Abstract
A RANDOMIZED ACUTE AUGMENTATION TREATMENT STUDY AND ADAPTIVE DESIGN: USING A SINGLE SESSION INTERVENTION TO ASSESS EARLY RAPID RESPONSE
Tracey Wade1, Glenn Waller2
1Flinders University Institute for Mental Health and Wellbeing, Adelaide, Australia/2Department of Psychology, Sheffield University, Sheffield, United Kingdom
Introduction. The most robust predictor of outcome at end of treatment and follow-up is greater symptom change early in treatment. More intensive therapy offered to slower responders might assist this group to catch up. In this study we examine whether a pre-treatment single session intervention (SSI) can help to match people to the correct intensity of treatment. Methods. In the 2-week period between assessment and start of treatment, 40 people were randomized to one of three SSIs: growth mindset, behavioural activation, emotion regulation. Those who reduced their dietary restraint (EDE-Q) by 30% or more (rapid early responders) were offered 10 sessions of online guided self-help cognitive behaviour therapy (GSH-CBT) and those who did not (slow early responders) were offered face-to-face CBT-T. Results. There were no differences between the three groups at assessment. The behavioural activation SSI reduced dietary restriction more than the emotion regulation SSI. At the start of treatment, the rapid responders had a significantly lower level of disordered eating (global EDE-Q score) than the slow responders - ES=0.98 (.32,1.63). However, the slow responders had caught up by session 3-4. End of treatment results will also be discussed. Conclusions. SSIs can kick start progress before treatment commences. Behavioural activation may be the best SSI for this purpose. Matching therapy intensity to speed of early change ensures comparable positive outcomes between groups.
Category
Treatment/Prevention