Results of a randomized controlled superiority trial of the effect of modified collaborative assessment vs. standard assessment on patients’ readiness for psychotherapy (CO-ASSM-RCT)

Abstract

Abstract Background Avoidant personality disorder (AvPD) and social phobia (SP) are associated with high personal and societal costs. While psychotherapy can be efficient, many patients drop out during treatment. Little is known about what can be done to increase a patient’s readiness for psychotherapy. However, research highlights the fields of collaborative and therapeutic assessment as a possible means to enhance readiness for psychotherapy. Methods We conducted a randomized controlled feasibility and superiority trial on patients with SP or AvPD who were to initiate psychotherapeutic treatment in outpatient mental health services. Patients were randomized 1:1 to either assessment as usual or modified collaborative assessment (MCA), provided as a pre-treatment intervention before psychotherapy initiation. MCA included the collaborative administration of a battery of psychological tests designed to assess the patient’s psychopathology more systematically. The tests were administered in collaboration with the patient, and detailed oral and written feedback was provided. We investigated the feasibility of the MCA intervention regarding acceptability, patient satisfaction, and adherence. We also investigated MCA’s effect on readiness for psychotherapy, as assessed with the University of Rhode Island Change Assessment Scale (URICA), and outcomes relating to symptomatology and dropout rates. Results All three prespecified feasibility outcomes were met. At the end of treatment, no significant difference was observed in any other outcome, except client satisfaction, which favored MCA (− 7.42 (95% CI − 11.75; − 3.09; p = 0.002)). Discussion We found that MCA was feasible, and patients were highly satisfied with the intervention. It is relevant to investigate another implementation of MCA. Trial registration ClinicalTrials.gov NCT05018312. Registered on August 24, 2021.

Keywords

• Assessment
• Personality disorders
• Social phobia
• Psychotherapy
• Evasiveness
• Collaborative assessment