Transfer of manualized Short Term Psychodynamic Psychotherapy (STPP) for social phobia into clinical practice: study protocol for a cluster-randomised controlled trial

Abstract

BackgroundPsychodynamic psychotherapy is frequently applied in the treatment of social phobia. Nevertheless, there has been a lack of studies on the transfer of manualized treatments to routine psychodynamic practice. Our study is the first one to examine the effects of additional training in a manualized Short Term Psychodynamic Psychotherapy (STPP) procedure on outcome in routine psychotherapy for social phobia. This study is an extension to a large multi-site RCT (N = 512) comparing the efficacy of STPP to Cognitive-Behavioral Therapy (CBT) of Social Phobia.Methods/DesignThe manualized treatment is designed for a time limited approach with 25 individual sessions of STPP over 6 months. Private practitioners will be randomized to training in manualized STPP vs. treatment as usual without a specific training (control condition). We plan to enrol a total of 105 patients (84 completers). Assessments will be conducted before treatment starts, after 8 and 15 weeks, after 25 treatment sessions, at the end of treatment, 6 months and 12 months after termination of treatment. The primary outcome measure is the Liebowitz Social Anxiety Scale. Remission from social phobia is defined scoring with 30 or less points on this scale.DiscussionWe will investigate how the treatment can be transferred from a controlled trial into the less structured setting of routine clinical care. This question represents Phase IV of psychotherapy research. It combines the benefits of randomized controlled and naturalistic research. The study is genuinely designed to promote faster and more widespread dissemination of effective interventions. It will answer the questions whether manualized STPP can be implemented into routine outpatient care, whether the new methods improve treatment courses and outcomes and whether treatment effects reached in routine psychotherapeutic treatments are comparable to those of the controlled, strictly manualized treatment of the main study.Trial RegistrationGerman Clinical Trials Register (DRKS) DRKS00000570

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

“…Please note that this is the only assumption differing from those made in [37] resulting in a higher a priori sample size than in [37]. …”

“…During diagnostics, a rating on symptoms severity using the Clinical Global Impression scale (CGI [ 36 ]) is also given. The majority of these measures will also be used in a related trial of manualized short-term psychodynamic therapy allowing for high comparability between both trials [ 37 ]. Furthermore, patient sociodemographic data and costs of SP treatment are assessed using selected items of the German adaptation of the client sociodemographic and service receipt inventory (CSSRI; for example number of treatment sessions, days of work disability [ 38 ]).…”

Transfer of manualized Short Term Psychodynamic Psychotherapy (STPP) for social anxiety disorder into clinical practice: results from a cluster-randomised controlled trial

“…The manualized intervention was based on Luborsky’s Supportive Expressive Therapy (SET) and has been described elsewhere [ 15 – 17 ]. The treatment was customized to 25 individual sessions of STPP over 6 months (short-term therapy, as reimbursed by the German health insurance).…”

“…Thus, we initially planned to include N = 35 patients in each center. Details on sample size calculation can be found elsewhere [ 15 ].…”

“…It is unknown whether new treatment approaches will improve the effects of routine psychodynamic psychotherapy. However, meta-analytical findings indicate the superiority of strictly manualized STPP [ 13 ] compared to mostly non-manualized STPP for the reduction of general psychiatric symptoms [ 14 , 15 ]. Therefore it is important to investigate how the manualized psychodynamic treatment evaluated in the first funding period of the Social Phobia Network [ 10 ] can be transferred from controlled trials into routine clinical care and whether the health care system benefits from such developments.…”