Improving Patient Mental Health With Psychotherapist Virtual Training: A Practice- Research Network Study
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 489
- 试验地点
- 2
- 主要终点
- Working Alliance Inventory (WAI) therapist or patient short form
研究概览
简要总结
Several types of psychotherapy are equally effective to treat mental disorders. However, many patients remain symptomatic after treatment. The investigators demonstrated that a professional development training program to improve psychotherapists' skills at identifying and repairing therapeutic alliance tensions resulted in improved therapeutic alliance (an important therapeutic ingredient) and patient mental health outcomes. However, the investigators delivered this training program by conventional in-person workshops which limited access by psychotherapists living outside large urban centres. Further, post-study interviews with therapists suggested that cultural/diversity factors complicated the therapeutic alliance.
In the current study, the investigators will test the effectiveness and acceptability of a virtually-delivered training program to psychotherapists in North America to improve their capacity to identify and repair problems in the therapeutic alliance, including tensions related to patient diversity. The investigators will also examine how acceptable the virtually-delivered training is to psychotherapists and whether they would use such training in their practice. Participants in the study will be community-based licensed psychotherapists and their patients engaging in therapy in North America. Patient mental health outcomes, therapeutic alliance, and diversity issues will be assessed by comparing outcome measures between three groups: 1) therapists complete a self-paced virtual course + consultation, 2) therapists complete synchronous workshop + consultation, 3) control: therapists do not complete training.
The team of investigators developed Canada's largest psychotherapy practice-research network and has expertise in clinical trials, diversity, and education research of virtual training. State of the art training is often out of the reach of therapists who live outside of urban centres, and the effectiveness and acceptability of providing training virtually is not well-studied in mental health care. This study will improve psychotherapists' effectiveness at managing the therapeutic alliance and issues related to diversity, and will improve patient mental health outcomes thus promising to reduce the burden of mental illness.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Single (Participant)
盲法说明
Patients will be blind to therapist study arm allocation.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Therapist participants: The investigators will recruit mental health professionals who deliver psychotherapy in North American community settings; inclusion criteria: therapists are in good standing with their provincial or state regulatory college, their scope of practice includes individual psychotherapy for adults in North America; they are able to accept a minimum of 3 new participating patients into their current practice to conduct 6 consecutive therapy sessions via a secure, PHIPA compliant virtual meeting platform.
- •Patient Participants: Adults (> 18 years) residing in Canada or the United States who want to engage in therapy with a study therapist or who have recently sought services from a study therapist; inclusion criteria: have participated in fewer than 3 sessions with their study therapist and anticipate being able to see their study therapist for 6 sessions over the next 6 months.
排除标准
- •Therapist participants: The investigators will exclude therapists who are employed by an organization if the investigators cannot obtain organizational approval from their employer or coordinate data collection from an alternate virtual platform in instances where the employing organization does not permit the use of the study platform. Therapists will also be excluded if they have completed professional development workshop after 2017 with PPRNet.
- •Patient participants: The investigators will exclude patients if they: (a) have a psychotic or neurocognitive disorder that may preclude engagement in psychotherapy, (b) are in concurrent psychological treatment with another practitioner, (c) are at high risk of suicide or suicidal behaviors as assessed by their therapist (e.g., suicide attempt or hospitalization for suicidal behaviors in the past 6 months), or (d) for whom the therapist judge that approaching them with information about the study will be harmful.
研究组 & 干预措施
Virtual Training Program
Asynchronous virtual training professional development program including consultation.
干预措施: Virtual Training Program (Behavioral)
Training as Usual
Synchronous virtual workshop professional development including consultation.
干预措施: Training as Usual (Behavioral)
No Training
No training, therapy as usual.
干预措施: No Training (Behavioral)
结局指标
主要结局
Working Alliance Inventory (WAI) therapist or patient short form
时间窗: Patients and therapists will complete it after each of 6 consecutive study psychotherapy session (frequency will range from once a week to once a month depending on the client's typical session interval).
12-item self-report measure used to assess the therapeutic alliance by either therapist or client. Yields scores on three subscales: task, bond, and goal. Min subscale score is 12, max score is 84 with higher scores indicate greater alliance.
Ruptures Resolution Rating System (3RS)
时间窗: Sessions will be coded by trained raters after all session recordings have been collected.
Observer-based coding system for identifying therapeutic alliance ruptures and resolutions.
Working Alliance Inventory (WAI) therapist or patient short form
时间窗: Patients and therapists will complete it after each of 6 consecutive study psychotherapy session (frequency will range from once a week to once a month depending on the client's typical session interval).
12-item self-report measure used to assess the therapeutic alliance by either therapist or client. Yields scores on three subscales: task, bond, and goal. Min subscale score is 12, max score is 84 with higher scores indicate greater alliance.
Ruptures Resolution Rating System (3RS)
时间窗: Sessions will be coded by trained raters after all session recordings have been collected.
Observer-based coding system for identifying therapeutic alliance ruptures and resolutions.
次要结局
- Patient Health Questionnaire (PHQ-9)(Patients will complete it before starting study psychotherapy sessions, after completing all study sessions (6 weeks to 6 months depending on the client's typical session interval), and at 3-month follow-up.)
- Generalized Anxiety Disorder questionnaire (GAD-7)(Patients will complete it before starting study psychotherapy sessions, after completing all study sessions (6 weeks to 6 months depending on the client's typical session interval), and at 3-month follow-up.)
- Inventory of Interpersonal Problems (IIP-32)(Patients will complete it before starting study psychotherapy sessions (6 weeks to 6 months depending on the client's typical session interval), after completing all study sessions, and at 3-month follow-up.)
