Psychotherapy Strategies for the Treatment of Professionals and Students From Essential Services With High Levels of Emotional Distress in the Context of COVID-19

NCT ID: NCT04635618

Last Updated: 2020-11-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

999 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-05

Study Completion Date

2021-07-20

Brief Summary

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The study consists in a pragmatic superiority randomized controlled trial comparing different strategies of psychotherapy for professionals and students from essential services with high levels of emotional distress during the COVID-19 pandemic in Brazil. Therapeutic strategies to be evaluated are Brief Cognitive Behavioral Telepsychotherapy, Brief Interpersonal Telepsychotherapy and Telepsychoeducation, as an active control.

Note: This study was approved by the Ethics and Research Committee of the Hospital de Clínicas de Porto Alegre and is originally registered at Plataforma Brasil, a Brazilian study registration platform (under CAAE: 30608420.5.0000.5327). Recruitment began in May 28th 2020.

Detailed Description

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PRAGMATIC TREATMENT TRIAL

TITLE: "A pragmatic superiority randomized controlled trial comparing Brief Cognitive Behavioral Telepsychotherapy, Brief Interpersonal Telepsychotherapy and Telepsychoeducation for the reduction of emotional distress during COVID-19 outbreak in professionals and students from essential services with a high level of emotional distress in Brazil".

IMPORTANCE: COVID-19 outbreak is associated with increased emotional distress (depression, anxiety, and irritability) all over the world. Currently, there are no large randomized trials testing interventions to reduce the burden caused by mental disorders during a pandemic outbreak of these proportions.

OBJECTIVE: To test the effectiveness of two modalities of Brief-Telepsychotherapy (Cognitive Behavioral and Interpersonal) to the reduction of symptoms of emotional distress (anxiety, depression, and irritability) in professionals and students from essential services with a high level of those symptoms in Brazil during the COVID-19 outbreak.

DESIGN, SETTING, AND PARTICIPANTS Thee-arm randomized clinical trial. Participants were recruited in Brazil from the national service of telehealth provided by the ministry of health. Participants included professional and students from essential services suffering from high levels of anxiety, depression, and irritability symptoms during the COVID-19 outbreak. High levels of symptoms were defined by either of the following: (1) T score higher than 70 on the PROMIS Anxiety Scale; (2) T score higher than 70 on the PROMIS Depression Scale; (3) T score higher than 70 on the PROMIS Anger Scale.

INTERVENTIONS: All participants will be randomized 1:1:1: to the Cognitive Behavioral Brief-Telepsychotherapy group (B-CBT, four sessions), Brief Interpersonal Telepsychotherapy (B-IPT, four sessions) or Telepsychoeducation group (a single session psychoeducation group plus weekly personalized pre-recorded videos for 4 weeks).

MAIN OUTCOMES AND MEASURES: The primary outcome will be the proportion of participants with a 50% reduction in T-scores in all the scales that were scored above 70 at baseline at 1-month. Secondary outcomes (1) the same measure of the primary outcome but measured at 3-month and 6-months follow-up; (2) mean score change in individual scales, quality of life and remission levels (proportion of patients with T-score of 50 or below in all of the four emotional distress subscales); (3) the same measure of the primary outcome but measured at midpoint (after the second session or 2-weeks); and (4) service satisfaction and net-promoter score at the end of the treatment.

EXPECTED RESULTS: To detect a 15% group difference between each group, an alpha of 0.017 (3 comparisons, 0,05/3), power of 90%, and 20% loss to follow up, we would need a total of 333 participants per group.

Conditions

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Mental Disorder COVID Emotional Distress Depression Anxiety Irritable Mood

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Three-arm randomized clinical trial , including professionals and students from essential services suffering from high levels of anxiety, depression, and irritability symptoms during the COVID-19 outbreak randomized 1:1:1: to the Cognitive Behavioral Brief-Telepsychotherapy group (B-CBT, four sessions), Brief Interpersonal Telepsychotherapy (B-IPT, four sessions) or Telepsychoeducation group (a single session psychoeducation group plus weekly personalized pre-recorded videos for 4 weeks).
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Intervention I: Cognitive Behavioral Brief-Telepsychotherapy

Four sessions of cognitive-behavioral therapy (CBT) conducted through a video call by a psychologist, accompanied by sending videos of 2 to 3 minutes with psychoeducational content and content related to CBT technique.

Group Type EXPERIMENTAL

Cognitive Behavioral Brief-Telepsychotherapy

Intervention Type BEHAVIORAL

Four sections of Cognitive Behavioral Brief-Telepsychotherapy plus personalized pre-recorded videos

Intervention II: Brief Interpersonal Telepsychotherapy

Four sessions of interpersonal therapy (IPT) conducted by video call by a psychologist, accompanied by the sending of 2 to 3 minute videos with psychoeducational content and content related to the ITP technique.

Group Type EXPERIMENTAL

Brief Interpersonal Telepsychotherapy

Intervention Type BEHAVIORAL

Four sections of Brief Interpersonal Telepsychotherapy plus personalized pre-recorded videos

Active Comparator: Telepsychoeducation group

One single session of psychoeducation conducted through a video call by a psychologist, accompanied by sending videos of 2 to 3 minutes with psychoeducational content for 4 weeks.

Group Type ACTIVE_COMPARATOR

Telepsychoeducation

Intervention Type BEHAVIORAL

A single session psychoeducation group plus weekly personalized pre-recorded videos for 4 weeks

Interventions

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Cognitive Behavioral Brief-Telepsychotherapy

Four sections of Cognitive Behavioral Brief-Telepsychotherapy plus personalized pre-recorded videos

Intervention Type BEHAVIORAL

Brief Interpersonal Telepsychotherapy

Four sections of Brief Interpersonal Telepsychotherapy plus personalized pre-recorded videos

Intervention Type BEHAVIORAL

Telepsychoeducation

A single session psychoeducation group plus weekly personalized pre-recorded videos for 4 weeks

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

Professionals and students from essential services suffering from high levels of emotional distress

* T score higher than 70 on the PROMIS Anxiety Scale
* T score higher than 70 on the PROMIS Depression Scale
* T score higher than 70 on the PROMIS Anger Scale

Exclusion Criteria

* Moderate to severe suicide risk assessed by a psychiatrist
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital de Clinicas de Porto Alegre

OTHER

Sponsor Role lead

Responsible Party

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Giovanni Abrahao Salum Junior

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Giovanni Salum, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital de Clínicas de Porto Alegre, Porto Alegre/Brazil

Locations

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Hospital de Clínicas de Porto Alegre

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

Countries

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Brazil

References

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Martins DS, Viduani A, Dreher CB, Salum G, Manfro GG. Examining therapeutic alliance, adherence, and dropout in brief telepsychotherapy: A qualitative study. J Couns Psychol. 2025 Jun 2. doi: 10.1037/cou0000806. Online ahead of print.

Reference Type DERIVED
PMID: 40455512 (View on PubMed)

Other Identifiers

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20200213_Treatment

Identifier Type: -

Identifier Source: org_study_id