Skip to main content
Top
Published in: Trials 1/2016

Open Access 01-12-2016 | Study protocol

Comparing systemic therapy and cognitive behavioral therapy for social anxiety disorders: study protocol for a randomized controlled pilot trial

Authors: Christina Hunger, Rebecca Hilzinger, Theresa Koch, Johannes Mander, Anja Sander, Hinrich Bents, Jochen Schweitzer

Published in: Trials | Issue 1/2016

Login to get access

Abstract

Background

Social anxiety disorders are among the most prevalent anxiety disorders in the general population. The efficacy of cognitive behavioral therapy (CBT) for social anxiety disorders is well demonstrated. However, only three studies point to the efficacy of systemic therapy (ST) in anxiety disorders, and only two of them especially focus on social anxiety disorders. These ST studies either do not use a good comparator but minimal supportive therapy, they do not use a multi-person ST but a combined therapy, or they do not especially focus on social anxiety disorders but mood and anxiety disorders in general. Though ST was approved as evidence based in Germany for a variety of disorders in 2008, evidence did not include anxiety disorders. This is the first pilot study that will investigate multi-person ST, integrating a broad range of systemic methods, specifically for social anxiety disorders and that will compare ST to the "gold standard" CBT.

Design

This article describes the rationale and protocol of a prospective, open, interventive, balanced, bi-centric, pilot randomized controlled trial (RCT). A total of 32 patients with a primary SCID diagnosis of social anxiety disorder will be randomized to either CBT or ST. Both treatments will be manualized.
The primary outcome will include social anxiety symptoms at the end of therapy. Therapy will be restricted to no more than 26 hours (primary endpoint). Secondary outcomes will include psychological, social systems and interpersonal functioning, symptom adjustment, and caregiver burden, in addition to change measures, therapist variables and treatment adherence. At the secondary endpoints, 9 and 12 months after the beginning of therapy, we will again assess all outcomes.

Discussion

The study is expected to pilot test a RCT which will be the first to directly compare CBT and multi-person ST, integrating a broad range of systemic methods, for social anxiety disorders, and it will provide empirical evidence for the calculation of the number of patients needed for a confirmatory RCT.

Trial registration

ClinicalTrials.gov: NCT02360033; date of registration: 21 January 2015.
Footnotes
1
The term “bi-centric” is used with respect to the two centers involved in this study, the CPP and IMP.
 
