Imagery Rescripting Within Primary Care to Manage Depression: A Single-Case Experimental Design
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 12
- 试验地点
- 1
- 主要终点
- Depressive symptom severity
研究概览
简要总结
In the current study we aim to investigate the feasibility, acceptability, and effectiveness of ImRs offered by mental health assistants within primary care to reduce depressive symptoms. In a single-case experimental design (SCED) study, the following hypotheses will be tested:
- ImRs results in a reduction of depressive symptoms compared to baseline, and this reduction lasts up to six months.
- Patients with complaints of depressive symptoms find ImRs an acceptable form of intervention when offered by mental health assistants within a general practice setting.
Participants will wait for 2-4 weeks and then receive 5 sessions of ImRs over a period of 10 weeks. During these sessions, negative memories related to their depressed feelings are rescripted.
详细描述
The study consists of a multiple-baseline case series in which the effectiveness and feasibility of Imagery Rescripting as a therapeutic technique will be investigated within primary care, with the aim of reducing depressive symptoms. The intervention will be provided by the mental health assistants (POH-GGZ) at the GP practice that is linked to the University of Amsterdam (Huisartsenpraktijk UvA). These mental health assistant have been trained in Imagery Rescripting. In the study, participants are randomly assigned to a baseline condition of 2-4 weeks, and a subsequent intervention condition of 10 weeks. During the intervention, all patients receive five sessions of Imagery Rescripting (45 minutes per session). Throughout these 12-14 weeks, and for 4 weeks after, participants complete bi-weekly (i.e., twice per week) measurements. The total number of bi-weekly measurements is thus 32-36, depending on the baseline condition that participants are randomized to. In addition, there will be 5 longer questionnaires, including a 3 and 6-month follow-up. Participants that are invited to the study but that do not want to participate will receive care as usual by the mental health assistant.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Main complaint of depressive feelings, as indicated by both the mental health assistant and the patient.
- •HADS score for the depression subscale ≥
- •Ability to understand, read, write and speak Dutch or English.
- •Age between 18 and
- •Willingness to participate in the study and treatment.
排除标准
- •Acute suicide risk (BDI-II-item9 score of 3).
- •If the mental health assistant suspects that the patient may have a primary diagnosis of bipolar disorder, psychosis, substance use disorder, low IQ, or if the patient suffers from serious neurological problems such as dementia, then the patient is not included. There will not be a formal assessment of a primary diagnosis.
研究组 & 干预措施
Imagery Rescripting
The ImRs will follow the protocol as developed by Arntz and Weertman (1999), that was tailored for the primary care setting. The total of sessions will be set at 6. In session 1, the patient and therapist will create a list of core beliefs and memories to be rescripted. Session 1 will take place before the baseline phase, allowing us to assess core beliefs prior to the intervention. In session 2-6, one negative emotional memory is selected and rescripted (45 minutes per session). If necessary, a memory can be rescripted twice. In session 2-3 the therapist enters the image and rescripts the memory, whereas in session 4-6 the patient adult-self enters the image and rescripts the memory. If patients are uncomfortable doing so, session 4 can still be guided by the therapist.
干预措施: Imagery Rescripting (Behavioral)
结局指标
主要结局
Depressive symptom severity
时间窗: 16-18 weeks, twice a week
Depressive symptom severity is assessed with the PHQ-2 (Kroenke et al., 2003). The PHQ-2 consists of the first two items of the PHQ-9 and measures the frequency of depressed mood and anhedonia in the past week. Scores range from 0-6 and higher scores mean more depressive symptoms.
Self-esteem
时间窗: 16-18 weeks, twice a week
Self-esteem will be measured with a single question "How have you felt about yourself in the past week?" Participants rate this question on a scale from -100 (very negative) to +100 (very positive).
Dysfunctional core beliefs
时间窗: 16-18 weeks, twice a week + 3 month and 6 month follow-up
Participants will formulate these negative beliefs about themselves or the world/other people together with the mental health assistant during the first session and then rate how convincing these beliefs are on a scale from 0 (not at all convincing) -100 (very convincing).
次要结局
- Hospital Anxiety and Depression Scale(Baseline, pre-treatment, 4-weeks post-treatment, 3 month follow-up, 6 month follow-up)
- Rosenberg Self-Esteem Scale(Baseline, pre-treatment, 4-weeks post-treatment, 3 month follow-up, 6 month follow-up)
- Suicidal thoughts(Baseline, pre-treatment, 4-weeks post-treatment, 3 month follow-up, 6 month follow-up)
- Emotional memory(Pre-treatment, 4-weeks post-treatment, 3 month follow-up, 6 month follow-up)
研究者
Lotte Stemerding
Dr.
University of Amsterdam