Mental Health Clinical Trial
Official title:
Optimizing Outcomes of Dynamic Psychotherapy by the MATRIX: A Preliminary Study
Mental disorders require therapeutic effort that contains drug components and psychotherapeutic intervention. The latter requires many resources in light of the skill required. Moreover, such intervention is long, and it takes a long time to assess its effectiveness. The proposed study seeks to implement a management system (ie, a system that monitors and intervenes in ineffective and even harmful treatments) for the purpose of optimizing psychotherapies. The system monitors the improvement in patients' condition in treatment using a mobile phone-based system, and when the treatment is ineffective, it recommends correction strategies. The study will help reduce the ineffective or harmful treatment in dynamic psychotherapy, increasing the quality of care the patient receives. And will lead to the optimal utilization of resources in the mental health system.
The purpose of the proposed study is to examine, on a preliminary basis, the feasibility of a
monitoring and intervention system that will enable the identification and even improvement
of ineffective (and even harmful) hours of therapy in dynamic psychotherapy.
The study will take place in the clinic complex located at the Shalvata Mental Health Center
campus (Shalva clinic, departmental follow-up clinics, day department), and will include 10
therapists (psychiatrists, psychologists, social workers) and 10 patients.The duration of the
study will be two months. Once the patient and the therapist have signed an informed consent
form, they will be integrated into a cellular-based routine outcome monitoring (ROM) that is
developed specifically for the present study. This system, which is completely separate from
the clinical systems of the Center, is operated after each session by the therapist. Its
activation sends an SMS to the patient and to the therapist, in which a referral to a
designated and secure site in which questionnaires are administered in order to measure the
patient's condition and the assessment of the therapist and the patient regarding the quality
of the therapeutic session. In addition, during the entire study period, the hours of
treatment will be recorded in a dedicated manual recording device. This is done routinely in
many research institutes in Israel and around the world, with the aim of approving the
analysis of inefficient or harmful treatment hours. Treatment hours based on ROM data that
have a negative effect (ie, evaluated negatively by the patient) will be transcribed by the
therapist, and will undergo full MATRIX analysis. In each treatment pair, an analysis of up
to two hours will be possible throughout the four months of the study. This analysis includes
the conversion of the text to MATRIX codes, 3-letter codes that mark the section speaker
(patient or therapist), the subject of the section (patient, therapist, or both) and its
character (whether it deals with the ability to experience [ , Or the relationship between
experiences [interrelation]). The coding will be performed by the principal investigator or
by the secondary investigator. After the encoding analysis, a MATRIX-based feedback will be
given by the Principal Investigator to the therapist, in which the recommendations of the
analysis will be submitted.
The proposed study combines routine conventional follow-up practices (ROM) in psychotherapy
with innovative analysis tools (MATRIX), and seeks to be a first and significant step in
addressing the urgent need to implement managed care in psychotherapy. This has far-reaching
implications for the management of mental health care in community, clinic, day care and
hospitalization units.
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