Literature
1.
go back to reference Hofmann S, Asnaani A, Vonk I, Sawyer A, Fang A. The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cogn Ther Res. 2012;36(5):427–40.CrossRef Hofmann S, Asnaani A, Vonk I, Sawyer A, Fang A. The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cogn Ther Res. 2012;36(5):427–40.CrossRef
2.
go back to reference Scientific Advisory Board on Psychotherapy. Gutachten zur wissenschaftlichen Anerkennung der Systemischen Therapie. Berlin: Scientific Advisory Board on Psychotherapy; 2008. Available from: www.wbpsychotherapie.de. Scientific Advisory Board on Psychotherapy. Gutachten zur wissenschaftlichen Anerkennung der Systemischen Therapie. Berlin: Scientific Advisory Board on Psychotherapy; 2008. Available from: www.​wbpsychotherapie​.​de.
3.
go back to reference Sydow K, Beher S, Retzlaff R, Schweitzer J. Die Wirksamkeit der systemischen Therapie/Familientherapie. Göttingen: Hogrefe; 2007. p. 182. Sydow K, Beher S, Retzlaff R, Schweitzer J. Die Wirksamkeit der systemischen Therapie/Familientherapie. Göttingen: Hogrefe; 2007. p. 182.
4.
go back to reference Knekt P, Lindfors O, Härkänen T, Välikoski M, Virtala E, Laaksonen MA, et al. Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychol Med. 2008;38:689–703.CrossRefPubMed Knekt P, Lindfors O, Härkänen T, Välikoski M, Virtala E, Laaksonen MA, et al. Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychol Med. 2008;38:689–703.CrossRefPubMed
5.
go back to reference Willutzki U, Neumann B, Haas H, Koban C, Schulte D. Zur Psychotherapie sozialer Ängste: Kognitive Verhaltenstherapie im Vergleich zu einem kombiniert ressourcenorientierten Vorgehen. Z Klin Psychol Psychother. 2004;33(1):42–50.CrossRef Willutzki U, Neumann B, Haas H, Koban C, Schulte D. Zur Psychotherapie sozialer Ängste: Kognitive Verhaltenstherapie im Vergleich zu einem kombiniert ressourcenorientierten Vorgehen. Z Klin Psychol Psychother. 2004;33(1):42–50.CrossRef
6.
go back to reference Rakowska JM. Brief strategic therapy in patients with social phobia with or without personality disorder. Psychother Res. 2011;21(4):462–71.CrossRefPubMed Rakowska JM. Brief strategic therapy in patients with social phobia with or without personality disorder. Psychother Res. 2011;21(4):462–71.CrossRefPubMed
7.
go back to reference Wittchen HU, Fehm L. Epidemiology and natural course of social fears and social phobia. Acta Psychiatr Scand. 2003;108(417):4–18.CrossRef Wittchen HU, Fehm L. Epidemiology and natural course of social fears and social phobia. Acta Psychiatr Scand. 2003;108(417):4–18.CrossRef
8.
go back to reference Stangier U, Clark DM, Ehlers A. Soziale Phobie. Göttingen: Hogrefe; 2006. p. 109. Stangier U, Clark DM, Ehlers A. Soziale Phobie. Göttingen: Hogrefe; 2006. p. 109.
9.
go back to reference Stein MB, Kean YM. Disability and quality of life in social phobia: epidemiologic findings. Am J Psychiatr. 2000;157:1606–13.CrossRefPubMed Stein MB, Kean YM. Disability and quality of life in social phobia: epidemiologic findings. Am J Psychiatr. 2000;157:1606–13.CrossRefPubMed
10.
go back to reference Alden LE, Taylor CT. Interpersonal processes in social phobia. Clin Psychol Rev. 2004;24(7):857–82.CrossRefPubMed Alden LE, Taylor CT. Interpersonal processes in social phobia. Clin Psychol Rev. 2004;24(7):857–82.CrossRefPubMed
11.
go back to reference Keller MB. The lifelong course of social anxiety disorder: a clinical perspective. Acta Psychiatr Scand. 2003;108 Suppl 417:85–94.CrossRef Keller MB. The lifelong course of social anxiety disorder: a clinical perspective. Acta Psychiatr Scand. 2003;108 Suppl 417:85–94.CrossRef
12.
go back to reference Yonkers KA, Dyck IR, Keller MB. An eight-year longitudinal comparison of clinical course and characteristics of social phobia among men and women. Psychiatr Serv. 2001;52(5):637–43.CrossRefPubMed Yonkers KA, Dyck IR, Keller MB. An eight-year longitudinal comparison of clinical course and characteristics of social phobia among men and women. Psychiatr Serv. 2001;52(5):637–43.CrossRefPubMed
13.
go back to reference Taylor CT, Alden LE. To see ourselves as others see us: an experimental integration of the intra and interpersonal consequences of self-protection in social anxiety disorder. J Abnorm Psychol. 2011;120(1):129–41.CrossRefPubMed Taylor CT, Alden LE. To see ourselves as others see us: an experimental integration of the intra and interpersonal consequences of self-protection in social anxiety disorder. J Abnorm Psychol. 2011;120(1):129–41.CrossRefPubMed
14.
go back to reference Davila J, Beck JG. Is social anxiety associated with impairment in close relationships? A preliminary investigation. Behav Ther. 2002;33:427–46.CrossRef Davila J, Beck JG. Is social anxiety associated with impairment in close relationships? A preliminary investigation. Behav Ther. 2002;33:427–46.CrossRef
15.
go back to reference Iwase M, Nakao K, Takaishi J, Yorifuji K, Ikezawa K, Takeda M. An empirical classification of social anxiety: performance, interpersonal and offensive. Psychiatry Clin Neurosci. 2000;54(1):67–75.CrossRefPubMed Iwase M, Nakao K, Takaishi J, Yorifuji K, Ikezawa K, Takeda M. An empirical classification of social anxiety: performance, interpersonal and offensive. Psychiatry Clin Neurosci. 2000;54(1):67–75.CrossRefPubMed
