Abstract
BackgroundPsychodynamic psychotherapy is frequently applied in the treatment of social phobia. Nevertheless, there has been a lack of studies on the transfer of manualized treatments to routine psychodynamic practice. Our study is the first one to examine the effects of additional training in a manualized Short Term Psychodynamic Psychotherapy (STPP) procedure on outcome in routine psychotherapy for social phobia. This study is an extension to a large multi-site RCT (N = 512) comparing the efficacy of STPP to Cognitive-Behavioral Therapy (CBT) of Social Phobia.Methods/DesignThe manualized treatment is designed for a time limited approach with 25 individual sessions of STPP over 6 months. Private practitioners will be randomized to training in manualized STPP vs. treatment as usual without a specific training (control condition). We plan to enrol a total of 105 patients (84 completers). Assessments will be conducted before treatment starts, after 8 and 15 weeks, after 25 treatment sessions, at the end of treatment, 6 months and 12 months after termination of treatment. The primary outcome measure is the Liebowitz Social Anxiety Scale. Remission from social phobia is defined scoring with 30 or less points on this scale.DiscussionWe will investigate how the treatment can be transferred from a controlled trial into the less structured setting of routine clinical care. This question represents Phase IV of psychotherapy research. It combines the benefits of randomized controlled and naturalistic research. The study is genuinely designed to promote faster and more widespread dissemination of effective interventions. It will answer the questions whether manualized STPP can be implemented into routine outpatient care, whether the new methods improve treatment courses and outcomes and whether treatment effects reached in routine psychotherapeutic treatments are comparable to those of the controlled, strictly manualized treatment of the main study.Trial RegistrationGerman Clinical Trials Register (DRKS) DRKS00000570
Highlights
Psychodynamic psychotherapy is frequently applied in the treatment of social phobia
The study is genuinely designed to promote faster and more widespread dissemination of effective interventions. It will answer the questions whether manualized Short Term Psychodynamic Psychotherapy (STPP) can be implemented into routine outpatient care, whether the new methods improve treatment courses and outcomes and whether treatment effects reached in routine psychotherapeutic treatments are comparable to those of the controlled, strictly manualized treatment of the main study
Estimating the sample size needed for a dichotomous approach, we introduced the following conservative assumptions: a) The Intracluster correlation coefficient (ICC) was set to 15%, which is high for comparable studies
Summary
Psychodynamic psychotherapy is frequently applied in the treatment of social phobia. There has been a lack of studies on the transfer of manualized treatments to routine psychodynamic practice. Our study is the first one to examine the effects of additional training in a manualized Short Term Psychodynamic Psychotherapy (STPP) procedure on outcome in routine psychotherapy for social phobia. This study is an extension to a large multi-site RCT (N = 512) comparing the efficacy of STPP to Cognitive-Behavioral Therapy (CBT) of Social Phobia. Social phobia is a chronic disorder usually accompanied by comorbid depression, personality disorders, other anxiety disorders or substance abuse [4]. Keller (2003) indicates, that only one-third of patients with social phobia attain full remission within 8 years [5]. Because the disorder is often mistaken as shyness, social phobia is often not recognized and undertreated [4,5]
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