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Adult Anxiety

Contribution of therapists' experience in delivering a transdiagnostic group treatment protocol for anxiety disorders to the development of a digital intervention modality

(PS9-B48) Contribution of Therapists' Experience in Delivering a Transdiagnostic Group Treatment Protocol for Anxiety Disorders to the Development of a Digital Intervention Modality

Saturday, November 19, 2022

1:30 PM – 2:30 PM EST

Location: Westside Ballroom, 5th Floor

Author(s)

Pasquale Roberge, Ph.D.

Professor
Université de Sherbrooke
Sherbrooke, Quebec, Canada

Co-Author(s)

MP

Martin D. Provencher, Ph.D.

Professor
Université Laval
Quebec, Quebec, Canada
CD

Camila Durand, M.S.

PhD student
Université de Sherbrooke
Sherbrooke, Quebec, Canada
PN

Peter J. Norton, Ph.D.

Professor
The Cairnmillar Institute
Hawthorne, Victoria, Australia

Background: Access to cognitive behaviour therapy (CBT), the most consistently efficacious psychological treatment for anxiety disorders, is confronted by limited resources and expertise in primary care. In response to this treatment gap psychological treatments with innovative modalities and high implementation potential are essential. Transdiagnostic group CBT (tCBT) protocols target cognitive and behavioural processes and intervention strategies common to different anxiety disorders and could increase CBT accessibility. Results from our large multicenter pragmatic randomized controlled trial of group tCBT for anxiety disorders reported the effectiveness of a group tCBT protocol (Norton, 2012) as a complement to treatment-as-usual in community-based primary mental health care in Quebec (Canada). The tCBT intervention comprises psychoeducation, cognitive restructuring and exposure strategies. It consists of 12 weekly 2-hour sessions in groups of 8-10 participants, delivered by two accredited psychologists or psychotherapists. Twenty-one therapists delivered treatment to study participants. Therapists had taken part in a two-day workshop with the treatment developer and were supervised during the course of the study.
Methods: In the perspective of the large-scale dissemination and implementation of this tCBT intervention, we conducted an embedded interpretative descriptive qualitative study with semi-structured interviews with 18 of the 21 psychologists or psychotherapists who facilitated the trial groups. Interviews aimed to explore their experience of facilitating tCBT groups for anxiety disorders and to obtain their perspectives on improvements for training and tCBT delivery.
Results: Therapists identified patient characteristics influencing tCBT adherence and group dynamics (e.g., type of anxiety disorder and severity, personality traits). They revealed different challenges encountered (e.g., exposure in a heterogeneous group) and intervention strengths such as co-facilitation. They proposed strategies to enhance the training program, as well as contextual adaptations to enhance therapist experience and patient engagement.
Discussion: Lessons learned from theses analyses suggest increased therapist training and support could promote therapists’ adherence to specific tCBT protocol components such as exposure. This study contributed to gaining an in-depth comprehension of the optimal strategies for the effective integration this intervention into community-based care. Considering the subsequent onset of the COVID-19 pandemic prior to the initiation of the follow-up dissimination and implemetation study, we rapidly conceptualized an innovative online tCBT training integrating therapists’ perspectives which, when completed, will be offered in both French and English. This virtual format in lieu of an on-site 2-day course will provide a much wider access to tCBT training without the usual geographical and time constraints, and could sustainably promote CBT accessibility.