NaTel: Multicenter trial of telephone-administered relapse prevention

Project coordination: Prof. Dr. Birgit Watzke; Markus Wolf, PhD

Project management: Savion Hesse, Dipl.-Psych.

Depressive disorders often take a recurrent or chronic course and cause large and enduring individual suffering. Although many patients benefit from acute phase psychotherapy there remains a substantial risk for relapse or recurrence. Results for psychological continuation or aftercare interventions for relapse prevention are promising, however, research also suggests that there are obstacles concerning access and compliance if aftercare interventions are delivered face-to-face. More flexible and low-threshold interventions and the use of distance technology might have the potential to overcome some of these obstacles.

The aim of the NaTel Study is to investigate the effectiveness of a telephone-administered cognitive-behavioral continuation therapy (T-CT) for patients with chronic or recurrent depression following acute phase psychotherapy. T-CT comprises eight telephone contacts within a period of approximately six months. Primary focus of the intervention is to train relapse prevention strategies and to support the participants in transferring skills learned during acute phase CBT to daily life.

The effectiveness of the intervention will be tested in a two-parallel group, multisite, evaluator-blind, randomized controlled clinical trial in which approx. 220 patients with chronic or recurrent major depressive disorder who have responded to acute phase CBT will receive T-CT in addition to care-as-usual (CAU) versus CAU alone. The primary endpoint of the study is depressive relapse. Secondary outcomes include well-being, depressive and anxiety symptoms, health-related-quality of life and psychosocial functioning, as well as cost-effectiveness as well as relevant moderators and process variables.

The NaTel Study addresses an urgent problem of mental health care by focusing on the sustainability of outcomes in patients with depression who are at risk for relapse. Using distance technology T-CT offers advantages over traditional ways of delivering aftercare interventions. In case of positive results an effective and feasible low-threshold intervention for continuation treatment will be available which could facilitate the implementation and dissemination of aftercare services, and ultimately, improve treatment pathways of patients suffering from depression.

Project duration: 2017 - 2021

Funding: Swiss National Science Foundation (SNSF)

Project partners:

• Universität Zürich, Praxisstelle Psychotherapie
• Universitätsspital Zürich, Klinik für Psychiatrie und Psychotherapie
• Universität Bern, Universitätsklinik fur Psychiatrie und Psychotherapie
• Psychiatrische Dienste Aargau AG, Zentrum Psychiatrie und Psychotherapie stationär
• Klinik Meissenberg AG, Psychiatrische und Psychotherapeutische Spezialklinik für Frauen
• Privatklinik Meiringen, Zentrum für seelische Gesundheit
• Spitalverbund Appenzell Ausserrhoden, Psychiatrisches Zentrum AR, Klinik für Psychiatrie und Psychotherapie
• Triaplus AG, Klinik Zugersee, Zentrum für Psychiatrie und Psychotherapie
• Klinik Gais AG
• Klinikum Stuttgart, Krankenhaus Bad Cannstatt, Institut für Klinische Psychologie
• Universitätsspital Zürich, Zentrum für Klinische Forschung (Clinical Monitoring)
• Universitätsklinikum Hamburg-Eppendorf, Institut und Polyklinik für Medizinische Psychologie (Biometry)

Here you can find more information on participating in the study (PDF, 1 MB) (only available in German)