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Cited by 19Psychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPersonality Disorders and Psychopathology

Modular-based psychotherapy (MoBa) versus cognitive–behavioural therapy (CBT) for patients with depression, comorbidities and a history of childhood maltreatment: study protocol for a randomised controlled feasibility trial.

Open access
Elsaesser, Moritz, Herpertz, Sabine, Piosczyk, Hannah, Jenkner, Carolin, Hautzinger, Martin, Schramm, Elisabeth·2022·BMJ Open
DOI 10.1136/bmjopen-2021-057672PMC PMC9277372
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Abstract

INTRODUCTION: In depression treatment, most patients do not reach response or remission with current psychotherapeutic approaches. Major reasons for individual non-response are interindividual heterogeneity of etiological mechanisms and pathological forms, and a high rate of comorbid disorders. Personalised treatments targeting comorbidities as well as underlying transdiagnostic mechanisms and factors like early childhood maltreatment may lead to better outcomes. A modular-based psychotherapy (MoBa) approach provides a treatment model of independent and flexible therapy elements within a systematic treatment algorithm to combine and integrate existing evidence-based approaches. By optimally tailoring module selection and application to the specific needs of each patient, MoBa has great potential to improve the currently unsatisfying results of psychotherapy as a bridge between disorder-specific and personalised approaches. METHODS AND ANALYSIS: In a randomised controlled feasibility trial, N=70 outpatients with episodic or persistent major depression, comorbidity and childhood maltreatment are treated in 20 individual sessions with MoBa or standard cognitive-behavioural therapy for depression. The three modules of MoBa focus on deficits associated with early childhood maltreatment: the systems of negative valence, social processes and arousal. According to a specific questionnaire-based treatment algorithm, elements from cognitive behavioural analysis system of psychotherapy, mentalisation-based psychotherapy and/or mindfulness-based cognitive therapy are integrated for a personalised modular procedure.As a proof of concept, this trial will provide evidence for the feasibility and efficacy (post-treatment and 6-month follow-up) of a modular add-on approach for patients with depression, comorbidities and a history of childhood maltreatment. Crucial feasibility aspects include targeted psychopathological mechanisms, selection (treatment algorithm), sequence and application of modules, as well as training and supervision of the study therapists. ETHICS AND DISSEMINATION: This study obtained approval from the independent Ethics Committees of the University of Freiburg and the University of Heidelberg. All findings will be disseminated broadly via peer-reviewed articles in scientific journals and contributions to national and international conferences. TRIAL REGISTRATION NUMBER: DRKS00022093.

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  • The modularized approach allows combining and integrating different independent treatment modules and ensures high flexibility and goodness-of-fit to patient needs and preferences.

    “The modularized approach moreover allows to combine and integrate different independent treatment modules and therewith ensures high flexibility and goodness-of-fit to patient needs and preferences (146).”

    From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [146]

    The Introduction (‘Personalised treatments’; page not available) describes independent, combinable modules that allow treatment to be tailored to patient needs. The Discussion (page not available) says this approach provides flexibility and goodness-of-fit. The paper does not specifically say that module selection accommodates patient preferences; its Methods describe selection by questionnaire scores and a treatment algorithm. (LLM, conf=0.85)

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Research works printed but not linked: 2

  1. [1]Beck AT. Cognitive therapy of depression. Guilford Press, 1979.
  2. [47]Harvey AG, Watkins E, Mansell W. Cognitive behavioral processes across psychological disorders: a Transdiagnostic approach to research and treatment. Oxford University Press, 2004.

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Authors
Elsaesser, M., Herpertz, S., Piosczyk, H., Jenkner, C., Hautzinger, M., & Schramm, E.
Affiliations
  • University of Freiburg (DE)
  • Heidelberg University (DE)
  • University Medical Center Freiburg (DE)
  • University of Tübingen (DE)
Corresponding author
Schramm, Elisabeth
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2022-07
Volume
12
Issue
7
Pages
e057672
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2021-057672
PMC
PMC9277372
OpenAlex
W4285098577
Cited by
19
References
105
Citations by year
2026: 2 · 2025: 4 · 2024: 5 · 2023: 8
FWCI
3.88
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Deutsche Forschungsgemeinschaft (SCHR 443/16-1)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords
MOBA, cognitive behavioral therapy, major depressive disorder, child abuse, comorbidities, transdiagnostic mechanisms, negative valence systems, social processes, arousal, mindfulness-based cognitive therapy, treatment algorithm, adjunctive therapy, therapist training and supervision
MeSH terms
Child, Preschool, Depression, Depressive Disorder, Major, Major Depressive Disorder, Feasibility Studies, Humans, Comorbidity, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Mindfulness

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