Daniel Glenn1, Daniela Golinelli2, Raphael D Rose1, Peter Roy-Byrne3, Murray B Stein4, Greer Sullivan5, Alexander Bystritksy6, Cathy Sherbourne2, Michelle G Craske1. 1. Department of Psychology, University of California, Los Angeles. 2. RAND Corporation. 3. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine. 4. Departments of Psychiatry and Family and Preventive Medicine, University of California, San Diego. 5. South Central Veterans Affairs Mental Illness Research Education and Clinical Center. 6. Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.
Abstract
OBJECTIVE: The present study explored treatment dose and patient engagement as predictors of treatment outcome in cognitive behavioral therapy (CBT) for anxiety disorders. METHOD: Measures of high versus low treatment dose and high versus low patient engagement in CBT were compared as predictors of 12- and 18-month outcomes for patients being treated for anxiety disorders withCBT (with or without concurrent pharmacotherapy) in primary care settings as part of a randomized controlled effectiveness trial of the Coordinated Anxiety Learning and Management (CALM) intervention. Measures of dose (attendance, exposure completion) and engagement in CBT (homework adherence, commitment) were collected throughout treatment, and blinded follow-up phone assessments of outcome measures (12-item Brief Symptom Inventory, Patient Health Questionnaire 8, Sheehan Disability Scale) were completed at 12 and 18 months. Propensity score weighting controlled for baseline differences in demographics and symptom severity between patients with high and low dose and engagement. These analyses included the 439 patients who selected CBT as treatment modality. RESULTS: Completing exposures, having high attendance, and being more adherent to completing homework predicted better outcomes across all measures at 12 and 18 months, and high CBT commitment predicted better outcomes on all measures at 18 months. CONCLUSIONS: This study found that higher treatment dose and patient engagement in CBT for anxiety disorders were stable and robust predictors of greater reductions in anxiety symptoms, depression symptoms, and functional disability. PsycINFO Database Record (c) 2013 APA, all rights reserved.
RCT Entities:
OBJECTIVE: The present study explored treatment dose and patient engagement as predictors of treatment outcome in cognitive behavioral therapy (CBT) for anxiety disorders. METHOD: Measures of high versus low treatment dose and high versus low patient engagement in CBT were compared as predictors of 12- and 18-month outcomes for patients being treated for anxiety disorders with CBT (with or without concurrent pharmacotherapy) in primary care settings as part of a randomized controlled effectiveness trial of the Coordinated Anxiety Learning and Management (CALM) intervention. Measures of dose (attendance, exposure completion) and engagement in CBT (homework adherence, commitment) were collected throughout treatment, and blinded follow-up phone assessments of outcome measures (12-item Brief Symptom Inventory, Patient Health Questionnaire 8, Sheehan Disability Scale) were completed at 12 and 18 months. Propensity score weighting controlled for baseline differences in demographics and symptom severity between patients with high and low dose and engagement. These analyses included the 439 patients who selected CBT as treatment modality. RESULTS: Completing exposures, having high attendance, and being more adherent to completing homework predicted better outcomes across all measures at 12 and 18 months, and high CBT commitment predicted better outcomes on all measures at 18 months. CONCLUSIONS: This study found that higher treatment dose and patient engagement in CBT for anxiety disorders were stable and robust predictors of greater reductions in anxiety symptoms, depression symptoms, and functional disability. PsycINFO Database Record (c) 2013 APA, all rights reserved.
Authors: Raphael D Rose; Ariel J Lang; Stacy Shaw Welch; Laura Campbell-Sills; Denise A Chavira; Greer Sullivan; Cathy Sherbourne; Alexander Bystritsky; Murray B Stein; Peter P Roy-Byrne; Michelle G Craske Journal: Gen Hosp Psychiatry Date: 2011-06-08 Impact factor: 3.238
Authors: Jay C Fournier; Robert J DeRubeis; Richard C Shelton; Steven D Hollon; Jay D Amsterdam; Robert Gallop Journal: J Consult Clin Psychol Date: 2009-08
Authors: Laura Campbell-Sills; Sonya B Norman; Michelle G Craske; Greer Sullivan; Ariel J Lang; Denise A Chavira; Alexander Bystritsky; Cathy Sherbourne; Peter Roy-Byrne; Murray B Stein Journal: J Affect Disord Date: 2008-05-16 Impact factor: 4.839
Authors: Kathleen M Grubbs; Ann M Cheney; John C Fortney; Carrie Edlund; Xiaotong Han; Patricia Dubbert; Cathy D Sherbourne; Michelle G Craske; Murray B Stein; Peter P Roy-Byrne; J Greer Sullivan Journal: Psychiatr Serv Date: 2014-12-15 Impact factor: 3.084
Authors: Judith A Callan; Nikolaos Kazantzis; Seo Young Park; Charity G Moore; Michael E Thase; Abu Minhajuddin; Sander Kornblith; Greg J Siegle Journal: Behav Ther Date: 2018-06-05