Optimizing treatment expectations and decision making through informed consent for psychotherapy: A randomized controlled trial.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2024-02-01 Epub Date: 2023-11-16 DOI:10.1037/ccp0000851

Leonie Gerke, Franz Pauls, Sönke Ladwig, Sarah Liebherz, Klaus Michael Reininger, Levente Kriston, Manuel Trachsel, Martin Härter, Yvonne Nestoriuc

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Abstract

Objective: The objective of this research was to determine the efficacy and safety of an optimized informed consent (OIC) consultation for psychotherapy.

Method: We performed a randomized controlled superiority online trial involving 2 weeks of treatment and 3 months of follow-up. One hundred twenty-two adults with mental disorders confirmed by structured interview currently neither in out- nor inpatient psychotherapy (mean age: 32, gender identity: 51.6% female, 1.6% diverse), were randomized. Participants received an information brochure about psychotherapy for self-study (treatment as usual [TAU]; n = 61) or TAU plus a one-session OIC utilizing expectation management, contextualization, framing, and shared decision making (n = 61). The primary outcome was treatment expectations at 2-week follow-up.

Results: At 2-week follow-up, participants receiving OIC showed more positive treatment expectations compared to those receiving TAU only (mean difference: 0.70, 95% CI [0.36, 1.04]) with a medium effect size (d = 0.73). Likewise, OIC positively influenced motivation (d = 0.74) and adherence intention (d = 0.46). OIC entailed large effects on reduction of decisional conflict (d = 0.91) and increase of knowledge (d = 0.93). Participants receiving OIC showed higher capacity to consent to treatment (d = 0.63) and higher satisfaction with received information (d = 1.34) compared to TAU. No statistically significant group differences resulted for expected adverse effects of psychotherapy. Results were maintained at 3-month follow-up. Data sets for n = 10 cases (8.2%) were missing (postassessment n = 4, 2-week n = 6, 3-month follow-up n = 8).

Conclusions: Explaining to patients how psychotherapy works via a short consultation was effective in strengthening treatment expectations and decision making in a nonharmful way. Further trials clarifying whether this effectively translates to better treatment outcomes are required. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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通过心理治疗的知情同意优化治疗期望和决策:一项随机对照试验。

目的:本研究的目的是确定一种优化的知情同意(OIC)心理治疗咨询的有效性和安全性。方法:我们进行了一项随机对照优势在线试验，包括2周的治疗和3个月的随访。通过结构化访谈确认的122名成人精神障碍患者目前既没有接受过门诊治疗也没有住院治疗(平均年龄:32岁，性别认同:51.6%为女性，1.6%为多元)被随机化。参与者收到一份关于心理治疗自学的信息手册(照常治疗[TAU];n = 61)或TAU加上利用期望管理、情境化、框架化和共享决策制定的一次会议OIC (n = 61)。主要结局是2周随访时的治疗预期。结果:在2周的随访中，与仅接受TAU治疗的参与者相比，接受OIC治疗的参与者表现出更积极的治疗预期(平均差异:0.70,95% CI[0.36, 1.04])，具有中等效应量(d = 0.73)。同样，OIC正向影响动机(d = 0.74)和依从性意愿(d = 0.46)。OIC对减少决策冲突(d = 0.91)和增加知识(d = 0.93)有很大的影响。与TAU相比，接受OIC的参与者表现出更高的同意治疗能力(d = 0.63)和更高的对接收信息的满意度(d = 1.34)。心理治疗预期不良反应的组间差异无统计学意义。结果在随访3个月时保持不变。n = 10例(8.2%)的数据集缺失(后评估n = 4, 2周n = 6, 3个月随访n = 8)。结论:通过简短的咨询向患者解释心理治疗如何起作用，可以有效地增强治疗预期和决策。需要进一步的试验来澄清这是否有效地转化为更好的治疗结果。(PsycInfo数据库记录(c) 2023 APA，版权所有)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.