Elements of relapse prevention in outpatient therapy for depression

Project management: Katja Machmutow, MSc; Prof. Dr. Birgit Watzke; in cooperation with Prof. Dr. Martin grosse Holtforth (University of Berne)

Title and abstract:

Relapse prevention elements in acute treatment for depression – measuring quantity, quality and associations with outcome

Psychotherapeutic treatments are effective in reducing depression. However, research shows that a large proportion of patients relapses within two years after terminating psychotherapy. Among the  factors that increase the risk of relapse are frequency and severity of previous depressive episodes but also treatment-related factors such as a suboptimal relapse prevention to guide the patient’s transition from acute therapy to post-treatment everyday life (without therapeutic support). Up to now, few research has focused on the elements of relapse prevention applied by therapists in acute therapy, and standardized methods and reliable instruments assessing these elements are lacking.

The current project aims to investigate relapse preventive elements applied by therapists in acute therapy for depression, more specifically, to discover how therapists prepare patients for the time following the termination of treatment. Moreover, this study explores how these elements are associated with depressive symptoms at follow-up in order to determine the long-term preventive impact of specific techniques. The study uses data from a project conducted previously at Zurich University by Prof. Dr. Martin grosse Holtforth (University of Berne) that compared the effectiveness of cognitive behavioral therapy versus emotion-focused therapy for depression. Video-tapes from this study will be analyzed to develop a coding system that can be used to map quantity and quality of relapse prevention elements in individual therapy sessions. Based on codings of the last two sessions of each individual therapy we will investigate potential associations of these elements with symptom severity at follow-up.

This project intends to 1) develop an instrument for the measurement of specific elements of relapse prevention applied by therapists in outpatient psychotherapy of depression, and 2) explore potential effects of these elements with long-term symptom outcome. In the long run, the identification of valid and meaningful elements of relapse prevention that guide the patients’ transitions from acute therapy to their everyday life will help to maintain outcomes of acute therapy, and as a result, decrease the likelihood of experiencing relapse.

Project start: summer 2014

Expected end of project: fall/winter 2016