16.
go back to reference Beck AT, Emery G. Anxiety disorders and phobias: a cognitive perspective. New York: Basic Books; 1985. Beck AT, Emery G. Anxiety disorders and phobias: a cognitive perspective. New York: Basic Books; 1985.
17.
go back to reference Clark DM, Wells A. A cognitive model of social phobia. Social phobia. 1995;41(68):22–3. Clark DM, Wells A. A cognitive model of social phobia. Social phobia. 1995;41(68):22–3.
18.
go back to reference von Schlippe A, Schweitzer J. Lehrbuch der systemischen Therapie und Beratung I: Das Grundlagenwissen. V & R: Göttingen; 2012. von Schlippe A, Schweitzer J. Lehrbuch der systemischen Therapie und Beratung I: Das Grundlagenwissen. V & R: Göttingen; 2012.
19.
go back to reference Rotthaus W. Ängste von Kindern und Jugendlichen. Heidelberg: Carl-Auer; 2015. Rotthaus W. Ängste von Kindern und Jugendlichen. Heidelberg: Carl-Auer; 2015.
20.
go back to reference Jones E, Asen E. Wenn Paare leiden: Wege aus der Depressionsfalle. Dortmund: Borgmann; 2002. Jones E, Asen E. Wenn Paare leiden: Wege aus der Depressionsfalle. Dortmund: Borgmann; 2002.
21.
go back to reference Szapocznik J, Hervis O, Schwartz S. Brief strategic family therapy for adolescent drug abuse. National Institutes of Health: Bethesda; 2003.CrossRef Szapocznik J, Hervis O, Schwartz S. Brief strategic family therapy for adolescent drug abuse. National Institutes of Health: Bethesda; 2003.CrossRef
22.
go back to reference Stratton P, Pote H, Cottrell D, Boston P, Shapiro D, Hanks H. The Leeds systemic family therapy manual. Leeds: University of Leeds; 2000. Stratton P, Pote H, Cottrell D, Boston P, Shapiro D, Hanks H. The Leeds systemic family therapy manual. Leeds: University of Leeds; 2000.
23.
go back to reference de Shazer S, Berg IK, Lipchik E, Nunnally E, Molnar A, Gingerich W, et al. Brief therapy: focused solution development. Fam Process. 1986;25:207–21.CrossRefPubMed de Shazer S, Berg IK, Lipchik E, Nunnally E, Molnar A, Gingerich W, et al. Brief therapy: focused solution development. Fam Process. 1986;25:207–21.CrossRefPubMed
24.
go back to reference Watzlawick P, Weakland JH, Fisch R. Change: principles of problem formation and problem resolution. New York: Norton; 1974. Watzlawick P, Weakland JH, Fisch R. Change: principles of problem formation and problem resolution. New York: Norton; 1974.
25.
go back to reference Nardone G, Hildenbrand A. Pirouetten im Supermarkt: strategische Interventionen für Therapie und Selbsthilfe. Heidelberg: Carl-Auer-Verlag; 2007. Nardone G, Hildenbrand A. Pirouetten im Supermarkt: strategische Interventionen für Therapie und Selbsthilfe. Heidelberg: Carl-Auer-Verlag; 2007.
26.
go back to reference Schumacher B. Systemische Angsttherapie in einer Sitzung. Teil I Familiendynamik. 2008;33(1):16–34. Schumacher B. Systemische Angsttherapie in einer Sitzung. Teil I Familiendynamik. 2008;33(1):16–34.
27.
go back to reference Schumacher B. Systemische Angsttherapie in einer Sitzung. Teil I Familiendynamik. 2008;33(1):177–93. Schumacher B. Systemische Angsttherapie in einer Sitzung. Teil I Familiendynamik. 2008;33(1):177–93.
28.
go back to reference Lieb H. So hab ich das noch nie gesehen. Systemische Therapie und Verhaltenstherapie. Heidelberg: Carl-Auer; 2009. Lieb H. So hab ich das noch nie gesehen. Systemische Therapie und Verhaltenstherapie. Heidelberg: Carl-Auer; 2009.
29.
go back to reference Lieb H. Störungsspezifische Systemtherapie. Konzepte und Lösungen. Heidelberg: Carl-Auer; 2013. Lieb H. Störungsspezifische Systemtherapie. Konzepte und Lösungen. Heidelberg: Carl-Auer; 2013.
30.
go back to reference Schweitzer J, Hunger C. Systemic therapy for social anxiety disorders. Heidelberg: Carl-Auer; in press. Schweitzer J, Hunger C. Systemic therapy for social anxiety disorders. Heidelberg: Carl-Auer; in press.
31.
go back to reference Heinrichs N, Stangier U, Gerlach AL, Willutzki U, Fydrich T. Evidenzbasierte Leitlinie zur Psychotherapie der Sozialen Angststörung. Hogrefe Verlag: Göttingen; 2010. Heinrichs N, Stangier U, Gerlach AL, Willutzki U, Fydrich T. Evidenzbasierte Leitlinie zur Psychotherapie der Sozialen Angststörung. Hogrefe Verlag: Göttingen; 2010.
32.
go back to reference Acarturk C, Cuijpers P, van Straten A, de Graaf R. Psychological treatment of social anxiety disorder: a meta-analysis. Psychol Med. 2009;39(2):241–54.CrossRefPubMed Acarturk C, Cuijpers P, van Straten A, de Graaf R. Psychological treatment of social anxiety disorder: a meta-analysis. Psychol Med. 2009;39(2):241–54.CrossRefPubMed
33.
go back to reference Bandelow B, Baldwin DS, Dolberg OT, Andersen HF, Stein DJ. What is the threshold for symptomatic response and remission for major depressive disorder, panic disorder, social anxiety disorder, and generalized anxiety disorder? J Clin Psychiatry. 2006;67(9):1428–34.CrossRefPubMed Bandelow B, Baldwin DS, Dolberg OT, Andersen HF, Stein DJ. What is the threshold for symptomatic response and remission for major depressive disorder, panic disorder, social anxiety disorder, and generalized anxiety disorder? J Clin Psychiatry. 2006;67(9):1428–34.CrossRefPubMed
