Competence-feedback and Therapy Outcome

Johannes Gutenberg University (JGU)

Status: Completed

Conditions: Depression

Treatments: Behavioral: competence-feedback; Other: control

Study type: Interventional

Funder types: Other

Identifiers

NCT02479594

WE 4652/7-1 (Other Grant/Funding Number)

WE_01

Details and patient eligibility

About

In a randomized controlled study design, n = 58 treatments of patients with depression were to be conducted under a feedback-condition, in which the therapist would receive feedback five times within 20 treatment sessions. The competence-feedback includes detailed feedback about 14 different aspects of therapist behavior. The control group includes n = 58 further treatments within which therapists do not receive any competence-feedback (treatment as usual; TAU).

Full description

Psychotherapeutic competencies are considered to be an important factor for therapy success. However, empirical studies which have investigated the competence-outcome relationship were only based on correlational analyses. Therefore, these studies are inappropriate for the investigation of causal relationships. In previous studies, feedback on therapists' competencies was found to be suitable for enhancing such competencies. Therefore, in the current research project, competence-feedback should be used to enhance therapeutic competencies systematically, in order to investigate the causal impact of these competencies on therapy outcome. Using a randomized controlled study design, n = 58 treatments of patients with depression were to be conducted under a feedback-condition, in which the therapist would receive feedback five times within 20 treatment sessions. The competence-feedback includes detailed feedback about 14 different aspects of therapist behavior. The control group includes n = 58 further treatments within which therapists do not receive any competence-feedback (treatment as usual; TAU). In order to ensure comparability of both treatment conditions (regarding an observation situation), the therapists in the TAU condition should also receive feedback, but only after the treatments are finished. We hypothesize that the feedback-group is superior to the TAU-group and that their treatments lead to significantly better therapy outcome. Moreover, we use mediator analysis to analyze whether the group-outcome relationship is mediated by therapeutic competencies or by the quality of the therapeutic alliance. The results are highly relevant for clinical process research, psychotherapy training and for the dissemination of treatment approaches in routine care.

Enrollment: 114 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

THERAPISTS

Inclusion Criteria:

• Having successfully completed the interim Audit
• Having started to treat ambulant patients

Exclusion Criteria:

---

PATIENTS

Inclusion Criteria:

• Clinical diagnosis of Major Depression (Meeting DSM-IV criteria)
• Informed consent

Exclusion Criteria:

• Suicidal tendency
• Clinical diagnosis of alcohol or drug addiction, acute schizophrenia, schizoaffective disorder or bipolar disorder
• Clinical diagnosis of personality disorder cluster A (odd disorders) and B (dramatic, emotional or erratic)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

114 participants in 2 patient groups, including a placebo group

competence-feedback

Experimental group

Description:

Therapists assigned to this group will receive standardized feedback on their psychotherapeutic competency after every fourth treatment session with a patient for a period of 20 therapy sessions. The feedback will be given by two experienced raters who are licensed as psychological psychotherapists.

Treatment:

Behavioral: competence-feedback

control

Placebo Comparator group

Description:

Therapists assigned to this group will receive no competence-feedback.

Treatment:

Other: control