Anxiety Disorders
Conditions
Keywords
Anxiety Disorders, Group Psychotherapy, Cognitive-Behavioral Therapy, Dance/Movement Therapy, CBT, DMT, Unified Protocol
Brief summary
The current pilot study will examine and compare the effectiveness of two group psychotherapies for mixed anxiety disorders: 1. unified cognitive-behavioral protocol, adapted to a group format. 2. combined cognitive-behavioral and dance/movement therapy. In addition, change in proposed mechanism in each therapy will be examined, along with their association with change in outcome measures during therapy.
Detailed description
The current pilot study will examine and compare the effectiveness of two group psychotherapies for mixed anxiety disorders: 1. unified cognitive-behavioral protocol, adapted to a group format. 2. combined cognitive-behavioral and dance/movement therapy. 24 patients will be randomized to 1 of the two treatment arms and treated with 20 weekly 1.5-2 hours therapy sessions. Independent evaluator and self-reports measures will be collected at intake, pre-treatment, session by session, post-treatment and and follow-up. Hypotheses: 1. Both groups will show effectiveness, as revealed by reduction in anxiety severity and increase in valued living. 2. Changes in process measures (proposed mechanism of change - emotion regulation, working alliance, fear of bodily sensations, bodily/movement awareness) will be predictive of change in outcome measures (anxiety severity and valued living). 3. Changes in bodily/movement awareness will be more predictive of change in outcome measures in the CBT-DMT group than in the unified protocol group.
Interventions
BEHAVIORALUnified Cognitive-Behavioral Therapy
20 weekly sessions (1.5-2 hours each), based on the principles of the Unified Protocol for Trans-diagnostic Treatment of Emotional Disorders (Barlow et al., 2011) adapted for a group format. The treatment will include 8 different modules of varying length: motivation enhancement, understanding emotions, identifying and monitoring emotions, emotional awareness training, cognitive appraisal and reappraisal, emotional avoidance, emotion driven behaviors, awareness and tolerance of bodily sensations, relapse prevention.
BEHAVIORALCombined Cognitive-Behavioral and Dance/Movement Therapy
20 weekly sessions (1.5-2 hours each), based on combined cognitive-behavioral techniques (psychoeducation, awareness and tolerance of emotions, interoceptive exposures, in-vivo exposures, cognitive flexibility) and dance/movement techniques.
Sponsors
Shalvata Mental Health Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* One of the following primary axis I DSM-IV-TR diagnoses: Panic disorder with or without Agoraphobia; Social Anxiety Disorder; Generalized Anxiety Disorder; Anxiety Disorder Not Otherwise Specified; Adjustment Disorder With Anxiety; Adjustment Disorder With Mixed Anxiety and Depressed Mood * If on medication or in other types of treatments, patients must be willing to remain stable on their treatment for the duration of the acute phase of the study (5-6 months) * Provision of written informed consent
Exclusion criteria
* Current or past schizophrenia, psychosis, or bipolar disorder. * Current suicidal ideation. * Current substance/alcohol dependence or abuse. * Cluster A or B personality disorder. * Pregnancy (for women).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Hamilton Anxiety Rating Scale | Intake (entry to study), Pre-treatment (1 month from intake), Post-Treatment (6 months from intake), Follow-Up (7 months from intake) | Structured independent evaluator interview for assessing severity of anxiety |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Depression, Anxiety, Stress Scales-21 | Intake (entry to study), Weekly during treatment (weekly between 1-6 months from intake), Post-Treatment (6 months from intake), Follow-Up (7 months from intake) | Self-report measure of depression, anxiety and stress |
| Change in Valued Living Questionnaire | Intake (entry to study), Pre-treatment (1 month from intake), Mid-Treatment (3.5 months from intake), Post-Treatment (6 months from intake), Follow-Up (7 months from intake) | Self-report measure of valued living |
| Change in Mini International Neuropsychiatric Interview | Intake (entry to study), Pre-treatment (1 month from intake), Post-Treatment (6 months from intake), Follow-Up (7 months from intake) | Structured independent evaluator interview for assessing Diagnostic and Statistical Manual of Mental Disorders IV Text Revision (DSM-IV-TR) axis I diagnoses |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change in Difficulties in Emotion Regulation Scale | Intake (entry to study), Weekly during treatment (weekly between 1-6 months from intake), Post-Treatment (6 months from intake), Follow-Up (7 months from intake) | Self-report measure of different aspects of emotion regulation difficulties |
| Change in Body Sensations Questionnaire | Intake (entry to study), Pre-treatment (1 month from intake), Mid-Treatment (3.5 months from intake), Post-Treatment (6 months from intake), Follow-Up (7 months from intake) | Self-report measure of fear of bodily sensations |
| Change in Bodily Awareness of Emotions Subscale of the Emotion Awareness Questionnaire - Revised | Intake (entry to study), Pre-treatment (1 month from intake), Mid-Treatment (3.5 months from intake), Post-Treatment (6 months from intake), Follow-Up (7 months from intake) | Self-report measure of awareness of bodily sensations/movement and their emotional meaning |
| Change in Working Alliance Inventory - Short and Revised form - Group version | Intake (entry to study), Pre-treatment (1 month from intake), Session 5 (2 months from intake), Mid-Treatment (3.5 months from intake), Post-Treatment (6 months from intake), Follow-Up (7 months from intake) | Self-report measure of working alliance in group therapy |
Countries
Israel
Outcome results
None listed