Mechanisms Of Change in Psychotherapy: The Effects of Cognitive Behavioral Therapy and Psychodynamic Therapy in Once - Versus Twice - Weekly Sessions on Outcomes in Depression.

NCT07408687 | Not Yet Recruiting

• 1 other identifier: 924857
• Study Type: interventional
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

The MOP II study examines how to improve therapy for people struggling with a depressive disorder. Cognitive Behavioral Therapy (CBT) and Short-Term Psychodynamic Psychotherapy (STPP) are two evidence-based treatments for depression that are widely used. Meta-analyses indicate that CBT and STPP are one average equally effective and superior to no treatment. However, many patients do not respond sufficiently and relapse rates after acute phase treatment are high. Earlier research and theoretical insights suggest three promising strategies to enhance the effectiveness of psychotherapy. First, we want to examine whether increasing the frequency of the sessions will increase the effect of therapy. We want to compare once-weekly and twice-weekly sessions in both CBT and STPP to see whether more frequent sessions lead to better and more lasting reductions in depressive symptoms with the same total number of sessions. Second, the study aims to answer what works for whom in two different psychotherapeutic approaches. People with depression differ in personality, life experiences, relationship styles, and how they understand the causes of their depression. Previous findings suggest that patients do better when the therapy approach matches how they see their problems. The MOP II study wants to replicate this finding. Third, the study wants to examine how therapy leads to change. In CBT, improvement is thought to happen through changes in thinking patterns, such as fewer negative automatic thoughts and less rumination. In STPP, change is expected to come from better self-understanding, greater emotional awareness, and healthier ways of relating to others. Consequently, the goal of the MOP II study is to find out whether more frequent therapy, better matching of patients to treatment type, and a clearer understanding of how therapy works can lead to faster improvement of depressive symptoms.

Conditions

Depression - Major Depressive Disorder; Cognitive Behavior Therapy; Psychodynamic Therapy

Keywords

Mechanisms of change in Psychotherapy; Frequency of therapy sessions

Outcome Measures

Primary Outcomes (2)

• Hamilton Depression Rating Scale (HDRS)

  Hamilton Depression Rating Scale (HDRS) is a clinician-rated questionnaire used to assess the severity of depressive symptoms. Higher total scores indicate more severe depression.

  From enrollment to the end of treatment at 28 weeks

• The Patient Health Questionnaire (PHQ-9)

  PHQ-9 is a 9-item scale that measures levels of depression. The PHQ-9 is a self assessment instrument and higher scores indicate more severe depressive symptoms

  From baseline (enrollment) to end of treatment at 28 weeks

Secondary Outcomes (50)

• General Anxiety Disorder

  From baseline to end of treatment at 28 weeks

• The Work And Social Adjustment Scale (WSAS)

  From enrollment to end of treatment at 28 weeks

• The Personality Inventory for DSM-5-Brief Form (PID-5-BF)-Adult

  From enrollment to end of treatment at 28 weeks

• The Level of Personality Functioning Scale-Brief Form (LPFS-BF)

  From enrollment to end of treatment at 28 weeks

• The Self- Reflection and Insight Scale (SRIS)

  From enrollment to end of treatment at 28 weeks

Study Arms (4)

CBT once weekly

EXPERIMENTAL

The patients in this arm will receive CBT once a week in 16 weeks plus three monthly boosters during 3 months

Behavioral: Cognitive behavior therapy

CBT twice weekly

EXPERIMENTAL

The patients in this arm will receive CBT twice a week in 8 weeks plus three booster sessions every second week three times.

Behavioral: Cognitive behavior therapy

STPP once weekly

EXPERIMENTAL

The patients in this arm will receive STPP once a week in 28 weeks.

Behavioral: Psychodynamic therapy

STPP twice weekly

EXPERIMENTAL

The patients in this arm will receive STPP twice a week in 14 weeks.

Behavioral: Psychodynamic therapy

Interventions

Psychodynamic therapy BEHAVIORAL

The patients will receive psychodynamic therapy

STPP once weekly; STPP twice weekly

Cognitive behavior therapy BEHAVIORAL

The study explores cognitive behavior therapy and psychodynamic therapy

CBT once weekly; CBT twice weekly

Eligibility Criteria

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

You may qualify if:

• age 18-65 years
• Major Depressive Disorder Hamilton Depression Rating Scale (HDRS) \> 14.
• Speak and understand a Scandinavian language
• Willingness and ability to give informed consent.

You may not qualify if:

• Current or past neurological illness
• Traumatic brain injury
• Current alcohol and/or substance dependency disorders
• Psychotic disorders
• Bipolar disorders
• Developmental disorders
• IQ \<70.

Sponsors & Collaborators

• University of Oslo: lead

Study Sites (1)

Oslo University Hospital

Oslo, Norway, Postboks 4959, Norway

Location

MeSH Terms

Interventions

Cognitive Behavioral Therapy

Intervention Hierarchy (Ancestors)

Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: February 6, 2026
• First Posted: February 13, 2026
• Study Start: March 1, 2026
• Primary Completion (Estimated): December 31, 2030
• Study Completion (Estimated): December 31, 2030
• Last Updated: February 18, 2026

Record last verified: 2026-02

Locations

NO (1)