- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01075672
Outcomes of Cognitive Behavioral Therapy (CBT) Interventions Provided by Unlicensed Professionals
May 5, 2023 updated by: Sabine Wilhelm, PhD, Massachusetts General Hospital
Outcomes of Cognitive Behavioral Therapy (CBT) Interventions Provided by Unlicensed Professionals in a General Hospital Setting
To examine the effectiveness and clinical care outcomes of cognitive-behavioral therapy interventions at Massachusetts General Hospital (MGH).
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Detailed Description
Cognitive behavioral interventions are the most widely studied and evidenced-based psychosocial treatment approaches for mental health and health related behavioral problems.
Despite their documented efficacy, there is a scarcity of licensed mental health professionals who are available to treat patients with problems that would be amenable to Cognitive Behavioral Therapy (CBT).
While CBT interventions have a strong base in terms of efficacy in randomized trials, effectiveness and dissemination studies are lacking in comparison, and hence, these interventions are not reaching the patients in most need of services.
Complicating the problem further, insurance companies typically do not reimburse for services provided by trainees who are not licensed.
This is a public mental health problem because it limits the degree to which CBT clinicians can be trained to deliver these treatments, and a particular problem at MGH because referring providers do not have a place to send their patient for CBT services, as trainees constitute a large portion of clinical staff.
To address this issue, the current study seeks to document outcomes of CBT interventions delivered by credentialed but not licensed trainees.
This information can be used to guide policy and reimbursement guidelines for trainees, as well as promote the ability to disseminate efficacious interventions.
Information gained from this project will be used to provide feedback to insurance companies, licensing boards, and mental health community stakeholders regarding decision making re: reimbursement for care provided by supervised trainees.
Additionally, this may be used as a pilot study for a comparative effectiveness study comparing trainees to licensed staff psychologists.
Study Type
Interventional
Enrollment (Anticipated)
250
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02114
- Cognitive-Behavioral Therapy and Behavioral Medicine Programs, Massachusetts General Hospital
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Patients presenting to the Behavioral Medicine Service are generally individuals with an acute or chronic medical condition or medically related concern with or without an associated DSM-IV psychiatric disorder, as well as adult patients who require assistance with changing health or health-risk behaviors. Patients presenting to the OCD program typically have obsessive compulsive disorder, body dysmorphic disorder, Tourette syndrome, compulsive skin picking, or trichotillomania. Patients presenting to the general CBT program typically have panic disorder, social phobia, generalized anxiety disorder, depression, specific phobia, post traumatic stress disorder, attention deficit hyperactivity disorder, or an eating disorder. Patients at any of the programs have an identifiable behavior or behavioral pattern/ mood problem that they would like to change.
- Age 18 or older
- Ability to provide informed consent and comply with the study procedures
- Ability to complete self-report questionnaires (either written hardcopy or computer-based version) with adequate accommodation, if necessary
- Patients with a PCP at MGH, receiving specialty care at MGH, or employees of MGH.
Exclusion Criteria:
- Exhibit active suicidality (suicidal ideation with intent or plan) to the point that more intensive treatment (i.e. acute hospitalization) is required.
- Active untreated and unstable bipolar disorder (i.e. stable bipolar disorder under care of a psychiatrist is allowed).
- Psychosis.
- Mental retardation.
- Any condition that, after the baseline evaluation, is determined to preclude treatment with cognitive behavioral therapy.
- Received more than 4 sessions of CBT for the target disorder within the past 3 years.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Cognitive Behavioral Therapy
|
The participant will then undergo a structured clinical interview with a supervised psychology intern/fellow, which will take approximately 1-3 hours over the course of 1-3 sessions.
The initial assessment will be followed by up to 24 sessions of cognitive behavioral therapy tailored to their particular diagnosis (most diagnoses/problems require approximately 12 sessions, some require fewer, others require more).
The length of treatment will depend on the primary diagnosis/ problem and the complexity and severity of the case.
The clinician and patient will agree on a treatment plan after the initial evaluation, targeting a particular mental health or health related behavioral problem with Cognitive Behavioral Therapy.
This treatment plan will include an agreed upon number of treatment sessions (up to 24).
Other Names:
|
Experimental: Behavioral Medicine with Cognitive Behavioral Therapy
Participants enrolled in this arm of this study will be treated by the behavioral medicine interns with cognitive behavioral therapy focused on both their general health concerns and mental health concerns.
|
The participant will then undergo a structured clinical interview with a supervised psychology intern/fellow, which will take approximately 1-3 hours over the course of 1-3 sessions.
The initial assessment will be followed by up to 24 sessions of cognitive behavioral therapy tailored to their particular diagnosis (most diagnoses/problems require approximately 12 sessions, some require fewer, others require more).
The length of treatment will depend on the primary diagnosis/ problem and the complexity and severity of the case.
The clinician and patient will agree on a treatment plan after the initial evaluation, targeting a particular mental health or health related behavioral problem with Cognitive Behavioral Therapy.
This treatment plan will include an agreed upon number of treatment sessions (up to 24).
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The Schwartz Outcome Scale (SOS-10)
Time Frame: at baseline, and at visits 1 through 24, which will occur approximately 1 week apart.
|
The Schwartz Outcome Scale (SOS-10) is designed to measure a broad domain of psychological health.
It appears to be sensitive to change with treatment.
So, we will be measuring whether the total score of this scale changes throughout treatment, i.e., whether the CBT interventions tend to improve psychological health.
|
at baseline, and at visits 1 through 24, which will occur approximately 1 week apart.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Sabine Wilhelm, PhD, Massachusetts General Hospital
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
January 1, 2010
Primary Completion (Anticipated)
January 1, 2025
Study Completion (Anticipated)
January 1, 2025
Study Registration Dates
First Submitted
February 22, 2010
First Submitted That Met QC Criteria
February 24, 2010
First Posted (Estimate)
February 25, 2010
Study Record Updates
Last Update Posted (Actual)
May 9, 2023
Last Update Submitted That Met QC Criteria
May 5, 2023
Last Verified
May 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Behavioral Symptoms
- Mental Disorders
- Pathologic Processes
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Genetic Diseases, Inborn
- Basal Ganglia Diseases
- Movement Disorders
- Neurodegenerative Diseases
- Trauma and Stressor Related Disorders
- Heredodegenerative Disorders, Nervous System
- Attention Deficit and Disruptive Behavior Disorders
- Neurodevelopmental Disorders
- Disruptive, Impulse Control, and Conduct Disorders
- Somatoform Disorders
- Tic Disorders
- Depression
- Disease
- Obsessive-Compulsive Disorder
- Anxiety Disorders
- Stress Disorders, Traumatic
- Stress Disorders, Post-Traumatic
- Feeding and Eating Disorders
- Attention Deficit Disorder with Hyperactivity
- Trichotillomania
- Phobia, Social
- Panic Disorder
- Phobic Disorders
- Tourette Syndrome
- Body Dysmorphic Disorders
Other Study ID Numbers
- 2009P002479
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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