34.
go back to reference Cohen J. Statistical power analysis for behavioral sciences. Hillsdale: Erlbaum; 1988. Cohen J. Statistical power analysis for behavioral sciences. Hillsdale: Erlbaum; 1988.
35.
go back to reference Leichsenring F, Salzer S, Beutel ME, Herpertz S, Hiller W, Hoyer J, et al. Psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: A multicenter randomized controlled trial. Am J Psychiatry. 2013;170(7):759–67.CrossRefPubMed Leichsenring F, Salzer S, Beutel ME, Herpertz S, Hiller W, Hoyer J, et al. Psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: A multicenter randomized controlled trial. Am J Psychiatry. 2013;170(7):759–67.CrossRefPubMed
36.
go back to reference Horowitz LM, Strauß B, Kordy H. Inventar zur Erfassung Interpersonaler Probleme (IIP-D). Testmappe. Beltz: Weinheim; 1994. Horowitz LM, Strauß B, Kordy H. Inventar zur Erfassung Interpersonaler Probleme (IIP-D). Testmappe. Beltz: Weinheim; 1994.
37.
go back to reference Davidson JRT, Foa EB, Huppert JD, Keefe FJ, Franklin ME, Compton JS, et al. Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia. Arch Gen Psychiatry. 2004;61(10):1005–13.CrossRefPubMed Davidson JRT, Foa EB, Huppert JD, Keefe FJ, Franklin ME, Compton JS, et al. Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia. Arch Gen Psychiatry. 2004;61(10):1005–13.CrossRefPubMed
38.
go back to reference Heimberg RG, Liebowitz MR, Hope DA, Schneier FR, Holt CS, Welkowitz LA, et al. Cognitive behavioral group therapy vs phenelzine therapy for social phobia: 12-week outcome. Arch Gen Psychiatry. 1998;55(12):1133–41.CrossRefPubMed Heimberg RG, Liebowitz MR, Hope DA, Schneier FR, Holt CS, Welkowitz LA, et al. Cognitive behavioral group therapy vs phenelzine therapy for social phobia: 12-week outcome. Arch Gen Psychiatry. 1998;55(12):1133–41.CrossRefPubMed
39.
go back to reference Franke GH, Derogatis LR. Die Symptom-Checkliste von Derogatis: Manual. SCL-90-R; deutsche Version. Beltz Test: Göttingen; 1995. Franke GH, Derogatis LR. Die Symptom-Checkliste von Derogatis: Manual. SCL-90-R; deutsche Version. Beltz Test: Göttingen; 1995.
40.
go back to reference Derogatis LR. SCL-90-R: Administration, scoring and procedures manual for the revised version and other instruments of the psychopathology rating scale series. Baltimore: Clinical Psychometric Research; 1983. Derogatis LR. SCL-90-R: Administration, scoring and procedures manual for the revised version and other instruments of the psychopathology rating scale series. Baltimore: Clinical Psychometric Research; 1983.
41.
go back to reference Stangier U, Heidenreich T, Berardi A, Golbs U, Hoyer J. Die Erfassung sozialer Phobie durch Social Interaction Anxiety Scale (SIAS) und die Social Phobia Scale (SPS) [Assessment of social phobia by the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS)]. Z Klin Psychol. 1999;28(1):28–36.CrossRef Stangier U, Heidenreich T, Berardi A, Golbs U, Hoyer J. Die Erfassung sozialer Phobie durch Social Interaction Anxiety Scale (SIAS) und die Social Phobia Scale (SPS) [Assessment of social phobia by the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS)]. Z Klin Psychol. 1999;28(1):28–36.CrossRef
42.
go back to reference Heinrichs N, Hahlweg K, Fiegenbaum W, Frank M, Schroeder B, von Witzleben I. Validität und Reliabilität der Social Interaction Anxiety Scale (SIAS) und der Social Phobia Scale (SPS) [Validity and reliability of the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS)]. Verhaltenstherapie. 2002;12(1):26–35.CrossRef Heinrichs N, Hahlweg K, Fiegenbaum W, Frank M, Schroeder B, von Witzleben I. Validität und Reliabilität der Social Interaction Anxiety Scale (SIAS) und der Social Phobia Scale (SPS) [Validity and reliability of the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS)]. Verhaltenstherapie. 2002;12(1):26–35.CrossRef
43.
go back to reference Mattick RP, Clarke JC. Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behav Res Ther. 1998;36:455–70.CrossRefPubMed Mattick RP, Clarke JC. Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behav Res Ther. 1998;36:455–70.CrossRefPubMed
44.
45.
go back to reference Baker SL, Heinrichs N, Kim HJ, Hofmann SG. The Liebowitz social anxiety scale as a self-report instrument: a preliminary psychometric analysis. Behav Res Ther. 2002;40(6):701–15.CrossRefPubMed Baker SL, Heinrichs N, Kim HJ, Hofmann SG. The Liebowitz social anxiety scale as a self-report instrument: a preliminary psychometric analysis. Behav Res Ther. 2002;40(6):701–15.CrossRefPubMed
46.
go back to reference Arain M, Campbell MJ, Cooper CL, Lancaster GA. What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Med Res Methodol. 2010;10(1):1–7.CrossRef Arain M, Campbell MJ, Cooper CL, Lancaster GA. What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Med Res Methodol. 2010;10(1):1–7.CrossRef
47.
go back to reference Cocks K, Torgerson DJ. Sample size calculations for pilot randomized trials: a confidence interval approach. J Clin Epidemiol. 2013;66(2):197–201.CrossRefPubMed Cocks K, Torgerson DJ. Sample size calculations for pilot randomized trials: a confidence interval approach. J Clin Epidemiol. 2013;66(2):197–201.CrossRefPubMed
