Readiness and Progress in Emotion Regulation Therapy

Teachers College, Columbia University36 enrolled

Overview

This study is an open trial designed to examine individual changes that occur before, during, and after 6 modules of Emotion Regulation Therapy (ERT) delivered via telehealth for individuals in New York State who are experiencing elevated worry, rumination, or self-criticism.

The main questions this study aims to answer are to: 1. Examine temporal patterns of ERT-specific treatment mechanisms (attention regulation, metacognitive regulation, motivation regulation, and valued living), relationships between these mechanisms and negative self-referential processing (NSRP; i.e., rumination, worry, and self-criticism) severity over time, and changes in these mechanisms in response to specific intervention strategies/modules. 2. Investigate the effect of concordance and/or discordance between therapists and clients regarding skill acquisition, treatment goals, and case conceptualizations on treatment mechanisms as well as measures of treatment outcome and satisfaction. 3. Demonstrate the preliminary efficacy of a 6-module, time-variable version of ERT in reducing symptoms of psychological distress (e.g., anxiety, depression, worry, rumination, self-criticism), changing ERT-specific treatment mechanisms (e.g., attention regulation), and improving quality of life and overall functioning. Participants will: 1. Fill out an online pre-screening questionnaire and complete a structured clinical interview via Zoom Healthcare 2. Be enrolled as a patient at the Dean Hope Center for Educational and Psychological Services (DHCEPS), located at Teachers College 3. Attend between 12-22 once-weekly telehealth ERT sessions 4. Complete between 18-28 weekly questionnaires online via Qualtrics (two before starting treatment, 12-22 during each week of treatment, and 4 after ending treatment).

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Rumination Worry Self-Criticism Anxiety Depression Distress, Emotional

Interventions

Emotion Regulation Therapy via TelehealthBEHAVIORAL

The initial stage of treatment focuses on psychoeducation about anxiety/depression, the impact that these cognitions/behaviors/emotions have on recent situations, and self-monitoring of worry/anxiety/depression. The sessions focus on the development of skills that help understand and regulate one's emotional experience (i.e., recognizing emotions when they are happening, identifying the meaning of a given emotion experience, soothing oneself in the context of negative emotional experiences). Following the development of these skills, sessions focus on the application of somatic awareness and emotion regulation skills while imagining emotionally evocative themes. The remaining session focuses on terminating therapy, relapse prevention, and future goals. An Internet-based online platform will be used to promote engagement with and increase accessibility to between-session skills practice and treatment-related activities (e.g., self-monitoring, session summaries, worksheets).

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Between the ages of 18 and 65 * Fluent in English (and therefore able to provide consent) * Currently living in New York State * Access to at least one device with internet and video-conferencing capabilities * High self-reported worry, rumination, and/or self-criticism * Meet Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) criteria for at least one, current psychological disorder Exclusion Criteria: * Active suicidal ideation or intent * Substance dependence disorder, schizophrenia, bipolar-I disorder, or a primary DSM-5 diagnosis of borderline or narcissistic personality disorder * Currently in therapy or receiving any type of psychosocial treatment * Individuals taking psychotropic mediation that has not been stabilized for a period of at least 3 months * Current students at Teachers College, Columbia University

Locations (1)

Teachers College, Columbia University

New York, New York, United States

RECRUITING

Outcomes

Primary Outcomes

Weekly Assessment of Change in Attentional Control

The Attentional Control Scale (ACS) is a 21-item measure used to measure difficulties with concentration associated with problems regulating emotions. The focusing and shifting subscales of the ACS align with the two attention emotion regulation (ER) skills taught in ERT.

Time frame: Weekly from Baseline (2 weeks) through Treatment (12-22 weeks) and Follow-Up (4 weeks)

Weekly Assessment of Change in Decentering

The decentering subscale of the Experiences Questionnaire (EQ-D) is an 11-item subscale assessing one's ability to distance themselves from their emotional experience, which is one metacognitive ER skill taught during ERT. Higher scores on this subscale indicate better ability to distancing oneself from one's emotional experience.

Time frame: Weekly from Baseline (2 weeks) through Treatment (12-22 weeks) and Follow-Up (4 weeks)

Weekly Assessment of Change in Reappraisal

The reappraisal subscale of the Emotion Regulation Questionnaire (ERQ) is a 6-item measure of the ability to regulate emotions, using the strategy of reappraisal. Higher scores on this subscale indicate a better ability to regulate emotions using the strategy of reappraisal.

Time frame: Weekly from Baseline (2 weeks) through Treatment (12-22 weeks) and Follow-Up (4 weeks)

Weekly Assessment of Change in Valued Living/Action

The Valuing Questionnaire (VQ) is a 10-item measure of the degree to which patients live by their values in daily life. It uses a 7-point Likert scale (0-6) to assess progress and obstructions to valued living. Higher scores on this measure indicate more valued living.

Time frame: Baseline, 1st Treatment Session, Follow-Up (4 weeks)

Weekly Assessment of Change in Clarity of Approach-Avoidance Motivation

The Mental Representation of Approach Avoidance Questionnaire (MRAAQ) is a 42-item self-report assessment designed to capture the mental representation of approach-avoidance motivation.