Treatment and Therapists

Question 1

therapist: what do you need to think about

Answer 1

1. in which setting is the treatment delivered? (e.g., in treatment center, you have to work with the therapists there)
2. therapists requirements and training (which therapists can I use for my trial?)
3. delivering treatment in one or both arms

Question 2

therapists requirements and training (which therapists can I use for my trial?)

Answer 2

• do you allow all therapists or do you have requirements?:
  1. what background?
  2. experience?
  3. additional training necessary? how much? what?
  4. supervision?
  5. how do you motivate therapists to participate?

Question 3

delivering treatment in one or both arms

Answer 3

advantages both arms:
- you need less therapists
- no influence of therapist on your results
disadvantages both arms:
- level of expertise may differ within one therapist
- more therapists needed
- danger of contamination: if 1 therapist delivers both, the therapist may use a mix of both treatments

Question 4

therapist: be aware

Answer 4

• high turnover of therapists

- expect to recruit and train therapists multiple times

Question 5

therapy: you need to

Answer 5

1. define your therapy

2. make a plan to ensure that treatments will be delivered according to plan

Question 6

define your therapy

Answer 6

1. use an existing protocol (to which you can refer)
2. adapt an existing protocol
3. create your own protocol

Question 7

elements of the protocol

Answer 7

1. supposed working mechanisms/ aim of the treatment
2. setting: individual/ group/ internet/ blended …
3. number of sessions, and duration of each session
4. frequency of the session
5. goal of each session and what therapist should do & what homework
   if CAU: you have to describe what CAU usually is

Question 8

make a plan to ensure that treatments will be delivered according to plan

Answer 8

1. train therapists to reduce variability
2. define a standard to evaluate treatment integrity
3. assess treatment integrity
   e. g., video-taping, short checklist filled out by therapist

Question 9

why important to be so detailed?

Answer 9

• makes study replicable

- enhance implementation (what do we need to implement?)

Question 10

therapists: be aware

Answer 10

often practical problems with delivering treatment, if this fails, trial fails;

• hard for therapists to do something different than normal
• not enough time for training and supervision
• therapists leaving and new ones coming in