Frontiers in psychology · 2019
Twelve Months Post-treatment Results From the Norwegian Version of Improving Access to Psychological Therapies.
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Sæther Solbjørg Makalani Myrtveit, Knapstad Marit, Grey Nick, Smith Otto R F
Аннотация
OBJECTIVES: Prompt Mental Health Care (PMHC) is the Norwegian version of the England's Improving Access to Psychological Therapies (IAPT). Both programs have been associated with substantial symptom reductions from pre- to post-treatment. The present study extends these findings by investigating symptom levels at 12 months post-treatment, as well as treatment outcome in relation to low- vs. high-intensity treatment forms.
DESIGN AND OUTCOME MEASURES: A prospective cohort design was used. All participants (n = 1530) were asked to complete the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 questionnaire (GAD-7) at baseline, before each session during treatment, at final treatment, and at 12 months post-treatment. Cohen's d was used as effect size measure. Sensitivity analyses were conducted to examine the impact of the high missing data rates at post-treatment (≈44%) and 12 months post-treatment (≈58%).
RESULTS: A large symptom reduction was seen from baseline to 12 months post-treatment for both PHQ (d = -0.98) and GAD (d = -0.94). Improvements observed at post-treatment were largely maintained at 12 months post-treatment (PHQ (Δd = 0.10) and GAD (Δd = 0.09). Recovery rates decreased only slightly from 49.5% at post-treatment to 45.0% at follow-up. Both low- and high-intensity treatment forms were associated with substantial and lasting symptoms reductions (-1.26 ≤ d ≤ -0.73). Sensitivity analyses did not substantially alter the main results.
CONCLUSION: The findings suggest long-lasting effects of the PMHC program and encourage the use of low-intensity treatment forms in PMHC like settings.
DESIGN AND OUTCOME MEASURES: A prospective cohort design was used. All participants (n = 1530) were asked to complete the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 questionnaire (GAD-7) at baseline, before each session during treatment, at final treatment, and at 12 months post-treatment. Cohen's d was used as effect size measure. Sensitivity analyses were conducted to examine the impact of the high missing data rates at post-treatment (≈44%) and 12 months post-treatment (≈58%).
RESULTS: A large symptom reduction was seen from baseline to 12 months post-treatment for both PHQ (d = -0.98) and GAD (d = -0.94). Improvements observed at post-treatment were largely maintained at 12 months post-treatment (PHQ (Δd = 0.10) and GAD (Δd = 0.09). Recovery rates decreased only slightly from 49.5% at post-treatment to 45.0% at follow-up. Both low- and high-intensity treatment forms were associated with substantial and lasting symptoms reductions (-1.26 ≤ d ≤ -0.73). Sensitivity analyses did not substantially alter the main results.
CONCLUSION: The findings suggest long-lasting effects of the PMHC program and encourage the use of low-intensity treatment forms in PMHC like settings.