficiency: narrative literature review. British Journal of Psychiatry, 186, 11–17.10.1192/bjp.186.1.11CrossRefGoogle ScholarPubMed
Boyatzis, R. E. (1998). Transforming Qualitative Information: Thematic Analysis and Code Development. California, CA, USA: Sage Publications Incorporated.Google Scholar
Cuijpers, P., Karyotaki, E., de Wit, L., & Ebert, D. D. (2020). The effects of fifteen evidence-supported therapies for adult depression: a meta-analytic review. Psychotherapy Research, 30, 279–293.10.1080/10503307.2019.1649732CrossRefGoogle ScholarPubMed
Cuijpers, P., Van Straten, A., Andersson, G., & Van Oppen, P. (2008). Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology, 76, 909–922.CrossRefGoogle ScholarPubMed
Elliott, R. (2010). Psychotherapy change process research: realizing the promise. Psychotherapy Research, 20, 123–135.10.1080/10503300903470743CrossRefGoogle ScholarPubMed
Hallam, C., Simmonds-Buckley, M., Kellett, S., Greenhill, B., & Jones, A. (2020). The acceptability, effectiveness, and durability of cognitive analytic therapy: systematic review and meta-analysis. Psychology and Psychotherapy, Theory, Research and Practice (in press).10.1111/papt.12286CrossRefGoogle Scholar
Halpern, S. D. (2003). Evaluating preference effects in partially unblinded, randomized clinical trials. Journal of Clinical Epidemiology, 56, 109–115.CrossRefGoogle ScholarPubMed
Howard, L., & Thornicroft, G. (2006). Patient preference randomised controlled trials in mental health research. British Journal of Psychiatry, 188, 303–304 10.1192/bjp.188.4.303CrossRefGoogle ScholarPubMed
Kellett, S., Simmonds-Buckley, M., Limon, E., Stride, C., Hughes, L., Hague, J., & Millings, A. (2020). Defining the assessment and treatment competencies during low intensity cognitive behavioural therapy: a multi-centre validation study. Behavior Therapy (in press). https://doi.org/10.1016/j.beth.2020.01.006 CrossRefGoogle Scholar
King, M., Nazareth, I., Lampe, F., Bower, P., Chandler, M., Morou, M., Sibbald, B., & Lai, R. (2005). Impact of participant and physician intervention preferences on randomized trials: a systematic review. JAMA, 293, 1089–1099.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.CrossRefGoogle ScholarPubMed
Marriott, M., & Kellett, S. (2009). Evaluating a cognitive analytic therapy service; practice-based outcomes and comparisons with person-centred and cognitive-behavioural therapies. Psychology and Psychotherapy; Theory, Research and Practice, 82, 57–82.10.1348/147608308X336100CrossRefGoogle ScholarPubMed
Meadows, J., & Kellett, S. (2017). Development and evaluation of cognitive analytic guided self-help (CAT-SH) for use in IAPT services. Behavioural and Cognitive Psychotherapy, 45, 266–284.10.1017/S1352465816000485CrossRefGoogle ScholarPubMed
Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002). The Work and Social Adjustment Scale: a simple measure of impairment in functioning. British Journal of Psychiatry, 180, 461–464.CrossRefGoogle ScholarPubMed
Muntingh, A. D., van der Feltz-Cornelis, C. M., van Marwijk, H. W., Spinhoven, P., Penninx, B. W., & van Balkom, A. J. (2011). Is the Beck Anxiety Inventory a good tool to assess the severity of anxiety? A primary care study in the Netherlands Study of Depression and Anxiety (NESDA). BMC Family Practice, 12, 66.CrossRefGoogle Scholar
National Institute for Health and Clinical Excellence (NICE) (2011). Generalised Anxiety and Panic Disorder in Adults: Management (CG:113). London, UK: NICE.Google Scholar
O’Connor, A. M., Boyd, N. F., Warde, P., Stolbach, L., & Till, J. E. (1987). Eliciting preferences for alternative drug therapies in oncology: influence of treatment outcome description, elicitation technique and treatment experience on preferences. Journal of Chronic Disease, 40, 811–818.10.1016/0021-9681(87)90133-0CrossRefGoogle ScholarPubMed
Perfect, D., Jackson, C., Pybis, J., & Hill, A. (2016). Choice of therapies in IAPT: an overview of the availability and client profile of step 3 therapies. Lutterworth, UK: British Association for Counselling & Psychotherapy.Google Scholar
Richards, D., & Whyte, M. (2011). Reachout. National Programme Student Materials to Support the Delivery of Training for Psychological Wellbeing Practitioners Delivering Low Intensity Interventions. Rethink Publishing.Google Scholar
Sheehan, D. V., Lecrubier, Y., Harnett-Sheehan, K., Amorimm, P., Janavs, J., Weiller, E., Hergueta, T., Baker, R., & Dunbar, G. (1998). The mini international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview. Journal of Clinical Psychiatry, 59, 22–33.Google ScholarPubMed
Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 1092–1097.CrossRefGoogle ScholarPubMed
Torgerson, D., & Sibbald, B. (1998). Understanding controlled trials: what is a patient preference trial? British Medical Journal, 316, 360–365.10.1136/bmj.316.7128.360CrossRefGoogle ScholarPubMed
Tzouramanis, P., Adamopoulou, A., Bozikas, V., Voikli, M., Zagora, C., Lombtzianidou, M., Mamouzelos, E., & Garyfallos, G. (2010). Evaluation of cognitive-analytic therapy (CAT) outcome in patients with panic disorder. Psychiatrike, 21, 287–293.Google ScholarPubMed
Ward, E., King, M., Lloyd, M., Bower, P., Sibbald, B., Farrelly, S., Gabbay, M., Tarrier, N., & Addington-Hall, J. (2000). Randomised controlled trial of non-directive counselling, cognitive behavioural therapy, and usual general practitioner care for patients with depression. British Medical Journal, 321, 1383–1388.10.1136/bmj.321.7273.1383CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.