Doing More With Less": Optimizing Psychotherapeutic Services in the Mental Health System

NCT03608449 | Unknown

• 1 other identifier: SHA-005-18
• Study Type: interventional
• Target: 100
• Locations: 0 countries
• Sites: N/A

Brief Summary

Psychotherapy is one of the cornerstones of mental health services. It is provided by psychiatrist, psychologists and psychiatric social worker in both hospital and out-patient services, and is assumed to require massive manpower and training inputs. Internationally, the clinical outcomes of routine mental health services are rarely recorded or reported. However, a rough estimation is that half (40-60%) of all psychotherapies have a favorable clinical outcome. Recently (Clark et al, 2017), the English Improving Access to Psychological Therapies (IAPT) Program, which delivers psychotherapies to more than 537 000 patients in the UK each year, indicated that 44% of the patients recovered, and 62%- improved. Consistent with a causal model, most organizational factors also predicted between-year changes in outcome, together accounting for 33% of variance in reliable improvement and 22% for reliable recovery. The proposed study aims at dramatically improving the yield of psychotherapies in the Mental Health Services by combining monitoring and patient-therapist matching strategies. The first will be achieved by implementing Routine Outcome Monitoring (ROM), and the second- by applying a patient-therapist match-re-match procedure during psychotherapy

Conditions

Anxiety Disorder; Affective Disorders; Personality Disorders

Outcome Measures

Primary Outcomes (4)

• OQ-45 (outcome measure)

  is the most commonly-used outcome measure in psychotherapy. It provides both a measure of weekly change on which the feedback to therapists and patients was based and the criterion measure for classification of a patient into an outcome group on a scale of 0 ("never") to 4 ("always")

  up to 14 months

• SEQ (session outcome)

  The SEQ-4 validates the WAI-6, and allows the better identification of sessions in which ruptures and repairs occurred. The questionnaire includes 20 bipolar statements ranges on a 7 degrees Likert scale (e.g.:, 1 "sad" to 7 "happy"). the statements refers to 2 dimensions: the dimension of the meeting itself ("the current meeting was ...") and the dimension of feeling ("I feel now ...").

  up to 14 months

• WAI (working alliance)

  To measure alliance at the end of each session, we will use the patient-version of the Session Alliance Inventory. The SAI is a 6-item short-short version of the Working Alliance Inventory. the questionnaire includes 6 items on a scale of 1 ("does not describe how I feel") to 7("exactly describes how I feel").

  up to 14 months

• HSCL-11 (symptoms)

  The HSCL-11 will be filled by the patient at the beginning of study and thereafter- every two weeks. it includes 11 items on a scale of 1 ("not at all") to 4("a lot").

  up to 14 months

Secondary Outcomes (2)

• PWB (psychological well-being)

  up to 14 months

• Satisfaction from therapy (CSQ)

  up to 14 months

Study Arms (2)

study group

ACTIVE COMPARATOR

after monitoring treatment outcomes for 4 weeks, treatment plan or psychotherpist will be changed according to scoring by the director of department.

Other: questionnaires

control group

PLACEBO COMPARATOR

treatment as usual. treatment counitunes as usual without depending on monitoring treatment outcomes.

Other: questionnaires

Interventions

questionnaires OTHER

questionnaire about mental health status during psychotherapy

control group; study group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• All enrolled patients must have a mobile phone capable of hosting the ROM-on-mobile system.
• patients with anxiety/ affective (depressive and bi-polar)/ personality disorders

You may not qualify if:

• Patients exceeding 65 years at their date of admission,
• Patients with impaired Hebrew fluency (difficulties in either reading or writing),
• Evidence of organic brain syndrome or mental retardation,
• Patients with psychotic disorders (e.g. - schizophrenia, delusional disorders)
• Evidence of probable need for hospitalization,
• Patients admitted only for diagnostic purposes,
• Patients unwilling to be enrolled in the study.

Sponsors & Collaborators

• Shalvata Mental Health Center: lead

MeSH Terms

Conditions

Anxiety Disorders; Mood Disorders; Personality Disorders

Interventions

Surveys and Questionnaires

Condition Hierarchy (Ancestors)

Mental Disorders

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Study Officials

• Shlomo Mendalovitch, Dr

  Shalvata mental health hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Shlomo Mendalovitch, Dr

CONTACT

+972-9-7478532; mendlovic@clalit.org.il

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: not relevant
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Parallel, randomized by order, open study, assignment (matching/rematching) supported by monitoring data.

Study Record Dates

• First Submitted: July 8, 2018
• First Posted: August 1, 2018
• Study Start: September 1, 2018
• Primary Completion: September 1, 2019
• Study Completion: September 1, 2020
• Last Updated: August 1, 2018

Record last verified: 2018-07

Data Sharing

• IPD Sharing: Will not share