48.
go back to reference Leichsenring F, Hoyer J, Beutel M, Herpertz S, Hiller W, Irle E, et al. The social phobia psychotherapy research network. The first multicenter randomized controlled trial of psychotherapy for social phobia: rationale, methods and patient characteristics. Psychother Psychosom. 2009;78(1):35–41.CrossRefPubMed Leichsenring F, Hoyer J, Beutel M, Herpertz S, Hiller W, Irle E, et al. The social phobia psychotherapy research network. The first multicenter randomized controlled trial of psychotherapy for social phobia: rationale, methods and patient characteristics. Psychother Psychosom. 2009;78(1):35–41.CrossRefPubMed
49.
go back to reference World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef
50.
go back to reference Falkai P, Wittchen HU, Döpfner M, Gaebel W, Maier W, Rief W, et al. Diagnostisches und Statistisches Manual Psychischer Störungen DSM-5 [Diagnostic and statistical manual of mental disorders DSM-5]. Göttingen: Hogrefe; 2014. Falkai P, Wittchen HU, Döpfner M, Gaebel W, Maier W, Rief W, et al. Diagnostisches und Statistisches Manual Psychischer Störungen DSM-5 [Diagnostic and statistical manual of mental disorders DSM-5]. Göttingen: Hogrefe; 2014.
51.
go back to reference Forand NR, Evans S, Haglin D, Fishman B. Cognitive behavioral therapy in practice: Treatment delivered by trainees at an outpatient clinic is clinically effective. Behav Ther. 2011;42(4):612–23.CrossRefPubMed Forand NR, Evans S, Haglin D, Fishman B. Cognitive behavioral therapy in practice: Treatment delivered by trainees at an outpatient clinic is clinically effective. Behav Ther. 2011;42(4):612–23.CrossRefPubMed
52.
go back to reference Schulz KF, Grimes DA. Reihe Epidemiologie 6: Generierung von Randomisierungslisten in randomisierten Studien: Zufall, nicht Auswahl. Zeitschrift für ärztliche Fortbildung und Qualität im Gesundheitswesen. 2007;101(6):419–26. Schulz KF, Grimes DA. Reihe Epidemiologie 6: Generierung von Randomisierungslisten in randomisierten Studien: Zufall, nicht Auswahl. Zeitschrift für ärztliche Fortbildung und Qualität im Gesundheitswesen. 2007;101(6):419–26.
53.
go back to reference Zwarenstein M, Treweek S, Gagnier JJ, Altman DG, Tunis S, Haynes B, et al. Improving the reporting of pragmatic trials: an extension of the CONSORT statement. BMJ. 2008;337:a2390.CrossRefPubMed Zwarenstein M, Treweek S, Gagnier JJ, Altman DG, Tunis S, Haynes B, et al. Improving the reporting of pragmatic trials: an extension of the CONSORT statement. BMJ. 2008;337:a2390.CrossRefPubMed
54.
go back to reference Luborsky L, Singer B, Luborsky L. Comparative studies of psychotherapies: is it true that everyone has won and all must have prizes? Arch Gen Psychiatry. 1975;32(8):995–1008.CrossRefPubMed Luborsky L, Singer B, Luborsky L. Comparative studies of psychotherapies: is it true that everyone has won and all must have prizes? Arch Gen Psychiatry. 1975;32(8):995–1008.CrossRefPubMed
55.
go back to reference Munder T, Flückiger C, Gerger H, Wampold BE, Barth J. Is the allegiance effect an epiphenomenon of true efficacy differences between treatments? A meta-analysis. J Couns Psychol. 2012;59(4):631–7.CrossRefPubMed Munder T, Flückiger C, Gerger H, Wampold BE, Barth J. Is the allegiance effect an epiphenomenon of true efficacy differences between treatments? A meta-analysis. J Couns Psychol. 2012;59(4):631–7.CrossRefPubMed
56.
go back to reference Leichsenring F, Leibing E. Psychodynamic psychotherapy: a systematic review of techniques, indications and empirical evidence. Psychol Psychother. 2007;80(2):217–28.CrossRefPubMed Leichsenring F, Leibing E. Psychodynamic psychotherapy: a systematic review of techniques, indications and empirical evidence. Psychol Psychother. 2007;80(2):217–28.CrossRefPubMed
57.
go back to reference Luborsky L. Einführung in die Analytische Psychotherapie. Ein Lehrbuch. Göttingen: V & R; 1984 [dt. 1999]. Luborsky L. Einführung in die Analytische Psychotherapie. Ein Lehrbuch. Göttingen: V & R; 1984 [dt. 1999].
58.
go back to reference von Consbruch K, Heinrich K, Engelhardt K, Clark DM, Stangier U. Psychometrische Eigenschaften der Cognitive Therapy Competence Scale for Social Phobia (CTCS-SP) und der Cognitive Therapy Adherence Scale for Social Phobia (CTAS-SP). In: Leibing E, Salzer S, Leichsenring F, editors. SOPHONET Forschungsverbund zur Psychotherapie der Sozialen Phobie. Göttingen: Cuvillier Verlag; 2008. p. 14–21. von Consbruch K, Heinrich K, Engelhardt K, Clark DM, Stangier U. Psychometrische Eigenschaften der Cognitive Therapy Competence Scale for Social Phobia (CTCS-SP) und der Cognitive Therapy Adherence Scale for Social Phobia (CTAS-SP). In: Leibing E, Salzer S, Leichsenring F, editors. SOPHONET Forschungsverbund zur Psychotherapie der Sozialen Phobie. Göttingen: Cuvillier Verlag; 2008. p. 14–21.
59.
