View Clinical Trial (Medical Research Study)
Outcomes of Cognitive Behavioral Therapy (CBT) Interventions Provided by Unlicensed Professionals in a General Hospital Setting
| City: |
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Boston |
| State: |
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Massachusetts |
| Zip Code: |
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02114 |
| Conditions: |
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Obsessive Compulsive Disorder - Body Dysmorphic Disorder - Tourette Syndrome - Trichotillomania - Panic Disorder - Social Phobia - Generalized Anxiety Disorder - Depression - Post-Traumatic Stress Disorder - Attention Deficit Hyperactivity Disorder - Eati |
| Purpose: |
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To examine the effectiveness and clinical care outcomes of cognitive-behavioral therapy
interventions at Massachusetts General Hospital.
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| Study Summary: |
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Cognitive behavioral interventions are the most widely studied and evidenced-based
psychosocial treatment approaches for mental health and health related behavioral problems.
Despite their documented efficacy, there is a scarcity of licensed mental health
professionals who are available to treat patients with problems that would be amenable to
CBT. While CBT interventions have a strong base in terms of efficacy in randomized trials,
effectiveness and dissemination studies are lacking in comparison, and hence, these
interventions are not reaching the patients in most need of services. Complicating the
problem further, insurance companies typically do not reimburse for services provided by
trainees who are not licensed. This is a public mental health problem because it limits the
degree to which CBT clinicians can be trained to deliver these treatments, and a particular
problem at MGH because referring providers do not have a place to send their patient for CBT
services, as trainees constitute a large portion of clinical staff. To address this issue,
the current study seeks to document outcomes of CBT interventions delivered by credentialed
but not licensed trainees. This information can be used to guide policy and reimbursement
guidelines for trainees, as well as promote the ability to disseminate efficacious
interventions. Information gained from this project will be used to provide feedback to
insurance companies, licensing boards, and mental health community stakeholders regarding
decision making re: reimbursement for care provided by supervised trainees. Additionally,
this may be used as a pilot study for a comparative effectiveness study comparing trainees
to licensed staff psychologists.
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| Criteria: |
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Inclusion Criteria:
- Patients presenting to the Behavioral Medicine Service are generally individuals with
an acute or chronic medical condition or medically related concern with or without an
associated DSM-IV psychiatric disorder, as well as adult patients who require
assistance with changing health or health-risk behaviors. Patients presenting to the
OCD program typically have obsessive compulsive disorder, body dysmorphic disorder,
Tourette syndrome, compulsive skin picking, or trichotillomania. Patients presenting
to the general CBT program typically have panic disorder, social phobia, generalized
anxiety disorder, depression, specific phobia, post traumatic stress disorder,
attention deficit hyperactivity disorder, or an eating disorder. Patients at any of
the programs have an identifiable behavior or behavioral pattern/ mood problem that
they would like to change.
- Age 18 or older
- Ability to provide informed consent and comply with the study procedures
- Ability to complete self-report questionnaires (either written hardcopy or
computer-based version) with adequate accommodation, if necessary
- Patients with a PCP or psychiatrist (who provides medication on an ongoing basis with
no plan to terminate the medication treatment over the upcoming year) at MGH or
employees of MGH.
Exclusion Criteria:
- Exhibit active suicidality (suicidal ideation with intent or plan) to the point that
more intensive treatment (i.e. acute hospitalization) is required.
- Active untreated and unstable bipolar disorder (i.e. stable bipolar disorder under
care of a psychiatrist is allowed).
- Psychosis.
- Mental retardation.
- Any condition that, after the baseline evaluation, is determined to preclude
treatment with cognitive behavioral therapy.
- Received more than 4 sessions of CBT for the target disorder within the past 3 years.
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| NCT ID: |
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NCT01075672 |
| Primary Contact: |
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Principal Investigator
Sabine Wilhelm, PhD
Massachusetts General Hospital
Liza Rosenfield, B.A.
Phone: 617-643-4387
Email: erosenfield@partners.org
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| Backup Contact: |
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N/A |
| Location Contact: |
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Boston, Massachusetts 02114
United States
Katherine Crowe, BA
Phone: 617-643-4387
Email: kcrowe2@partners.org
Site Status: Recruiting |
| Data Source: |
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ClinicalTrials.gov |
| Date Processed: |
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May 24, 2013 |
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