Digital Self-efficacy Training to Bridge Waiting Times for Psychotherapy

The main aim of this project is to improve waiting periods for specialised psychotherapy. We will apply a brief, smartphone-based self-efficacy training to patients with psychiatric disorders waiting for specialised psychotherapy. Additionally, we will use Ecological Momentary Assessment (EMA) to assess mood, social contacts, and other parameters daily. We will investigate whether the training can improve self-efficacy and related constructs and if it can help reduce stress and waitlist drop-outs during waiting periods. Additionally, we will investigate if the self-efficacy training has a positive effect on motivation and therapeutical relationship regarding the subsequent therapy.

After a screening for eligibility, participants will be randomly assigned to intervention and control group. At baseline, participants attend a laboratory session where they are assessed for current psychiatric disorders and further relevant psychological variables. They will then either participate in the digital self-efficacy training combined with EMA (intervention group) or in EMA only (control group). Both will be conducted via a smartphone app. Subsequently, participants will be asked to fill in post questionnaires at three different time points: after having finished app usage, one month later, and after the beginning of the subsequent psychotherapy.

Study Overview

• Status: Recruiting
• Conditions: Psychiatric Disorder; Waiting for Psychotherapy
• Intervention / Treatment: Behavioral: Digital self-efficacy training; Behavioral: Ecological Momentary Assessment

• Study Type: Interventional
• Enrollment (Estimated): 94
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Judith Rohde, MD; Phone Number: +41 (0)58 384 65 00; Email: judith.rohde@uzh.ch

Study Locations

• Switzerland
  • Winterthur, Switzerland
    • Recruiting
    • Integrated Psychiatry Winterthur
    • Contact: Jochen Binder
  • Zurich, Switzerland
    • Recruiting
    • Psychiatric University Hospital
    • Contact: Judith Rohde

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• psychiatric disorder
• age 18-65
• waiting for psychiatric assessment/treatment (being on waitlist)
• sufficient knowledge of the German language
• smartphone user
• internet access via smartphone
• internet access at home (laptop, tablet, or computer)

Exclusion Criteria:

• current intense psychotherapy
• acute suicidality
• acute psychotic symptoms
• substance addiction

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention group; Participants will receive an one-week digital self-efficacy training (3x/day) and an one-week Ecological Momentary Assessment (3x/day questions on mood, social and virtual contacts).	Behavioral: Digital self-efficacy training; Prior to the app participation, participants will receive psychoeducation on self-efficacy and will be instructed to define two autobiographical self-efficacy memories (own achievements, e.g., completion of an exam, success in a sporting event). During the week of app participation, they will be prompted three times per day and asked to perform an imagination task. Step by step, they will recall one of their autobiographic self-efficacy memories and focus on their character traits and abilities that were relevant for their achievement.; Behavioral: Ecological Momentary Assessment; Participants will receive questions on mood and social/virtual contacts 3 times per day.
Active Comparator: Control group; Participants will receive an one-week Ecological Momentary Assessment (3x/day questions on mood, social and virtual contacts).	Behavioral: Ecological Momentary Assessment; Participants will receive questions on mood and social/virtual contacts 3 times per day.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in self-efficacy	Validated measures ("General Self-Efficacy Scale" (10 items; higher scores indicate higher self-efficacy -> better outcome), "Coping Self-efficacy scale" (26 items; higher scores indicate higher self-effiacy -> better outcome) and individual questions based on validated measures assessing specific self-efficacy regarding emotion regulation, therapy and waitlist will be used to assess self-efficacy at baseline and 3 different time points after the intervention.	baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in hopelessness	Hopelessness will be assessed using the validated measure "Beck Hopelessness Scale" (20 items; higher scores indicate greater hopelessness -> worse outcome).	baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began
Change in anxiety	Anxiety will be assessed using the validated measure "State and Trait Anxiety Scale" (40 items; higher scores indicate greater anxiety -> worse outcome).	baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began
Change in stress	Stress will be assessed using the validated measure "Perceived Stress Scale" (10 items; higher scores indicate greater stress -> worse outcome).	baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began
Change in therapy expectations	Therapy expectations will be assessed using the validated measure "Patient Questionnaire on Therapy Expectation and Evaluation" (11 items; higher score indicates higher satisfaction -> better outcome).	baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began
Change in depression	Depression will be assessed using the validated measure "Beck Depression Inventory II" (21 items; higher scores indicate greater depression -> worse outcome).	baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began
Change in optimism	Change in life orientation will be assessed using the validated measure "Life Orientation Test Revised" (10 items; higher scores indicate greater optimism -> better outcome)	baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began
Change in intolerance of uncertainty	Intolerance of uncertainty will be assessed using the validated measure "Intolerance of uncertainty scale" (18 items; higher scores indicate greater uncertainty -> worse outcome).	baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in mood and contacts	pos. and neg. mood and contacts will be assessed with the Ecological Momentary Assessment. Higher pos. mood / lower neg. mood -> better outcome	3 per day during one-week
Change in in ability to work	We will ask about the participants' self-evaluation at baseline and 2 different time points after the intervention (self-evaluation; no specific score will be used)	baseline to 1 month after the intervention, within 1 month after the subsequent therapy began
Motivation and life enjoyment	Additional questionnaire with single items assessing therapy motivation and life enjoyment with items based on the validated questionnaires "Quality of Life Enjoymend and Satisfaction Questionnaire", "Fragebogen zur Psychotherapiemotivation" und "Fragebogen zur Messung der Psychotherapiemotivation"	baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began

Collaborators and Investigators

• Sponsor: Psychiatric University Hospital, Zurich
• Investigators: Principal Investigator: Judith Rohde, MD, Psychiatric University Hospital Zurich, University of Zurich

Study record dates

Study Major Dates

• Study Start (Actual): November 7, 2022
• Primary Completion (Estimated): November 1, 2025
• Study Completion (Estimated): November 1, 2025

Study Registration Dates

• First Submitted: September 25, 2022
• First Submitted That Met QC Criteria: September 26, 2022
• First Posted (Actual): September 29, 2022

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 27, 2025
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Problem Behavior; Mental Disorders
• Other Study ID Numbers: SeApp III

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No