go back to reference Rytwinski NK, Fresco DM, Heimberg RG, Coles ME, Liebowitz MR, Cissell S, et al. Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale. Depress Anxiety. 2009;26(1):34–8.CrossRefPubMed Rytwinski NK, Fresco DM, Heimberg RG, Coles ME, Liebowitz MR, Cissell S, et al. Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale. Depress Anxiety. 2009;26(1):34–8.CrossRefPubMed
60.
go back to reference Mennin DS, Fresco DM, Heimberg RG, Schneier FR, Davies SO, Liebowitz MR. Screening for social anxiety disorder in the clinical setting: using the Liebowitz Social Anxiety Scale. J Anxiety Disord. 2002;16(6):661–73.CrossRefPubMed Mennin DS, Fresco DM, Heimberg RG, Schneier FR, Davies SO, Liebowitz MR. Screening for social anxiety disorder in the clinical setting: using the Liebowitz Social Anxiety Scale. J Anxiety Disord. 2002;16(6):661–73.CrossRefPubMed
61.
go back to reference Fresco DM, Coles ME, Heimberg RG, Liebowitz MR, Hami S, Stein MB, et al. The Liebowitz Social Anxiety Scale: a comparison of the psychometric properties of self-report and clinician-administered formats. Psychol Med. 2001;31:1025–35.CrossRefPubMed Fresco DM, Coles ME, Heimberg RG, Liebowitz MR, Hami S, Stein MB, et al. The Liebowitz Social Anxiety Scale: a comparison of the psychometric properties of self-report and clinician-administered formats. Psychol Med. 2001;31:1025–35.CrossRefPubMed
62.
go back to reference Endicott J, Spitzer RL, Fleiss JL, Cohen J. The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry. 1976;33(6):766–71.CrossRefPubMed Endicott J, Spitzer RL, Fleiss JL, Cohen J. The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry. 1976;33(6):766–71.CrossRefPubMed
64.
go back to reference Hilsenroth MJ, Ackerman SJ, Blagys MD, Baumann BD, Baity MR, Smith SR, et al. Reliability and validity of DSM-IV axis V. Am J Psychiatry. 2000;157(11):1858–63.CrossRefPubMed Hilsenroth MJ, Ackerman SJ, Blagys MD, Baumann BD, Baity MR, Smith SR, et al. Reliability and validity of DSM-IV axis V. Am J Psychiatry. 2000;157(11):1858–63.CrossRefPubMed
65.
go back to reference Kühner PDC, Bürger C, Keller F, Hautzinger M. Reliabilität und Validität des revidierten Beck-Depressionsinventars (BDI-II). Nervenarzt. 2007;78(6):651–6.CrossRefPubMed Kühner PDC, Bürger C, Keller F, Hautzinger M. Reliabilität und Validität des revidierten Beck-Depressionsinventars (BDI-II). Nervenarzt. 2007;78(6):651–6.CrossRefPubMed
66.
go back to reference Hautzinger M, Keller F, Kühner C. Beck Depression Inventar II (BDI 2). Harcourt Test Services: Frankfurt; 2006. Hautzinger M, Keller F, Kühner C. Beck Depression Inventar II (BDI 2). Harcourt Test Services: Frankfurt; 2006.
67.
go back to reference Hiroe T, Kojima M, Yamamoto I, Nojima S, Kinoshita Y, Hashimoto N, et al. Gradations of clinical severity and sensitivity to change assessed with the Beck Depression Inventory-II in Japanese patients with depression. Psychiatry Res. 2005;135(3):229–35.CrossRefPubMed Hiroe T, Kojima M, Yamamoto I, Nojima S, Kinoshita Y, Hashimoto N, et al. Gradations of clinical severity and sensitivity to change assessed with the Beck Depression Inventory-II in Japanese patients with depression. Psychiatry Res. 2005;135(3):229–35.CrossRefPubMed
68.
go back to reference Geisheim C, Hahlweg K, Fiegenbaum W, Frank M, Schröder B, von Witzleben I. Das Brief Symptom Inventory (BSI) als Instrument zur Qualitätssicherung in der Psychotherapie. Diagnostica. 2002;48:28–36.CrossRef Geisheim C, Hahlweg K, Fiegenbaum W, Frank M, Schröder B, von Witzleben I. Das Brief Symptom Inventory (BSI) als Instrument zur Qualitätssicherung in der Psychotherapie. Diagnostica. 2002;48:28–36.CrossRef
69.
go back to reference Franke GH. Erste Studien zur Güte des Brief Symptom Inventory (BSI). Z Med Psychol. 1997;6:159–66. Franke GH. Erste Studien zur Güte des Brief Symptom Inventory (BSI). Z Med Psychol. 1997;6:159–66.
70.
go back to reference Derogatis LR. Brief symptom inventory (BSI): administration, scoring, and procedures manual. National Computer Systems: Minneapolis; 1993. Derogatis LR. Brief symptom inventory (BSI): administration, scoring, and procedures manual. National Computer Systems: Minneapolis; 1993.
71.
go back to reference Hunger, C., Bornhäuser, A., Link, L., Geigges, J., Voss, A., Weinhold, J., & Schweitzer, J. (2016). The Experience in Personal Social Systems Questionnaire (EXIS.pers.): Development and Psychometric Properties. Family Process, Vol. x, No. x. doi:10.1111/famp.12205. Hunger, C., Bornhäuser, A., Link, L., Geigges, J., Voss, A., Weinhold, J., & Schweitzer, J. (2016). The Experience in Personal Social Systems Questionnaire (EXIS.pers.): Development and Psychometric Properties. Family Process, Vol. x, No. x. doi:10.​1111/​famp.​12205.
72.
go back to reference Dinkel A, Balck F. Psychometrische Analyse der deutschen Dyadic Adjustment Scale. Z Psychol. 2006;214(1):1–9.CrossRef Dinkel A, Balck F. Psychometrische Analyse der deutschen Dyadic Adjustment Scale. Z Psychol. 2006;214(1):1–9.CrossRef
73.
go back to reference Thomas A, Brähler E, Strauß B. IIP-32: Entwicklung, Validierung und Normierung einer Kurzform des Inventars zur Erfassung interpersonaler Probleme. Diagnostica. 2011;57(2):68–83.CrossRef Thomas A, Brähler E, Strauß B. IIP-32: Entwicklung, Validierung und Normierung einer Kurzform des Inventars zur Erfassung interpersonaler Probleme. Diagnostica. 2011;57(2):68–83.CrossRef
74.
go back to reference Huber D, Henrich G, Klug G. The inventory of interpersonal problems (IIP): sensitivity to change. Psychother Res. 2007;17(4):474–81.CrossRef Huber D, Henrich G, Klug G. The inventory of interpersonal problems (IIP): sensitivity to change. Psychother Res. 2007;17(4):474–81.CrossRef
75.
go back to reference Craske MG, Burton T, Barlow DH. Relationships among measures of communication, marital satisfaction and exposure during couples treatment of agoraphobia. Behav Res Ther. 1989;27(2):131–40.CrossRefPubMed Craske MG, Burton T, Barlow DH. Relationships among measures of communication, marital satisfaction and exposure during couples treatment of agoraphobia. Behav Res Ther. 1989;27(2):131–40.CrossRefPubMed
76.
go back to reference Hunger, C., Bergmann, N., Schweitzer, J. (in prep.) Adjustment to psychological problems: Development and psychometric properties of the Adjustment to Symptomatology Scale (ASS). Institute for Medical Psychology, Heidelberg University Hospital. Hunger, C., Bergmann, N., Schweitzer, J. (in prep.) Adjustment to psychological problems: Development and psychometric properties of the Adjustment to Symptomatology Scale (ASS). Institute for Medical Psychology, Heidelberg University Hospital.
77.
go back to reference Reinhard SC, Gubman GD, Horwitz AV, Minsky S. Burden Assessment Scale for families of the seriously mentally ill. Eval Program Plann. 1994;17(3):261–9.CrossRef Reinhard SC, Gubman GD, Horwitz AV, Minsky S. Burden Assessment Scale for families of the seriously mentally ill. Eval Program Plann. 1994;17(3):261–9.CrossRef
78.
go back to reference Hunger, C., Krause, L., Schweitzer, J. (submitted). When Significant Others Suffer: German Validation of the Burden Assessment Scale (BAS). Institute for Medical Psychology, Heidelberg University Hospital. Hunger, C., Krause, L., Schweitzer, J. (submitted). When Significant Others Suffer: German Validation of the Burden Assessment Scale (BAS). Institute for Medical Psychology, Heidelberg University Hospital.
79.
go back to reference Mander J, Wittorf A, Schlarb A, Hautzinger M, Zipfel S, Sammet I. Change mechanisms in psychotherapy: multiperspective assessment and relation to outcome. Psychother Res. 2013;23(1):105–16.CrossRefPubMed Mander J, Wittorf A, Schlarb A, Hautzinger M, Zipfel S, Sammet I. Change mechanisms in psychotherapy: multiperspective assessment and relation to outcome. Psychother Res. 2013;23(1):105–16.CrossRefPubMed
80.
go back to reference Mander J, Schlarb A, Teufel M, Keller F, Hautzinger M, Zipfel S, et al. The individual therapy process questionnaire: development and validation of a revised measure to evaluate general change mechanisms in psychotherapy. Clin Psychol Psychother. 2015;22(4):328–45.CrossRefPubMed Mander J, Schlarb A, Teufel M, Keller F, Hautzinger M, Zipfel S, et al. The individual therapy process questionnaire: development and validation of a revised measure to evaluate general change mechanisms in psychotherapy. Clin Psychol Psychother. 2015;22(4):328–45.CrossRefPubMed
81.
go back to reference Duncan BL, Miller S, Sparks JA, Claud DA, Reynolds LR, Brown J, et al. The Session Rating Scale: preliminary psychometric properties of a “working” alliance measure. J Brief Ther. 2003;3(1):3–12. Duncan BL, Miller S, Sparks JA, Claud DA, Reynolds LR, Brown J, et al. The Session Rating Scale: preliminary psychometric properties of a “working” alliance measure. J Brief Ther. 2003;3(1):3–12.
82.
go back to reference Becker P, Mohr A. Psychometrische Argumente für die Verwendung untransformierter Skalenwerte im Inventar zur Erfassung interpersonaler Probleme (IIP-D). Z Klin Psychol Psychother. 2005;34(3):205–14.CrossRef Becker P, Mohr A. Psychometrische Argumente für die Verwendung untransformierter Skalenwerte im Inventar zur Erfassung interpersonaler Probleme (IIP-D). Z Klin Psychol Psychother. 2005;34(3):205–14.CrossRef
83.
go back to reference Mander J, Wittorf A, Teufel M, Schlarb A, Hautzinger M, Zipfel S, et al. Patients with depression, somatoform disorders and eating disorders on the stages of change: validation of a short-version of the URICA. Psychotherapy. 2012;49(4):519–27.CrossRefPubMed Mander J, Wittorf A, Teufel M, Schlarb A, Hautzinger M, Zipfel S, et al. Patients with depression, somatoform disorders and eating disorders on the stages of change: validation of a short-version of the URICA. Psychotherapy. 2012;49(4):519–27.CrossRefPubMed
84.
go back to reference Mooney TK, Gibbons MB, Gallop R, Mack RA, Crits-Christoph P. Psychotherapy credibility ratings: patient predictors of credibility and the relation of credibility to therapy outcome. Psychother Res. 2013;24(5):565–77.CrossRefPubMedPubMedCentral Mooney TK, Gibbons MB, Gallop R, Mack RA, Crits-Christoph P. Psychotherapy credibility ratings: patient predictors of credibility and the relation of credibility to therapy outcome. Psychother Res. 2013;24(5):565–77.CrossRefPubMedPubMedCentral
85.
go back to reference Orlinsky D, Ambühl H, Ronnestad MH, Davis J, Gerin P, Davis M, et al. Development of psychotherapists: concepts, questions, and methods of a collaborative international study. Psychother Res. 1999;9(2):127–53.CrossRef Orlinsky D, Ambühl H, Ronnestad MH, Davis J, Gerin P, Davis M, et al. Development of psychotherapists: concepts, questions, and methods of a collaborative international study. Psychother Res. 1999;9(2):127–53.CrossRef
86.
go back to reference Nissen-Lie HA, Monsen JT, Ulleberg P, Ronnestad MH. Psychotherapists’ self-reports of their interpersonal functioning and difficulties in practice as a predictor of patient outcome. Psychother Res. 2012;23(1):86–104.CrossRefPubMed Nissen-Lie HA, Monsen JT, Ulleberg P, Ronnestad MH. Psychotherapists’ self-reports of their interpersonal functioning and difficulties in practice as a predictor of patient outcome. Psychother Res. 2012;23(1):86–104.CrossRefPubMed
87.
go back to reference Nissen-Lie HA, Monsen JT, Ronnestad MH. Therapist predictors of early patient-rated working alliance: a multilevel approach. Psychother Res. 2010;20(6):627–46.CrossRefPubMed Nissen-Lie HA, Monsen JT, Ronnestad MH. Therapist predictors of early patient-rated working alliance: a multilevel approach. Psychother Res. 2010;20(6):627–46.CrossRefPubMed
88.
go back to reference Nissen-Lie HA, Monsen JT, Ronnestad MH. The contribution of the quality of therapists’ personal lives to the development of the working alliance. J Couns Psychol. 2013;60(4):483–95.CrossRefPubMed Nissen-Lie HA, Monsen JT, Ronnestad MH. The contribution of the quality of therapists’ personal lives to the development of the working alliance. J Couns Psychol. 2013;60(4):483–95.CrossRefPubMed
89.
go back to reference Roick C, Kilian R, Matschinger H, Bernert S, Mory C, Angermeyer MC. Die deutsche Version des Client Sociodemographic and Service Receipt Inventory—Ein Instrument zur Erfassung psychiatrischer Versorgungskosten. Psychiatr Prax. 2001;28:84–90.CrossRef Roick C, Kilian R, Matschinger H, Bernert S, Mory C, Angermeyer MC. Die deutsche Version des Client Sociodemographic and Service Receipt Inventory—Ein Instrument zur Erfassung psychiatrischer Versorgungskosten. Psychiatr Prax. 2001;28:84–90.CrossRef
90.
go back to reference Chisholm D, Knapp MRJ, Knudsen HC, Amaddeo F, Gaite L, van Wijngaarden B. Client Socio-Demographic and Service Receipt Inventory—European Version: Development of an instrument for international research: EPSILON Study 5. Br J Psychiatry. 2000;177 Suppl 39:s28–33.CrossRef Chisholm D, Knapp MRJ, Knudsen HC, Amaddeo F, Gaite L, van Wijngaarden B. Client Socio-Demographic and Service Receipt Inventory—European Version: Development of an instrument for international research: EPSILON Study 5. Br J Psychiatry. 2000;177 Suppl 39:s28–33.CrossRef
91.
go back to reference Kreft I, de Leeuw J. Introducing multivlevel modeling. Thousand Oaks: Sage; 1998.CrossRef Kreft I, de Leeuw J. Introducing multivlevel modeling. Thousand Oaks: Sage; 1998.CrossRef
92.
go back to reference Murray DM, Varnell SP, Blitstein JL. Design and analysis of group-randomized trials: a review of recent methodological developments. Am J Public Health. 2004;94(3):423–32.CrossRefPubMedPubMedCentral Murray DM, Varnell SP, Blitstein JL. Design and analysis of group-randomized trials: a review of recent methodological developments. Am J Public Health. 2004;94(3):423–32.CrossRefPubMedPubMedCentral
93.
go back to reference Shah PB. Intention-to-treat and per-protocol analysis. Can Med Assoc J. 2011;183(6):696.CrossRef Shah PB. Intention-to-treat and per-protocol analysis. Can Med Assoc J. 2011;183(6):696.CrossRef
94.
go back to reference Fisher LD, Dixon DO, Herson J, Frankowski RF, Hearron MS, Peace KE. Intention-to-treat in clinical trials. In: Peace KE, editor. Statistical issues in drug research and development. New York: Marcel Dekker; 1990. p. 331–50. Fisher LD, Dixon DO, Herson J, Frankowski RF, Hearron MS, Peace KE. Intention-to-treat in clinical trials. In: Peace KE, editor. Statistical issues in drug research and development. New York: Marcel Dekker; 1990. p. 331–50.
95.
go back to reference Field AP. Discovering statistics using SPSS. 3rd ed. SAGE: Los Angeles; 2009. Field AP. Discovering statistics using SPSS. 3rd ed. SAGE: Los Angeles; 2009.
96.
go back to reference Howell DC. Statistical methods for psychology. Duxbury Thomson Learning: Pacific Grove; 2009. Howell DC. Statistical methods for psychology. Duxbury Thomson Learning: Pacific Grove; 2009.
97.
go back to reference Coe R. It’s the effect size, stupid. What effect size is and why it is important. Unversity of Exeter: Exeter; 2002. Coe R. It’s the effect size, stupid. What effect size is and why it is important. Unversity of Exeter: Exeter; 2002.
Metadata
Title
Comparing systemic therapy and cognitive behavioral therapy for social anxiety disorders: study protocol for a randomized controlled pilot trial
Authors
Christina Hunger
Rebecca Hilzinger
Theresa Koch
Johannes Mander
Anja Sander
Hinrich Bents
Jochen Schweitzer
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Trials / Issue 1/2016
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-016-1252-1

Other articles of this Issue 1/2016

Trials 1/2016 Go to the issue