This research project seeks to acquire a deeper understanding of the complex influences of common factors and specific ingredients in psychotherapy. By using frequent process-outcome measures, it will address individualized mechanisms of change in psychotherapy by assessing both between and within patient change processes, using a wide spectrum of change indicators.
The study is a naturalistic study conducted by collecting data from in-patient units at Modum Bad (psychiatric hospital). The sample includes different patient groups with a variety of psychological disorders. Further, sample is gathered from units using different treatment approaches (short-term psychodynamic treatment, cognitive-behavioral treatment, metacognitive therapy, compassion-focused therapy, relational psychodynamic therapy, existential therapy and stabilizing trauma-therapy). The following specific research questions will be explored: 1. The role of common factors: 1. What are the relative influences of different common factors such as agreement on task and goals, treatment credibility and 'the real relationship', across treatments and diagnoses? 2. Do some common factor variables stand out regarding ability to explain variance in outcome and across outcomes? 3. Do measures of common factors have a consistent effect on outcome across treatment models and diagnoses, or does the explanatory value of common factors vary across diagnose and treatment model? 2. The role of specific change mechanisms (affective, cognitive and meta-cognitive): 1. To what extent do specific change mechanisms predict change in various outcome domains? 2. Are these specific change mechanisms equally important predictors, or do they vary across treatment or diagnose? 3. Are there interaction effects between common factors and specific factors across treatment models, patient diagnoses and outcome domain? Self-report data will be collected three times a week on mechanisms of change and symptoms, established by psychotherapy theory and research evidence as important for psychological change. The data collection consists of three different forms administered once per week on different days. The forms are separated by topic; symptoms, contextual factors, and change processes. The questions in the forms are selected from short instruments with good psychometric qualities. The data collection procedure has at present been tested on five patient cohorts with good results.
Study Type
OBSERVATIONAL
Enrollment
520
There are different psychotherapy models offered across the units. All patients receive individual treatment and group therapy or psychoeducative groups.
Modum Bad
Vikersund, Buskerud, Norway
RECRUITINGSymptom checklist revised (SCL-90-R)
A general measure of symptoms distress
Time frame: Change measure (baseline, 14 weeks, and 12 months).
Inventory of interpersonal problems
Self-report questionnaire of interpersonal problems
Time frame: Change measure (baseline, 14 weeks, and 12 months).
Beck's depression inventory
Measure of depressive symptoms
Time frame: Change measure (baseline, 14 weeks, and 12 months).
PTSD checklist for Diagnostic and Statistical Manual 5 (PCL-5)
PTSD symptom measure
Time frame: Change measure (baseline, 14 weeks, and 12 months).
M-POQ outcome, anxiety
Measures anxiety symptoms
Time frame: Change measure (baseline, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks and 14 weeks).
M-POQ outcome, depression
Measures depression symptoms
Time frame: Change measure (baseline, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks and 14 weeks).
M-POQ outcome, loneliness
Measures experienced loneliness
Time frame: Change measure (baseline, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks and 14 weeks).
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M-POQ outcome, resilience
Measures experienced recilience
Time frame: Change measure (baseline, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks and 14 weeks).
M-POQ outcome, well-being
Measures experienced well-being
Time frame: Change measure (baseline, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks and 14 weeks).