Examining Change Mechanisms in Psychotherapy (CAMP)

Examining Change Mechanisms in Psychotherapy: Relationship Between Specific Ingredients and Common Factors in Promoting Change.

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.

Study Overview

• Status: Unknown
• Conditions: Depression; Anxiety Disorders; Post Traumatic Stress Disorder; Eating Disorder; Psychological Disorder
• Intervention / Treatment: Other: Psychotherapy

Detailed Description

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 (Anticipated): 520

Contacts and Locations

• Study Contact: Name: Ingvild Finsrud, Master degree; Phone Number: 0047 95899278; Email: ingvilfi@gmail.com

Study Locations

• Norway
  • Buskerud
    • Vikersund, Buskerud, Norway, 3370
      • Recruiting
      • Modum Bad
      • Contact: Terje Tilden, PhD; Phone Number: 0047 32749869; Email: tilden@modum-bad.no
      • Principal Investigator: Ingvild Finsrud, Master

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

All patients accepted for inpatient treatment at Modum Bad Psychiatric hospital during the time of data collection will participate in this study, contingent on consent.

The patients included will be all genders, adults and reciving treatment from specialist health care.

Description

Inclusion Criteria:

• Must be a patient at Modum Bad
• Have a psychological disorder

• Must have rights to treatment according to the rules of specialist health care in Norway. Includes the following:

  1. Patient is expected to have poorer prognosis of life quality if not given treatment
  2. It is expected that the patient will benefit from treatment
  3. It is expected that there is a reasonable cost-effect balance regarding the treatment given and the patient's benefit from treatment.

Exclusion Criteria:

• Acute suicidality
• Ongoing/active abuse of harmful drug(s)
• Under 18 years

Study Plan

How is the study designed?

Number of groups / cohorts

5

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Anxiety unit; Patients have anxiety as a primary diagnose. Receive treatment for anxiety (CBT and MCT).	Other: Psychotherapy; There are different psychotherapy models offered across the units. All patients receive individual treatment and group therapy or psychoeducative groups.
Eating disorder unit; Patients have eating disorder as primary diagnose. Receive treatment for their eating disorder (CBT and compassion-focused therapy).	Other: Psychotherapy; There are different psychotherapy models offered across the units. All patients receive individual treatment and group therapy or psychoeducative groups.
Depression unit; Patients have depression as primary disorder. Receive treatment for their depression (Short-term dynamic therapy, existential therapy and relational psychodynamic therapy).	Other: Psychotherapy; There are different psychotherapy models offered across the units. All patients receive individual treatment and group therapy or psychoeducative groups.
Family unit; One of the members of the family has a psychological disorder. The treatment is focused towards the family and family dynamics.	Other: Psychotherapy; There are different psychotherapy models offered across the units. All patients receive individual treatment and group therapy or psychoeducative groups.
Trauma unit; Patients have PTSD and relational trauma as primary diagnosis. Receive stabilizing treatment and exposure therapy.	Other: Psychotherapy; There are different psychotherapy models offered across the units. All patients receive individual treatment and group therapy or psychoeducative groups.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Symptom checklist revised (SCL-90-R)	A general measure of symptoms distress	Change measure (baseline, 14 weeks, and 12 months).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Inventory of interpersonal problems	Self-report questionnaire of interpersonal problems	Change measure (baseline, 14 weeks, and 12 months).
Beck's depression inventory	Measure of depressive symptoms	Change measure (baseline, 14 weeks, and 12 months).
PTSD checklist for Diagnostic and Statistical Manual 5 (PCL-5)	PTSD symptom measure	Change measure (baseline, 14 weeks, and 12 months).
M-POQ outcome, anxiety	Measures anxiety symptoms	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	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	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, resilience	Measures experienced recilience	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	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).

Collaborators and Investigators

• Sponsor: Modum Bad
• Collaborators: University of Oslo

Publications and helpful links

General Publications

• Finsrud I, Nissen-Lie HA, Ulvenes P, Melsom L, Vrabel K, Wampold B. Confidence in the therapist and confidence in the treatment predict symptomatic improvement week by week in therapy: A latent curve modeling approach. J Couns Psychol. 2022 Nov;69(6):823-834. doi: 10.1037/cou0000640. Epub 2022 Sep 22.
• Finsrud I, Nissen-Lie HA, Vrabel K, Hostmaelingen A, Wampold BE, Ulvenes PG. It's the therapist and the treatment: The structure of common therapeutic relationship factors. Psychother Res. 2022 Feb;32(2):139-150. doi: 10.1080/10503307.2021.1916640. Epub 2021 May 2.

Study record dates

Study Major Dates

• Study Start (Actual): September 15, 2017
• Primary Completion (Anticipated): August 20, 2020
• Study Completion (Anticipated): August 20, 2021

Study Registration Dates

• First Submitted: January 25, 2018
• First Submitted That Met QC Criteria: April 11, 2018
• First Posted (Actual): April 20, 2018

Study Record Updates

• Last Update Posted (Actual): April 20, 2018
• Last Update Submitted That Met QC Criteria: April 11, 2018
• Last Verified: April 1, 2018

More Information

Terms related to this study

• Keywords: Process-outcome study; Mechanisms of change
• Additional Relevant MeSH Terms: Pathologic Processes; Trauma and Stressor Related Disorders; Disease; Anxiety Disorders; Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic; Feeding and Eating Disorders; Mental Disorders
• Other Study ID Numbers: CAMPFinsrud

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No