Modifying Treatment Expectations in Depression: the Role of Social Learning

NCT05245370 | Completed

• 1 other identifier: Social learning_testimonials
• Study Type: interventional
• Target: 171
• Locations: 1 country
• Sites: 1

Brief Summary

Research has shown that treatment expectations play a major role in the course of mental disorders and that positive expectations have a beneficial impact on treatment outcomes. Expectations can develop in different ways, whereby an emerging body of research has shown that social learning plays a significant role in this process. To date, most studies have investigated the impact of social learning on treatment expectations in the context of pain relief. Little is known about the impact of social learning in the psychotherapeutic treatment of depression. Therefore, this study investigates whether treatment expectations regarding the treatment of depression can be modulated via social learning, i.e., showing positive treatment testimonials. Hypotheses: H1: The investigators predict that individuals who are provided with treatment testimonials (experimental groups) show a greater change toward positive treatment expectations compared to individuals who do not view such testimonials (control groups). H2: The investigators predict that individuals provided with treatment testimonials will, compared to the control groups, show a greater change in secondary outcome variables in the following ways: a greater decrease in perceived uncertainty/ barriers; a greater decrease in stigma/ negative attitudes toward psychotherapy; a greater increase in intentions to seek therapy; a greater willingness to try the specific technique described in the videos. H3: Inter-individual differences in the effect of provided testimonials are associated with pre-existing factors: level of depressive symptoms; intolerance of uncertainty; treatment experience; locus of control; general self-efficacy; dispositional optimism and cognitive immunization tendencies. Exploratory questions:

1. 1.An exploratory aim of this study is to assess whether viewing different types of testimonials (clinician delivered; patient-delivered; combination of both) has differential effects on treatment expectation change.
2. 2.Furthermore, the investigators want to assess whether implicit treatment expectations change in a similar pattern as explicit treatment expectations.
3. 3.Based on the results of H1 and H2, the investigators aim to assess possible mechanisms of change: e.g. assess whether a change in treatment expectations is mediated by a decrease in perceived uncertainty or a change in stigma/ attitudes toward therapy.

Conditions

Health Care Utilization

Keywords

treatment expectations; social learning; psychotherapy; depression; testimonials

Outcome Measures

Primary Outcomes (1)

• Change from baseline in scores on the Credibility and Expectancy Questionnaire (CEQ) scale

  German version of the Credibility and Expectancy Questionnaire (CEQ), 6-item scale (Raeke, 2013).The CEQ consists of two subscales with four items measuring cognitive-focused credibility (e.g., "At this point, how logical does the therapy offered to you seem?") and two items measuring affect-focused expectations (e.g., "By the end of the therapy period, how much improvement in your symptoms do you really feel will occur?"). The CEQ applies different rating scales; a 9-point scale ranging from 1 (not at all) to 9 (very much) and a percentage rating scale ranging from 0% (not at all) to 100% (very much) with higher sum scores indicating greater treatment credibility and expectations.

  Baseline; post-Intervention (1 day after baseline, after viewing the intervention videos)

Secondary Outcomes (8)

• Change from baseline in scores on the Treatment Expectation Questionnaire (TEX-Q)

  Baseline; post-Intervention (1 day after baseline, after viewing the intervention videos)

• Change from baseline in scores on the subscale for treatment expectations of the the generic rating scale for previous treatment experiences, treatment expectations, and treatment effects (GEEE)

  Baseline; post-Intervention (1 day after baseline, after viewing the intervention videos)

• Change from baseline in D-Scores on the Single-Category Implicit Associations Test (SC-IAT)

  Baseline; post-Intervention (1 day after baseline, after viewing the intervention videos)

• Change from baseline in scores on the Credibility and Personal Reaction Scale

  Baseline; post-Intervention (1 day after baseline, after viewing the intervention videos)

• Change from baseline in scores on perceived uncertainty and perceived barriers to psychotherapy

  Baseline; post-Intervention (1 day after baseline, after viewing the intervention videos)

Other Outcomes (9)

• Patient Health Questionnaire (PHQ-9)

  Baseline

• General Self-Efficacy Scale (GSE)

  Baseline

• Empathy on the Interpersonal Reactivity Index (IRI)

  Baseline

Study Arms (5)

Control group 1: Control video

ACTIVE COMPARATOR

Behavioral: Control video

Control group 2: Rationale video + control video

ACTIVE COMPARATOR

Behavioral: Control video; Behavioral: Rationale video

Rationale video + clinician testimonial

EXPERIMENTAL

Behavioral: Rationale video; Behavioral: Clinician testimonial

Rationale video + patient testimonial

EXPERIMENTAL

Behavioral: Rationale video; Behavioral: Patient testimonial

Rationale video + clinician testimonial + patient testimonial

EXPERIMENTAL

Behavioral: Rationale video; Behavioral: Clinician testimonial; Behavioral: Patient testimonial

Interventions

Control video BEHAVIORAL

Control group 1 will see a control video consisting of basic information about the different types of psychotherapy that are covered by insurance in Germany and the process of applying for psychotherapy with the insurance. The control video is matched in duration (10 minutes), set-up and the overall topic (psychotherapy) to the intervention video testimonials.

Control group 1: Control video; Control group 2: Rationale video + control video

Rationale video BEHAVIORAL

The active control group 2 will see a short rationale and the control video. The rationale is a 2:45 minute-long animated video (designed via the visual communication platform powtoon, https://powtoon.com/) explaining some of the underlying mechanisms of depression.

Control group 2: Rationale video + control video; Rationale video + clinician testimonial; Rationale video + clinician testimonial + patient testimonial; Rationale video + patient testimonial

Clinician testimonial BEHAVIORAL

This group will see the rationale video first, followed by testimonial of a professional clinician/psychotherapist.

Rationale video + clinician testimonial; Rationale video + clinician testimonial + patient testimonial

Patient testimonial BEHAVIORAL

This group will see the rationale video first, followed by testimonial of a patient who is being treated for depression with psychotherapy.

Rationale video + clinician testimonial + patient testimonial; Rationale video + patient testimonial

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• at least 18 years old
• be able understand German (at least B1 level)
• have access to a computer device with internet access

You may not qualify if:

• age below 18 years old
• non correctable hearing or visual impairment

Sponsors & Collaborators

• Philipps University Marburg: lead

Study Sites (1)

Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg

Marburg, 35032, Germany

Location

MeSH Terms

Conditions

Patient Acceptance of Health Care; Depression

Condition Hierarchy (Ancestors)

Treatment Adherence and Compliance; Health Behavior; Behavior; Behavioral Symptoms

Study Officials

• Winfried Rief

  Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Germany, 35032

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: BASIC SCIENCE
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor, Dr.

Study Record Dates

• First Submitted: January 22, 2022
• First Posted: February 17, 2022
• Study Start: January 14, 2022
• Primary Completion: April 15, 2022
• Study Completion: April 15, 2022
• Last Updated: September 29, 2022

Record last verified: 2022-09

Locations

DE (1)