Digital Self-efficacy Training to Bridge Waiting Times for Psychotherapy

Study Overview
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Brief Summary
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The main aim of this project is to improve waiting periods for specialised psychotherapy. We will apply a brief, smartphone-based self-efficacy training to patients with psychiatric disorders waiting for specialised psychotherapy. Additionally, we will use Ecological Momentary Assessment (EMA) to assess mood, social contacts, and other parameters daily. We will investigate whether the training can improve self-efficacy and related constructs and if it can help reduce stress and waitlist drop-outs during waiting periods. Additionally, we will investigate if the self-efficacy training has a positive effect on motivation and therapeutical relationship regarding the subsequent therapy. After a screening for eligibility, participants will be randomly assigned to intervention and control group. At baseline, participants attend a laboratory session where they are assessed for current psychiatric disorders and further relevant psychological variables. They will then either participate in the digital self-efficacy training combined with EMA (intervention group) or in EMA only (control group). Both will be conducted via a smartphone app. Subsequently, participants will be asked to fill in post questionnaires at three different time points: after having finished app usage, one month later, and after the beginning of the subsequent psychotherapy.

Official Title
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Digital Self-efficacy Training to Bridge Waiting Times for Psychotherapy

Conditions
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Psychiatric Disorder, Waiting for Psychotherapy

Intervention / Treatment
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* Behavioral: Digital self-efficacy training
* Behavioral: Ecological Momentary Assessment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: psychiatric disorder age 18-65 waiting for psychiatric assessment/treatment (being on waitlist) sufficient knowledge of the German language smartphone user internet access via smartphone internet access at home (laptop, tablet, or computer) Exclusion Criteria: current intense psychotherapy acute suicidality acute psychotic symptoms substance addiction

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>Participants will receive an one-week digital self-efficacy training (3x/day) and an one-week Ecological Momentary Assessment (3x/day questions on mood, social and virtual contacts). | Behavioral: Digital self-efficacy training<br>* Prior to the app participation, participants will receive psychoeducation on self-efficacy and will be instructed to define two autobiographical self-efficacy memories (own achievements, e.g., completion of an exam, success in a sporting event). During the week of app participation, they will be prompted three times per day and asked to perform an imagination task. Step by step, they will recall one of their autobiographic self-efficacy memories and focus on their character traits and abilities that were relevant for their achievement.<br>Behavioral: Ecological Momentary Assessment<br>* Participants will receive questions on mood and social/virtual contacts 3 times per day.<br>|
| Active Comparator: Control group<br>Participants will receive an one-week Ecological Momentary Assessment (3x/day questions on mood, social and virtual contacts). | Behavioral: Ecological Momentary Assessment<br>* Participants will receive questions on mood and social/virtual contacts 3 times per day.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in self-efficacy | Validated measures (General Self-Efficacy Scale (10 items; higher scores indicate higher self-efficacy -> better outcome), Coping Self-efficacy scale (26 items; higher scores indicate higher self-effiacy -> better outcome) and individual questions based on validated measures assessing specific self-efficacy regarding emotion regulation, therapy and waitlist will be used to assess self-efficacy at baseline and 3 different time points after the intervention. | baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in hopelessness | Hopelessness will be assessed using the validated measure Beck Hopelessness Scale (20 items; higher scores indicate greater hopelessness -> worse outcome). | baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began | 
| Change in anxiety | Anxiety will be assessed using the validated measure State and Trait Anxiety Scale (40 items; higher scores indicate greater anxiety -> worse outcome). | baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began | 
| Change in stress | Stress will be assessed using the validated measure Perceived Stress Scale (10 items; higher scores indicate greater stress -> worse outcome). | baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began | 
| Change in therapy expectations | Therapy expectations will be assessed using the validated measure Patient Questionnaire on Therapy Expectation and Evaluation (11 items; higher score indicates higher satisfaction -> better outcome). | baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began | 
| Change in depression | Depression will be assessed using the validated measure Beck Depression Inventory II (21 items; higher scores indicate greater depression -> worse outcome). | baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began | 
| Change in optimism | Change in life orientation will be assessed using the validated measure Life Orientation Test Revised (10 items; higher scores indicate greater optimism -> better outcome) | baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began | 
| Change in intolerance of uncertainty | Intolerance of uncertainty will be assessed using the validated measure Intolerance of uncertainty scale (18 items; higher scores indicate greater uncertainty -> worse outcome). | baseline to 1 day after the intervention, 1 month after the intervention, within 1 month after the subsequent therapy began |