©2022 Stanford Medicine
Innovative Methods to Assess Psychotherapy Practices (imAPP)
Not Recruiting
Trial ID: NCT03479398
Purpose
This project compares two methods of assessing the quality of cognitive behavioral therapy
(CBT) that do not involve directly observing sessions: 1) adherence checklists embedded in
clinical notes, and 2) rating the quality of worksheets that are completed with therapist
guidance during sessions. It also examines whether ratings of worksheets completed on a
mobile app are reliable and valid quality measures. This information can inform strategies to
monitor and enhance CBT quality, which can ultimately improve the quality of care and
clinical outcomes.
Official Title
Leveraging Routine Clinical Materials and Mobile Technology to Assess CBT Quality
Stanford Investigator(s)
Eligibility
Inclusion Criteria:
A. Clinician eligibility:
- Private practice or employment at an agency at which the administration agrees to
allow the recruitment and participation of their providers in research related
activities
- English Speaking
- No anticipated plans to leave their current agency for at least 18 months
- Willingness to allow their CBT sessions, worksheets, surveys, and interview data, and
clinical notes to be used for research purposes
- Carry a caseload that typically includes patients who experience depression, anxiety,
or PTSD, with whom they regularly conduct individual therapy sessions and/or capacity
to increase the proportion of such patients (e.g., clinic sees a substantial number of
individuals with PTSD or depression)
- Must be trained (worksheet or web-based training and consultation) or in training for
Cognitive Processing Therapy (CPT) for PTSD or CBT for depression or anxiety that uses
worksheets Does not include CBT-i Can include aspects (i.e., worksheets) of CBT for
substance use as long as depression or anxiety is primary diagnoses
- Must anticipate at least 3 eligible patients
- Must be willing to record sessions and provide worksheets and symptom measures to the
study
- Must have computer and internet access
- Must be willing to use a mobile app on a tablet or mobile device
B. Patient eligibility:
- Must be 18 yrs. of age or older
- Experience one or more of the following (both a diagnosis and cut off score):
Clinician diagnosis of primary PTSD (PTSD-Checklist-5 score of 33 or more) Depressive
disorder (e.g., major depressive disorder, dysthymia; PHQ of 10 or above) Or an Anxiety
Disorder (Beck Anxiety Disorder score of 22 or above)
- Note that if a patient has a score close to the cut-off score, it's up to the
therapist digression
- Must be willing to allow the team to collect session recordings, measures, notes
and worksheets
- Must be able to read and write at a sixth-grade level or above
- Able to participate in sessions conducted in English, or Spanish (if working with
bilingual clinicians in community or private practice)
- Must be willing to engage in CBT/CPT
- Therapist considers the treatment with the individual patient to be "mostly" CBT
or CPT
Cannot have*:
- Imminent risk of suicide or homicide (requiring hospitalization) that require immediate
treatment In need of detoxification (can be enrolled when substance abuse treatment is not
the primary treatment target) Active psychosis or manic episode unless well controlled by
medication and not the primary focus of treatment Cognitive impairments that preclude any
participation in therapy
C. Administrator eligibility:
- Must have a support or managerial/supervisory position at the clinic(s) from which A
and B are being recruited from
- Must also be willing to complete a packet of study measures/partake in an interview
Intervention(s):
behavioral: Cognitive Behavioral Therapy
Not Recruiting
Contact Information
Stanford University
School of Medicine
300 Pasteur Drive
Stanford,
CA
94305
Shannon Wiltsey-Stirman, Ph.D.
650-493-5000 Ext. 20007