The adherence/resource priming paradigm – a randomised clinical trial conducting a bonafide psychotherapy protocol for generalised anxiety disorder
Open accessAbstract
BACKGROUND: Bonafide psychotherapy is an effective treatment for generalised anxiety disorder compared to no-treatment. Rather than creating increasing numbers of new overall treatment-packets within a medical meta-model, an additional approach to investigating clinical research designs may be to increase the understanding of already effective psychotherapies. Treatment manuals and protocols allow a relatively high degree of freedom for the way therapists implement the overall treatment manuals. There is a systematic lack of knowledge on how therapists should customise these overall protocols. The present study experimentally examines three ways of conducting a bonafide psychotherapy based on a 15 session time-limited cognitive-behavioural therapy (CBT) protocol and their relation to the therapists' protocol adherence and treatment efficacy. METHODS/DESIGN: This trial will investigate three different methods of customising a bonafide CBT-protocol using dyadic peer-tutoring methodology (primings). The individuals with GAD will be randomly assigned to one of three priming conditions (resource priming, supportive resource priming, or adherence priming). The participant treatment allocation will be performed randomly. Therapists will be assigned to a peer-tutoring partner and priming condition based on a mutual agreement. Treatment outcomes will be assessed at the following times: observer based in-session outcomes, session-by-session post-session outcomes, treatment outcome at post assessment and treatment outcome at 6-month follow-up. DISCUSSION: The proposed trial addresses the clinically relevant question of how to customise a bonafide psychotherapy protocol using tandem peer-tutoring methodology (three priming conditions). Through the development and testing of the proposed priming procedures, this study describes levels of adherence and how to conduct an overall treatment protocol in a more systematised way. TRIAL REGISTRATION: From ClinicalTrials.gov Identifier: NCT02039193.
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Power analyses with G*Power for detection of small effects (Cohen's f = 0.12) for interaction between time and treatment condition resulted in a sample size of 123 patients.
“Power analyses with G*Power (Faul et al. 2007) for the detection of small effects (Cohen’s f = 0.12) for the interaction between time (pre, mid-5, mid-15, post) and treatment condition (TAU-M versus TAU-PMR versus TAU) (ANOVA repeated measures, within-between-interaction, α = 0.05, power = 0.80, number of groups = 3, number of measurements = 4, pre-post correlation r = 0.05, nonsphericity correc”
From The process-outcome mindfulness effects in trainees (PrOMET) study: Protocol of a pragmatic randomized controlled trial (2015) · cites this paper as Flückiger 2014
The Methods/design ‘Sample size’ section reports a G*Power calculation yielding 60 participants, or 20 per priming condition, using a repeated-assessment correlation of r = .30—not 123 patients. The Methods/design section also describes different treatment conditions from those in the citing sentence. (LLM, conf=0.89)
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Experimental — accuracy not yet measuredThis is a typical limitation of most psychotherapy studies with a randomization process.
“this is a typical limitation of most psychotherapy studies with a randomization process (Flückiger 2014).”
From The process-outcome mindfulness effects in trainees (PrOMET) study: Protocol of a pragmatic randomized controlled trial (2015) · cites this paper as Flückiger 2014
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- Authors
- Flückiger, C.
- Affiliations
- University of Zurich (CH)
- Corresponding author
- Flückiger, Christoph
- ORCID
- Flückiger, Christoph
- Venue
- BMC Psychiatry
- Published
- 2014-02-20
- Volume
- 14
- Issue
- 1
- Pages
- 49-49
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC3931922
- OpenAlex
- W2081070135
- Cited by
- 6
- References
- 91
- Citations by year
- 2021: 1 · 2019: 1 · 2017: 1 · 2016: 1 · 2015: 2
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- National Science Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (136937, PZ00P1_136937/1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- generalized anxiety disorder, treatment protocol adherence, peer tutoring, cognitive behavioral therapy, treatment efficacy
- MeSH terms
- Anxiety Disorders, Clinical Protocols, Humans, Research Design, Cognitive Behavioral Therapy, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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