- Defense Mechanism Rating Scales (DMRS-SR-30)(Patients will complete it before starting study psychotherapy sessions, after completing all study sessions (6 weeks to 6 months depending on the client's typical session interval), and at 3-month follow-up.)
- Experiences in Close Relationships (ECR-12)(Patients will complete it before starting study psychotherapy sessions and 3 months after completing therapy sessions. Therapists will completed it before receiving training.)
- Certainty About Mental States Questionnaire (CAMSQ)(Therapists will complete the measure before and after receiving training.)
- Multidimensional scale of perceived social support (MSPSS)(Patients will complete it before starting study psychotherapy sessions.)
- Rosenberg Self-Esteem Scale (RSES)(Patients will complete it before starting study psychotherapy sessions.)
- Epistemic Trust, Mistrust, and Credulity Scale (ETMCQ)(Patients will complete it before starting study psychotherapy sessions.)
- Outcome Rating Scale (ORS)(Patients and therapists will complete it after each of 6 consecutive study psychotherapy session (frequency will range from once a week to once a month depending on the client's typical session interval).)
- Schwartz Outcome Scale (SOS-10).(Patients will complete it before starting study psychotherapy sessions, after each study-related therapy session (over 6 weeks to 6 month period), and at 3-month follow-up; therapists will complete it after each study session (6 weeks to 6 months).)
- Multitheoretical List of Therapeutic Interventions (MULTI-30)(Therapists and patients will complete respective versions of the measure after completing all study therapy sessions (6 weeks to 6 months after the first study session depending on the frequency of study session).)
- Real Relationship Inventory (RRI)(Therapists and patients will complete respective versions of the measure after completing all study therapy sessions.)
- Patient drop-out(Patient drop-out will be monitored throughout the study.)
- Trauma-informed Care Provider Survey (TICPS)(Therapists will complete the measure before and after receiving training.)
- Gay Affirmative Practice Scale (GAP)(Therapists will complete the measure before and after receiving training.)
- Multicultural Counseling Self-Efficacy Scale(Therapists will complete the measure before and after receiving training.)
- Psychologist and Counselor Self-Efficacy Scale (CASES)(Therapists will complete the measure before and after receiving training.)
- Adverse Childhood Experiences - Philadelphia version (Philly-ACES)(Patients will complete it before starting study psychotherapy sessions.)
- Trauma Symptom Discrimination Scale (TSDS)(Patients will complete it before starting study psychotherapy sessions.)
- Patient Health Questionnaire (PHQ-9)(Patients will complete it before starting study psychotherapy sessions, after completing all study sessions (6 weeks to 6 months depending on the client's typical session interval), and at 3-month follow-up.)
- Generalized Anxiety Disorder questionnaire (GAD-7)(Patients will complete it before starting study psychotherapy sessions, after completing all study sessions (6 weeks to 6 months depending on the client's typical session interval), and at 3-month follow-up.)
- Inventory of Interpersonal Problems (IIP-32)(Patients will complete it before starting study psychotherapy sessions (6 weeks to 6 months depending on the client's typical session interval), after completing all study sessions, and at 3-month follow-up.)
- Defense Mechanism Rating Scales (DMRS-SR-30)(Patients will complete it before starting study psychotherapy sessions, after completing all study sessions (6 weeks to 6 months depending on the client's typical session interval), and at 3-month follow-up.)
- Experiences in Close Relationships (ECR-12)(Patients will complete it before starting study psychotherapy sessions and 3 months after completing therapy sessions. Therapists will completed it before receiving training.)
- Certainty About Mental States Questionnaire (CAMSQ)(Therapists will complete the measure before and after receiving training.)
- Multidimensional scale of perceived social support (MSPSS)(Patients will complete it before starting study psychotherapy sessions.)
- Rosenberg Self-Esteem Scale (RSES)(Patients will complete it before starting study psychotherapy sessions.)
- Epistemic Trust, Mistrust, and Credulity Scale (ETMCQ)(Patients will complete it before starting study psychotherapy sessions.)
- Outcome Rating Scale (ORS)(Patients and therapists will complete it after each of 6 consecutive study psychotherapy session (frequency will range from once a week to once a month depending on the client's typical session interval).)
- Schwartz Outcome Scale (SOS-10).(Patients will complete it before starting study psychotherapy sessions, after each study-related therapy session (over 6 weeks to 6 month period), and at 3-month follow-up; therapists will complete it after each study session (6 weeks to 6 months).)
- Multitheoretical List of Therapeutic Interventions (MULTI-30)(Therapists and patients will complete respective versions of the measure after completing all study therapy sessions (6 weeks to 6 months after the first study session depending on the frequency of study session).)
- Real Relationship Inventory (RRI)(Therapists and patients will complete respective versions of the measure after completing all study therapy sessions.)
- Patient drop-out(Patient drop-out will be monitored throughout the study.)
- Trauma-informed Care Provider Survey (TICPS)(Therapists will complete the measure before and after receiving training.)
- Gay Affirmative Practice Scale (GAP)(Therapists will complete the measure before and after receiving training.)
- Multicultural Counseling Self-Efficacy Scale(Therapists will complete the measure before and after receiving training.)
- Psychologist and Counselor Self-Efficacy Scale (CASES)(Therapists will complete the measure before and after receiving training.)
- Adverse Childhood Experiences - Philadelphia version (Philly-ACES)(Patients will complete it before starting study psychotherapy sessions.)
- Trauma Symptom Discrimination Scale (TSDS)(Patients will complete it before starting study psychotherapy sessions.)
- Certainty About Mental States Questionnaire (CAMSQ)(Patients will complete it before starting study psychotherapy sessions.)
研究者
Giorgio A. Tasca
Principal Investigator, Full Professor
University of Ottawa