Using the PHQ-9 and GAD-7 as Feedback Instruments in Brief Psychotherapy

Study Overview
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Brief Summary
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This study will assess the effects of client feedback, using the Patient Health Questionnaire - 9 and Generalized Anxiety Disorder 7-Item Scale, on depression and anxiety in individuals undergoing brief psychotherapy. Client feedback allows therapists to monitor treatment progress in real time. Identifying an easily accessible treatment intervention, which utilizes commonly used scales, that potentially enhances the effect of brief psychotherapy and improves treatment outcomes is a valuable endeavor with clear implications for therapy practices. It is hypothesized that clients who complete these scales each session will show greater symptom improvement than clients who do not complete the scales.

Official Title
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Using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-Item Scale (GAD-7) as Feedback Instruments in Brief Psychotherapy

Conditions
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Depressive Symptoms, Anxiety States, Neurotic

Intervention / Treatment
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* Behavioral: Continuous Client Feedback
* Behavioral: Continuous Self Feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of Major Depressive Disorder, Generalized Anxiety Disorder, or Adjustment Disorder Exclusion Criteria: Require a higher level of care than brief psychotherapy, or have been diagnosed with an intellectual disability, personality disorder, substance use disorder, or major medical illness

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 64 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>Clients will complete symptom and quality of life scales before their first session and before their last or tenth session, whichever occurs first. Clients will not complete any scales during other sessions. | |
| Experimental: Continuous Client Feedback<br>Clients will complete symptom and quality of life scales before their first session and before their last or tenth session, whichever occurs first. Clients will then complete symptoms scales, specifically the Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-Item Scale before each other session. The treating clinician will review and discuss their results and at the beginning of each session. | Behavioral: Continuous Client Feedback<br>* Clients complete rating scales before each therapy session. The therapist then views these results and discusses treatment progress with the client during the session.<br>|
| Experimental: Continuous Self Feedback<br>Clients will complete symptom and quality of life scales before their first session and before their last or tenth session, whichever occurs first. Clients will then complete symptoms scales, specifically the Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-Item Scale before each other session. The treating clinician will not have access to these results. | Behavioral: Continuous Self Feedback<br>* Clients complete rating scales before each therapy session. Progress is not reviewed with the therapist.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in depressive symptoms as assessed by Patient Health Questionnaire-9 | Assesses depressive symptoms | Baseline and end of treatment up to 10 weeks | 
| Change in anxiety symptoms as assessed by Generalized Anxiety Disorder 7-Item Scale | Assesses anxiety symptoms | Baseline and end of treatment up to 10 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| World Health Organization - Quality of Life BREF Scale | Assesses domains of physical health, psychological health, social relationships, and environment | Baseline and end of treatment up to 10 weeks | 
| Schwartz Outcome Scale | Monitors treatment outcomes | Baseline and end of treatment up to 10 weeks |