Evidence-Based Brief Psychological Treatment for Emotional Disorders in Primary and Specialized Care: Study Protocol of a Randomized Controlled Trial

Abstract

Emotional Disorders (EDs) are very prevalent in Primary Care (PC). However, general practitioners (GPs) have difficulties to make the diagnosis and the treatment of this disorders that are usually treated with drugs. Brief psychological therapies may be a new option to treat EDs in a PC context. This article aims to present a study protocol to evaluate the effectiveness and the efficiency of an adaptation to brief format of the “Unified Protocol (UP) for the transdiagnostic treatment of EDs.” This is a single-blinded RCT among 165 patients with EDs. Patients will be randomly assigned to receive brief psychological treatment based on UP, conventional psychological treatment, conventional psychological treatment plus pharmacological treatment, minimum intervention based on basic psychoeducational information, or pharmacological treatment only. Outcome measure will be the following: GAD-7, STAI, PHQ-9, BDI-II, PHQ-15, PHQ-PD, and BSI-18. Assessments will be carried out by blinded raters at baseline, after the treatment and 6-month follow-up. The findings of this RCT may encourage the implementation of brief therapies in the PC context, what would lead to the decongestion of the public health system, the treatment of a greater number of people with EDs in a shorter time, the reduction of the side effects of pharmacological treatment and a possible economic savings for public purse.Clinical Trial Registration: ClinicalTrial.gov, identifier NCT03286881. Registered September 19, 2017.

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

“…This randomized controlled trial was registered in ClinicalTrials.gov with identifier NCT03286881 and its protocol was previously published ( Gálvez-Lara, Corpas, Venceslá et al, 2019 ). Four experimental groups were originally planned, but due to the functioning of the public health system clinicians were not able to treat patients as indicated in two of them (combined treatment and minimum psychological intervention).…”

“…The sample size calculation process was described elsewhere ( Gálvez-Lara, Corpas, Venceslá et al, 2019 ). In short, we assumed an effect size of 0.60 (Cohen´s d ), which is equivalent to an f index of 0.30.…”

L’efficacité de la thérapie est-elle modulée par la relation thérapeutique en fonction du motif de consultation ?

“…L'intérêt de la thérapie brève est multiple. Tout d'abord, dans le contexte des soins primaires, elle peut permettre de désengorger les systèmes de santé, étant donné qu'elle traite un grand nombre de personnes en un temps plus court, ce qui engendre une éventuelle économie pour les finances publiques [7]. C'est une des raisons pour laquelle la thérapie brève et stratégique a vite été très populaire dans les centres de santé de premiers soins [8].…”

“…En ce qui concerne les patients, la thérapie brève et stratégique présente des avantages économiques, mais elle présente également une réponse adéquate à leurs exigences, étant donné qu'elle se centre sur leurs objectifs personnels [5]. De plus, contrairement à un traitement médicamenteux, il n'y a pas d'effets secondaires [7].…”