Transfer of manualized CBT for social phobia into clinical practice (SOPHO-PRAX): a study protocol for a cluster-randomized controlled trial

Abstract

BackgroundCognitive-behavioral therapy (CBT) is generally known to be efficacious in the treatment of social phobia when applied in RCTs, namely when the treatment manual is based on the Clark-Wells approach. However, little is known about the efficacy of manualized treatments in routine clinical practice (Phase IV of psychotherapy research). The present study (SOPHO-PRAX) is a continuation of a large multicenter randomized clinical trial (SOPHO-NET) and analyzes the extent to which additional training practitioners in manualized procedures enhances treatment effect.Methods/designThirty-six private practitioners will be included in three treatment centers and randomly designated to either training in manualized CBT or no specific training. The treatment effects of the therapies conducted by both groups of therapists will be compared. A total of 162 patients (n = 116 completers; n = 58 per condition) will be enrolled. Liebowitz Social Anxiety Scale (LSAS) will serve as primary outcome measure. Remission from social phobia is defined as LSAS total ≤30 points. Data will be collected at treatment begin, after 8, 15, and 25 sessions (50 min each), at treatment completion, as well at 6 and 12 months post-treatment.DiscussionThe present CBT trial combines elements of randomized controlled trials and naturalistic studies in an innovative way. It will directly inform about the incremental effects of procedures established in a controlled trial into clinical practice. Study results are relevant to healthcare decisions and policy. They may serve to improve quality of treatment, and shorten the time frame between the development and widespread dissemination of effective methods, thereby reducing health cost expenditure.The results of this study will not only inform about the degree to which the new methods lead to an improvement of treatment course and outcome, but also about whether the effects of routine psychotherapeutic treatment are comparable to those of the controlled, strictly manualized treatments of the SOPHO-NET study.Trial registrationClinicalTrials.gov identifier: NCT01388231. This study was funded by the German Federal Ministry of Education and Research (SOPHO-NET: BMBF 01GV0607; SOPHO-PRAX: BMBF 01GV1001).

Defining and assessing adverse events and harmful effects in psychotherapy study protocols: A systematic review.

“…Whether an AE was expected or not was seldom addressed. Some researchers restricted the assessment of AEs to mental health (Crawcour et al, 2012; Wiltink et al, 2011; Zwerenz et al, 2012), but others did not distinguish physical and mental health (Hofmann et al, 2015; Ito et al, 2016; Sloan et al, 2016). Changes in the social or professional environment were explicitly defined as potential AEs in one study protocol (Fuhr et al, 2017).…”

Psychometric properties of the Chinese version of the Affective Style Questionnaire and its role as a moderator of the relationship between stress and negative affect

“…This theoretical perspective and the ASQ itself developed by Hofmann and Kashdan (2010) made a unique contribution to the comprehensive understanding of emotion regulation strategies. Studies showed that the ASQ has good reliability and validity, and it acts as a valuable measurement of affective style in various independent studies (Crawcour et al, 2012; Enebrink et al, 2013; Hofmann et al, 2012; Szasz et al, 2012).…”

Advancing psychotherapy and evidence‐based psychological interventions

“…When applied, treatment characteristics in routine care typically do not match the randomized controlled trial manual specification or treatment guidelines in terms of type, length and content. The reasons for this unfortunate situation are only partly understood despite promising suggestions on how to change the situation (Crawcour et al ., ). Increasing the “ecological validity” and clinical utility of CBT programmes by avoiding overly selective inclusion criteria and diagnostic fragmentation might provide guidance on how to deal with comorbid conditions, prior or concomitant drug treatment and with patients not achieving full remission.…”