Innovative Methods to Assess Psychotherapy Practices (imAPP)

Status unconfirmed

Conditions studied: Mobile Application-Based CBT Worksheet Collection, Paper-Based Worksheet Collection

In brief

This project compares two methods of assessing the quality of cognitive behavioral therapy (CBT) that do not involve directly observing sessions: 1) adherence checklists embedded in clinical notes, and 2) rating the quality of worksheets that are completed with therapist guidance during sessions. It also examines whether ratings of worksheets completed on a mobile app are reliable and valid quality measures. This information can inform strategies to monitor and enhance CBT quality, which can ultimately improve the quality of care and clinical outcomes.

Key facts

Study ID

NCT03479398

Run by

Palo Alto Veterans Institute for Research

People needed

439

Starts

2017-04-01

Expected to finish

2023-10-15

Last updated by the study team

2022-11-03

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• A. Clinician eligibility:
• Private practice or employment at an agency at which the administration agrees to allow the recruitment and participation of their providers in research related activities
• English Speaking
• No anticipated plans to leave their current agency for at least 18 months
• Willingness to allow their CBT sessions, worksheets, surveys, and interview data, and clinical notes to be used for research purposes
• Carry a caseload that typically includes patients who experience depression, anxiety, or PTSD, with whom they regularly conduct individual therapy sessions and/or capacity to increase the proportion of such patients (e.g., clinic sees a substantial number of individuals with PTSD or depression)
• Must be trained (worksheet or web-based training and consultation) or in training for Cognitive Processing Therapy (CPT) for PTSD or CBT for depression or anxiety that uses worksheets Does not include CBT-i Can include aspects (i.e., worksheets) of CBT for substance use as long as depression or anxiety is primary diagnoses
• Must anticipate at least 3 eligible patients
• Must be willing to record sessions and provide worksheets and symptom measures to the study
• Must have computer and internet access
• Must be willing to use a mobile app on a tablet or mobile device
• B. Patient eligibility:
• Must be 18 yrs. of age or older
• Experience one or more of the following (both a diagnosis and cut off score):
• Clinician diagnosis of primary PTSD (PTSD-Checklist-5 score of 33 or more) Depressive disorder (e.g., major depressive disorder, dysthymia; PHQ of 10 or above) Or an Anxiety Disorder (Beck Anxiety Disorder score of 22 or above)
• Note that if a patient has a score close to the cut-off score, it's up to the therapist digression
• Must be willing to allow the team to collect session recordings, measures, notes and worksheets
• Must be able to read and write at a sixth-grade level or above
• Able to participate in sessions conducted in English, or Spanish (if working with bilingual clinicians in community or private practice)
• Must be willing to engage in CBT/CPT
• Therapist considers the treatment with the individual patient to be "mostly" CBT or CPT
• Cannot have*:
• Imminent risk of suicide or homicide (requiring hospitalization) that require immediate treatment In need of detoxification (can be enrolled when substance abuse treatment is not the primary treatment target) Active psychosis or manic episode unless well controlled by medication and not the primary focus of treatment Cognitive impairments that preclude any participation in therapy
• C. Administrator eligibility:
• Must have a support or managerial/supervisory position at the clinic(s) from which A and B are being recruited from

Where it is running

• VA Palo Alto Health Care System — Palo Alto, California, United States
• NCPTSD - VA Boston HCS — Boston, Massachusetts, United States
• Massachusetts General Hospital — Chelsea, Massachusetts, United States
• Aaron T. Beck Psychopathology Research Center — Philadelphia, Pennsylvania, United States

Full record on ClinicalTrials.gov

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