Does Disciplined Personal Involvement Precede Change in CBASP?
Condition: Chronic Depression
MeSH terms: Depression
Study type: Interventional

Summary: 
      The purpose of the study is to investigate the process of symptom change in Cognitive
      Behavioural Analysis System of Psychotherapy (CBASP), and how the individual components of
      the therapy affect this change in individuals with chronic depression.
    

Detailed description: 
      A form of psychotherapy called Behaviour Analysis System of Psychotherapy (CBASP) has been
      developed specifically to treat individuals suffering from chronic, long-standing depression.
      There is a growing evidence base to suggest that CBASP is effective for these individuals,
      especially when combined with anti-depressant medication. This evidence comes from case
      series and randomised controlled trials that have compared CBASP with other forms of therapy
      such as Interpersonal Psychotherapy and Cognitive Behaviour Therapy, and with medication. The
      evidence from these studies consistently shows CBASP to be effective, and it compares
      favourably with other forms of therapy.

      Given these findings, it is important to understand how change happens in CBASP and how it is
      affected by the components of the therapy. Understanding how individuals experience change
      within CBASP will have important implications for how the therapy is delivered in the future.
      For example if change is found to be non-linear it would be important to understand what
      components of the therapy are associated with improvement. There could also be organisational
      implications, for example relating to the optimal number of sessions to offer in order to
      achieve acceptable change while balancing therapist time.

      The proposed study aims to investigate the process of psychological change in CBASP. This
      will be done by providing CBASP to a small number of individuals and gathering outcome data
      (rating of mood) at every therapy appointment. Session--by-session change will then be mapped
      for each participant. The study will include two arms: CBASP; and CBASP without Disciplined
      Personal Involvement (DPI). DPI involves specifically using the therapist--client
      relationship to help the client to discriminate between previous maladaptive relationships
      and other, positive ones. The reason for including this condition is to investigate whether
      DPI affects the process of psychological change in CBASP, as it is a unique feature of the
      therapy.

      The study will use a single-case design, as the aim is to map change within each individual
      participant in the context of the therapy. This design was deemed appropriate as the study
      does not aim to make claims about the overall effectiveness of CBASP, but to provide an
      analysis of individual psychological change for participants receiving CBASP.
    

Intervention name(s): Cognitive Behavioural Analysis System of Psychotherapy; CBASP Without DPI
Intervention type(s): Behavioral; Behavioral
Other intervention name(s): CBASP
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment