title: Transfer of manualized Short Term Psychodynamic Psychotherapy (STPP) for social anxiety disorder into clinical practice: results from a cluster-randomised controlled trial.
abstract: Despite growing evidence for manualized psychodynamic treatments, there is a lack of studies on their transfer to routine practice. This is the first study to examine the effects of an additional training in manualized Short Term Psychodynamic Psychotherapy (STPP) on the outcome in routine psychotherapy for social anxiety disorder (SAD). The study is an extension to a large RCT comparing STPP to Cognitive-Behavioral Therapy of SAD.
  
  
  
  The manualized treatment was designed for a time limited approach with 25 individual sessions of STPP over 6 months. Private practitioners were randomized to training in manualized STPP (mSTPP) vs. treatment as usual without a specific training (tauSTPP). A total of 109 patients were enrolled (105 started treatment; 75 completed at least 20 treatment sessions). Assessments were conducted pre-treatment, after 8 and 15 weeks, after 25 treatment sessions, at the end of treatment, 6 and 12 months after termination of treatment. Remission as primary outcome was defined by the Liebowitz-Social-Anxiety-Scale (LSAS) score ≤30. Secondary outcomes were response (at least 31% reduction in LSAS), treatment duration and number of sessions, changes in social anxiety (LSAS, SPAI), depression (BDI), clinical global impression (CGI), and quality of life (EQ-5D).
  
  
  
  Remission rates of mSTPP (9%) resp. tauSTPP (16%) and also response rates of 33% resp. 28% were comparable between the two treatment approaches as well as treatment duration and number of sessions. Most of the within-group differences (baseline to 25 sessions) indicated moderate to large improvements in both treatments; within-group differences from baseline to 12 months follow-up (LSAS, SPAI, BDI, CGI) were large ranging from d = -0.605 to d = -2.937. Benefits of mSTPP were limited to single outcomes.
  
  
  
  Findings are discussed with regard to implementation and dissemination of empirically validated treatments in psychodynamic training and practice. SAD patients with a high comorbidity of personality disorders and a long treatment history may need longer treatments.
  
  
  
  German Clinical Trials Register (DRKS) DRKS00000570 , registered 03. March 2011.
authors.affiliation: Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. joerg.wiltink@unimedizin-mainz.de.
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltink
authors.affiliation: Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Ruckes
authors.affiliation: Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hoyer
authors.affiliation: Department of Psychosomatics and Psychotherapy, University of Giessen, Giessen, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Leichsenring
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Joraschky
authors.affiliation: Department of Psychosomatics and Psychotherapy, University of Giessen, Giessen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Leweke
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Pöhlmann
authors.affiliation: Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Beutel
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003863:Depression / Q000628:therapy*; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072861:Phobia, Social / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D011614:Psychotherapy, Brief / Q000379:methods*; D064889:Psychotherapy, Psychodynamic / Q000379:methods*; D011788:Quality of Life; D012107:Research Design; D016896:Treatment Outcome
keywords: Cluster-randomised controlled trial; Manualized; Psychodynamic psychotherapy; Social anxiety; Transfer; Treatment