Priming Attachment Security Within an IAPT Setting
13 juillet 2019 mis à jour par: Charlotte Heathcote, University of Sheffield
Priming Attachment Security Within an IAPT Setting: A Feasibility and Pilot Study
There is growing evidence that priming attachment security is associated with improved attitudes towards therapy, increased engagement and decreased levels of depression and anxiety.
Within the Improving Access to Psychological Therapies (IAPT) programme a consistent problem has been identified of high dropout rates at step 2 services (i.e.
where mild to moderate anxious and depressed patients receive guided self-help interventions).
The current study incorporates a feasibility and pilot design.
The feasibility element will explore issues related to study design to determine suitability for conducting a future randomised control trial (RCT).
The pilot study will look at the processes outlined in the protocol to determine whether the study components all work together.
Moreover, it will preliminarily aim to explore the effectiveness of the attachment security priming intervention on symptoms of depression and anxiety, as well as impaired functioning.
Both elements of the study will determine whether any changes are needed to the study design or protocol, and whether a future RCT is suitable and necessary.
Aperçu de l'étude
Statut
Inconnue
Les conditions
Description détaillée
The study is being conducted in an IAPT primary care service in North Yorkshire.
The study will be recruiting 50 participants experiencing mild to moderate depression who are deemed suitable for 'behavioural activation' low intensity guided self-help intervention.
Following telephone screening for intervention, clinicians will ask clients if they wish to hear more about participating in a research study.
If participants say yes, their contact details will be passed on to the researcher who will send them the study information sheet and consent form in the post.
If the participant consents to taking part in the research, they will be randomised to receive either treatment as usual (low-intensity guided self-help utilising behavioural activation for depression) or treatment with security priming intervention (treatment as usual with an additional security priming task).
They will have between 6-8 sessions as routinely delivered within the service and will be asked to complete measures of depression, anxiety and impaired functioning on a sessional basis.
The principal investigator at the study site will collect information regarding attendance to therapy, dropout rates, and 'stepping' clients up to higher-intensity therapies as primary outcomes.
Type d'étude
Interventionnel
Inscription (Anticipé)
50
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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North Yorkshire
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Harrogate, North Yorkshire, Royaume-Uni, hg12pw
- Harrogate IAPT Service
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Oui
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- Accepted for Behavioural Activation guided self-help intervention for depression with study NHS IAPT site.
- Over age 18.
- Adequate English ability.
Exclusion Criteria:
- Not suitable for Behavioural Activation guided self-help intervention for depression with study NHS IAPT site.
- Inadequate English ability.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Comparateur actif: Treatment as Usual
Participants randomised to the 'treatment as usual' group will receive behavioural activation guided-self help intervention as routinely delivered in the service.
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Clients will engage in treatment as usual.
This involves low-intensity guided self-help behavioural activation for depression.
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Expérimental: Treatment with Security Prime
Participants randomised to the experimental group will receive behavioural activation guided self-help intervention as is routinely delivered in the service with additional attachment security priming intervention.
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In addition to their treatment as usual (low-intensity guided self-help behavioural activation for depression), participants will complete an initial attachment security priming task during the first session with their allocated clinician. Participants will be prompted in their intervention workbook with a caption regarding what a secure attachment relationship represents. They will be asked to think of a person/ people with whom they feel they have this relationship, and list them. Following this, they are asked to plot these individuals on a diagram of concentric circles in relation to how close they feel this person is to them. The closer to the middle of the diagram the individual places each person, the closer they feel their relationship to that person is. Prior to each session with their clinician, they will be prompted to complete a repeated security priming task in order to increase feelings of security prior to therapy sessions. |
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Attendance
Délai: Up to 8 weeks from the beginning to end of treatment
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Number of therapy appointments booked versus number attended for each participant
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Up to 8 weeks from the beginning to end of treatment
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Dropout
Délai: Up to 8 weeks from the beginning to end of treatment
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Number of participants who drop out of therapy after attending at least one session of treatment
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Up to 8 weeks from the beginning to end of treatment
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Stepping-up to higher intensity services
Délai: Up to 8 weeks from the beginning to end of treatment
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The number of participants in the study who are referred for a higher intensity form of therapy during their low-intensity therapy
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Up to 8 weeks from the beginning to end of treatment
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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The Patient Health Questionnaire 9 (PHQ-9; Kroenke, Spitzer, & Williams, 2001)
Délai: Weekly for up to 8 weeks from the beginning to end of treatment
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Self-report measure of depression with total possible score ranging from 0 to 27.
Scores of 0-4 indicate minimal depression; 5-9 indicates mild depression; 10-14 indicates moderate depression; 15-19 indicates moderately severe depression; and 20-17 indicates severe depression.
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Weekly for up to 8 weeks from the beginning to end of treatment
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The Generalized Anxiety Disorder 7 (GAD-7; Spitzer, Kroenke, Williams, & Lower, 2006)
Délai: Weekly for up to 8 weeks from the beginning to end of treatment
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Self-report measure of anxiety with total possible scores between 0 to 21. Scores of 0-5 indicate mild anxiety; 6-10 indicates moderate anxiety; 11-15 indicates moderately severe anxiety; and 16-20 indicates severe anxiety.
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Weekly for up to 8 weeks from the beginning to end of treatment
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The Work and Social Adjustment Scale (WSAS; Mundt, Shear, & Greist, 2002)
Délai: Weekly for up to 8 weeks from the beginning to end of treatment
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Self-report measure of impaired functioning with total possible scores of between 0-20.
Scores below 10 are associated with subclinical populations.
Scores between 10 and 20 indicate significant functional impairment but less severe clinical symptomatology.
Scores above 20 indicate moderately severe or worse psychopathology.
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Weekly for up to 8 weeks from the beginning to end of treatment
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Chercheur principal: James Walton, Harrogate IAPT Service
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Anticipé)
1 août 2019
Achèvement primaire (Anticipé)
1 octobre 2019
Achèvement de l'étude (Anticipé)
1 octobre 2019
Dates d'inscription aux études
Première soumission
17 juin 2019
Première soumission répondant aux critères de contrôle qualité
13 juillet 2019
Première publication (Réel)
17 juillet 2019
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
17 juillet 2019
Dernière mise à jour soumise répondant aux critères de contrôle qualité
13 juillet 2019
Dernière vérification
1 juillet 2019
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 249633
Plan pour les données individuelles des participants (IPD)
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NON
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
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