Guided Self-help for Anxiety - a Patient Preference Trial

University of Sheffield

Status: Unknown

Conditions: Anxiety

Treatments: Other: Cognitive Analytic Therapy Guided Self Help; Other: Cognitive Behavioural Therapy Guided Self Help

Study type: Interventional

Funder types: Other

Identifiers

NCT03730532

240751

Details and patient eligibility

About

Supporting patients in exerting choice over their treatment is a central aspect of modern healthcare. In Improving Access to Psychological Therapies (IAPT) services, then patients treated at step 2 are only and always offered cognitive-behaviourally informed guided self-help (GSH), when they are deemed suitable for treatment at step 2 of IAPT services (termed CBT-GSH). Step 2 interventions are guided self-help (GSH) delivered by Psychological Wellbeing Practitioners (PWPs). Recently, a new type of GSH has been developed and found to be feasible and effective in IAPT services - this is called cognitive-analytic guided self-help (CAT-GSH). This research aims to test the efficacy of CAT-GSH by comparing outcomes over time achieved in both types of GSH and interviewing participants about their experience of the GSH. The methodology to support patient choice is a patient preference trial. In this method, then patients that meet inclusion criteria for the trial are offered and choose between either CAT-GSH and CBT-GSH. Those patients that are unconcerned with the type of treatment are randomised to either CAT-GSH or CBT-GSH. The primary outcome measure is the Beck Anxiety Inventory. No changes to the standard practice of the PWPs will occur during the trial, the trial will be situated in a standard IAPT service and be a therefore conducted in a routine practice setting.

Enrollment: 134 estimated patients

Sex: All

Ages: 18 to 99 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• patients have self-referred or been referred by their GP or other health or social care professional for a step 2 intervention for treatment of a common mental health problem,
• patients meet criteria for an anxiety disorder on MINI screening interview assessment and also met caseness on the BAI (as defined by a score of >10 on the BAI at assessment).
• Patients want to engage in GSH to address the anxiety disorder
• patients are motivated to engage in treatment and can attend six sessions of face-to-face GSH.

Exclusion criteria

• engaging in any another IAPT step 2 interventions.
• Do not meet criteria for an anxiety disorder as defined by the MINI and the BAI score.
• Meet criteria for depression and a comorbid anxiety disorder, as identified by the BAI and MINI, where the depression is more severe and is the patient's main concern.
• Have a severe/chronic mental health problem and are already involved in psychiatric or secondary care mental health services.
• Have substance misuse issues that would interfere with engagement with the GSH.
• Have a diagnosed learning disability that precludes engagement in GSH.
• Have a diagnosis of social phobia or PTSD

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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134 participants in 4 patient groups

Randomised CBT

Experimental group

Description:

Cognitive Behavioural Therapy Guided Self Help

Treatment:

Other: Cognitive Behavioural Therapy Guided Self Help

Randomised CAT

Experimental group

Description:

Cognitive Analytic Therapy Guided Self Help

Treatment:

Other: Cognitive Analytic Therapy Guided Self Help

Preference CAT

Experimental group

Description:

Cognitive Analytic Therapy Guided Self Help

Treatment:

Other: Cognitive Analytic Therapy Guided Self Help

Preference CBT

Experimental group

Description:

Cognitive Behavioural Therapy Guided Self Help

Treatment:

Other: Cognitive Behavioural Therapy Guided Self Help