Cole, Charles Lewis;
(2021)
Do symptom change trajectories differ between Cognitive Behavioural Therapy (CBT) and Counselling? An application of growth curve modelling using a large IAPT dataset.
Doctoral thesis (D.Clin.Psy), UCL (University College London).
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Abstract
Background: Psychological interventions are often effective in reducing symptoms of common mental disorders (CMD). However, there are notable within- and between-person differences in how symptoms change over time. To investigate such differences, some studies have used growth curve modelling (GCM) to identify different trajectory classes, allowing for the earlier recognition of distinct patient outcomes through routine outcome monitoring (ROM). These are often associated with various patient characteristics, informing the likelihood of a patient’s trajectory during the early phases of treatment, but less is known about how these differ between specific treatments. Aims: The study aimed to investigate whether the trajectory classes identified differed between individuals receiving Cognitive Behavioural Therapy (CBT) and Counselling, using data from the Improving Access to Psychological Therapies (IAPT) programme. Method: The current study employed growth mixture modelling (GMM) to identify trajectory classes of depression and anxiety symptoms among a propensity-score matched sample (N = 10268) to control for pre-treatment confounding factors. Multinomial regression models were fitted to determine the associations between the classes and the two intervention types. Results: Four classes were identified for both depression and anxiety symptom change: (1) Rapid Responders (2) Delayed Responders (3) Low Severity Small Improvers and (4) Non-responders. Participants who received Counselling were less likely to be Rapid Responders according to change in their depression symptoms and less likely to be Delayed Responders with regards to anxiety symptoms. Conclusions: Through recognition of these classes during the delivery of CBT or Counselling, clinicians may be better placed to make treatment decisions that optimise patient outcomes.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | D.Clin.Psy |
| Title: | Do symptom change trajectories differ between Cognitive Behavioural Therapy (CBT) and Counselling? An application of growth curve modelling using a large IAPT dataset |
| Event: | University College London |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10134458 |
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