None listed
Conditions
Brief summary
This pilot study will evaluate the delivery of a novel adaptation of a transdiagnostic group cognitive behavioural treatment for 40 adults with mixed anxiety disorders (with or without depressive symptoms) of moderate severity treated in a primary care setting.: the Brief Intervention Coordination Service (BIC, Pegasus). The study will address feasibility and acceptability for participants and provide preliminary estimates of efficacy in reducing psychological distress, ahead of a planned randomised controlled trial. Anxiety symptoms, and mixed anxiety and depressive symptoms of moderate severity are the most common mental health conditions in the community, with high unmet need in primary care. This is an important public health concern due to the high prevalence, chronicity, impairment in quality of life and socioeconomic costs. Primary care counselling services are strained due to high demand. The Anxiety Disorders Service (CDHB) successfully developed and evaluated a transdiagnostic group cognitive behaviour therapy (TCBT) treatment for mixed anxiety disorders, with or without depression. The package was adapted from the Unified Protocol for transdiagnostic treatment of emotional disorders (David Barlow and colleagues 2010, 2011) .The TCBT package was effective and rated highly by participants with significant service efficiencies. This TCBT group has been adapted for this project to provide a shorter but sufficiently intense treatment for the moderate symptom group that may not be adequately treated by the limited number of counselling sessions (up to 5 hours) currently available in primary care. The efficiencies of group treatment mean that this evidenced-based treatment can be delivered with fewer staff resources yet patients receive at least twice the therapy hours compared to usual BIC treatment. Four group programmes (6 x 2 hour sessions) will be run with 10 participants per group. Treatment will be delivered jointly by staff from BIC and from the Anxiety Disorders Service. Primary outcome is the Kessler Psychological Distress Scale (Kessler 10+) assessed pre-post and at 3- month follow-up. If successful, the TCBT approach has the potential to boost routine service delivery in primary care. Early effective treatment may prevent the need for referrals to secondary services.
Interventions
Cognitive behaviour therapy (CBT) delivered in a transdiagnostic group therapy format i.e. for those with any anxiety symptoms of moderate severity (with or without depression).
Two hour sessions weekly for 6 weeks.
Each group will be delivered by two group facilitators. Group facilitators are qualified health professionals experienced in delivering CBT (clinical psychologists, counsellor with post graduate CBT qualifications).
The TCBT treatment package is manualised. An integrity checklist
Cognitive behaviour therapy (CBT) delivered in a transdiagnostic group therapy format i.e. for those with any anxiety symptoms of moderate severity (with or without depression). Two hour sessions weekly for 6 weeks. Each group will be delivered by two group facilitators. Group facilitators are qualified health professionals experienced in delivering CBT (clinical psychologists, counsellor with post graduate CBT qualifications). The TCBT treatment package is manualised. An integrity checklist will be used to check that all planned treatment modules are delivered in each session. Adherence will be monitored by attendance, and by self=reported days/week of practice of strategies, assessed from session 2 onwards. The content of the group includes education about the cognitive behavioural model of anxiety, skills for changing or detaching from unhelpful thinking patterns, learning to face rather than avoid situations, to better tolerate uncomfortable feelings, and developing a plan to maintain changes beyond the group.
Sponsors
Canterbury District Health Board
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Adults; male and female Moderate anxiety symptoms Sufficient English language to understand consent form, complete questionnaires and participate in group Willing to provide informed consent,for the research, willing to participate in group therapy and available to attend all sessions
Exclusion criteria
In crisis, needing acute intervention, substance dependence or other comorbidity which would interfere with the ability to attend or participate in the groups.
Outcome results
None listed