Brief psychological treatments for emotional disorders in Primary and Specialized Care: A randomized controlled trial

Abstract

Background/Objective Brief transdiagnostic psychotherapies are a possible treatment for emotional disorders. We aimed to determine their efficacy on mild/moderate emotional disorders compared with treatment as usual (TAU) based on pharmacological interventions. Method: This study was a single-blinded randomized controlled trial with parallel design of three groups. Patients ( N = 102) were assigned to brief individual psychotherapy ( n = 34), brief group psychotherapy ( n = 34) or TAU ( n = 34). Participants were assessed before and after the interventions with the following measures: PHQ-15, PHQ-9, PHQ-PD, GAD-7, STAI, BDI-II, BSI-18, and SCID. We conducted per protocol and intention-to-treat analyses. Results: Brief psychotherapies were more effective than TAU for the reduction of emotional disorders symptoms and diagnoses with moderate/high effect sizes. TAU was only effective in reducing depressive symptoms. Conclusions: Brief transdiagnostic psychotherapies might be the treatment of choice for mild/moderate emotional disorders and they seem suitable to be implemented within health care systems.

Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol

“…We used effect sizes from the previous literature to determine the sample size. Corpas et al’s primary care RCT [ 41 ] compared both group and individual brief tCBT with TAU for emotional disorders and found low to medium effect sizes for all outcomes. Individual effects were larger (Cohen’s d ranged from .54 to .74) than group effects (.4 to .63) when compared with TAU; however, there was no significant difference between both transdiagnostic formats, with (very) low effect sizes (.06 to .27).…”

“…We assumed an effect size of .3 (the equivalent f value); a statistical power (1 - β ) of .8; and a significance level ( α ) of .05, obtaining a required sample size of 111. However, to control withdrawals and take into account the abandonment rates in other similar trials [ 36 , 41 ], we assumed a dropout rate of 15%, which brought the required sample size to 128.…”

“…In addition, the individual format also allows the therapist to establish a better relationship with the patient, which can benefit clinical outcomes [ 39 ]. The PsiBrief project [ 40 , 41 ] compared brief versions of individual and group transdiagnostic CBT with the usual treatment in Spanish primary care. The results did not show any difference between the psychotherapy clusters in reducing emotional symptoms, though they were both more effective than primary care treatment (with moderate effect sizes).…”

Brief psychological therapies for emotional disorders in primary care: A systematic review and meta-analysis.

“…Within this transdiagnostic framework, brief psychological therapies could be a possible solution for the high comorbidity among EDs in the PC setting. In fact, brief transdiagnostic therapies have been designed, protocolized, and successfully applied (Corpas et al, 2021; Gálvez-Lara et al, 2019). Additionally, the recent systematic review of Cassiello-Robbins et al (2020) endorses their effectiveness for a wide range of patients with different characteristics and comorbid disorders worldwide.…”

“…Brief or time-limited psychological therapies have been conceptualized as a range of 2–10 sessions (Cape et al, 2010) in contrast to the 12–24 sessions usually required in traditional psychological therapies. Brief psychological therapies applied in PC have emerged as a good therapeutic option to respond to public health demands, as they have been shown to achieve favorable clinical results in reducing anxiety and depressive symptoms (Bernhardsdottir et al, 2013; Corpas et al, 2021; Churchill et al, 2002; Saravanan et al, 2017). In this vein, some countries have already begun to incorporate this type of treatment in PC, such as the Improving Access to Psychological Therapies (IAPT) program in the United Kingdom, which has been widely shown to achieve beneficial outcomes (Clark, 2018; Wakefield et al, 2021).…”