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AnxietyUPHWNCT04392856

Transdiagnostic Treatment of Emotional Disorders for Women in a Homeless Situation

A study testing Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) and Same than experimental condition (UP), after it finishes in people with Anxiety and Depression, run by Universidad Complutense de Madrid at 1 site in Spain.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The aim of this study is to assess the effectiveness and feasibility of an adaptation of the Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders to women living homeless in Madrid, Spain. To address this goal, both clinical and psychosocial outcomes will be measured. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Anxiety, Depression
What is being tested?
Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) and Same than experimental condition (UP), after it finishes
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
1 siteSpain
Study dates
Jan 2017to Jun 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Being a woman.
  • Being aged over 18 years old.
  • Providing written, informed consent.
  • The participant is fluent in the language in which the treatment and evaluation are performed (i.e. Spanish).
  • Being able to attend to the evaluation and treatment sessions
  • Having access to the shelters where the intervention will be carried out.

Who cannot join

  • Being diagnosed with a severe mental disorder in active phase (i.e. schizophrenia, bipolar disorder or an organic mental disorder).
  • Being diagnosed a severe cognitive deterioration.
  • Being under alcohol or substance effects when the pre-assessment is carried out.

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Faculty of Psychology. Complutense University of Madrid

    Madrid, 28223

Other trials in Spain

About this study

The aim of this study is to assess the effectiveness and feasibility of an adaptation of the Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders to women living homeless in Madrid, Spain. To address this goal, both clinical and psychosocial outcomes will be measured. The application of the UP is postulated as an effective tool for improving mental health and well-being of women in a homeless situation, which in turn will enhance their social inclusion process.

Read the detailed description

The European Strategy for the Homeless People states that homelessness is the most extreme form of poverty and exclusion, which violates human dignity and poses a risk to health and life. Women constitute a particularly vulnerable subgroup among homeless people. Women living homeless show significant deterioration in their psychological welfare and mental health, which, among other aspects, is an obstacle in the access to care resources and inclusion processes.

There is a growing interest in the effectiveness and efficiency of intervention techniques to address mental health problems. The high comorbidity between mental health disorders, and especially emotional disorders, has promoted the development and consolidation of a transdiagnostic perspective. This perspective raises the existence of common mechanisms involved in the maintenance of different disorders, so that there would be a preamble to cognitive and/or behavioral processes shared by various psychological disorders. The design of a transdiagnostic treatment strategy allows a more inclusive approach to mental health and facilitates the design of similar treatment programs applicable to a wide range of mental disorders. Therefore, the transdiagnostic treatment could be a feasible and effective alternative to address some of the most common problems in mental health among women in a homeless situation. This approach could be useful to improve a diversity of symptoms in the own context of homeless living women and facilitate a systematic evaluation of its effectiveness.

The overall objective of this project is the development of a feasible and effective intervention adapted to the needs of women in a homeless situation and the service resources where they are attended. Moreover, the project aims to compare the group versus individual delivery of the UP among women in a homeless situation. This research is based on the hypothesis that the UP adaptation, both in group and individual delivery, will be effective in reducing anxiety and depression symptoms, decreasing negative affect and increasing psychological well-being, health state, positive affect, social support and quality of life. Strengths but also barriers and difficulties encountered in each format of intervention will be examined. This knowledge will be key to develop specific and adapted materials that enable effective interventions practices in the services resources for homeless people.

The UP intervention will consist of 12 weekly sessions lasting an hour and a half, applied in different centers for homeless people in Madrid. There will be several assessment moments: before the intervention, twelve intersession assessments (i.e., one per session), after the intervention, and 3 months, 6 months and 9 months follow-ups. The psychological intervention will be carried out by therapists with a background in psychology.

With this research it is expected to achieve results with impact at the technical level (in the design of effective interventions for psychological treatment of women in a homeless situation), on a scientific level (expanding knowledge about the effectiveness of intervention programs for women in social exclusion situations), and, especially, at the social level (affecting the quality of life and the processes of social inclusion of women in a homeless situation).

Conditions
Anxiety, Depression
Being tested
Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), Same than experimental condition (UP), after it finishes
Keywords
Unified Protocol, Transdiagnostic approach, Homelessness
Medical subject headings
Anxiety Disorders, Depression

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP)Behavioural

    The Spanish Version of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders for Homeless Women. The protocol contains five modules: (1) mindful emotion awareness, (2) cognitive flexibility, (3) countering emotional behaviors, (4) recognizing and confronting physical sensations, and (5) emotion exposures. This adaptation of Unified Protocol is organized in twelve sessions: Emotional disorders and emotional regulation; Motivation for change; Understanding the role of emotions; Mindful emotion awareness, Cognitive flexibility, Understanding and confronting physical sensations, Countering emotional behaviors, Emotional avoidance, Emotion exposure; Achievement recognition and look to the future; and Relapse prevention and closure.

  • Same than experimental condition (UP), after it finishesBehavioural

    The Spanish Version of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders for Homeless Women. The protocol contains five modules: (1) mindful emotion awareness, (2) cognitive flexibility, (3) countering emotional behaviors, (4) recognizing and confronting physical sensations, and (5) emotion exposures. This adaptation of Unified Protocol is organized in twelve sessions: Emotional disorders and emotional regulation; Motivation for change; Understanding the role of emotions; Mindful emotion awareness, Cognitive flexibility, Understanding and confronting physical sensations, Countering emotional behaviors, Emotional avoidance, Emotion exposure; Achievement recognition and look to the future; and Relapse prevention and closure.

Study groups in NCT04392856
Study groupRoleWhat they receive
Unified Protocol Transdiagnostic Treatment Emotional DisordersExperimentalAn adaptation of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to women in a homeless situation will be implemented in public shelters setting in Madrid, Spain. The UP adaptation is an intervention based protocol for emotional disorders, consisted of 12 treatment sessions of one and a half hours of duration each, at a rate of one per week.
Receives: Behavioral: Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP)
Waitlist Control conditionOtherThe participants assigned to the waitlist control condition will not immediately receive the intervention. They will wait for 3 months, which is the duration of the intervention in the experimental group. After that time, they will be offered the same psychological treatment as those assigned to the UP (experimental condition).
Receives: Behavioral: Same than experimental condition (UP), after it finishes

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in the Beck Depression Inventory (BDI-II) (Beck, Steer, & Brown, 1990); Spanish adaptation (Sanz, Navarro, & Vázquez, 2003) at pre, post intervention and at 3, 6 and 9 month follow-ups.

    The BDI-II is a 21-item self-report measure designed to assess depression severity. Each item is rated from 0 to 3 with a total score of a maximum of 63 points. The Spanish version has shown good internal consistency (α = 0.86).

    Measured: Up to 9 months

  2. Change in the Beck Anxiety Inventory (BAI) (Beck, & Steer, 1993); Spanish adaptation (Magán, Sanz, & García-Vera, 2008) at pre, post intervention and at 3, 6 and 9 month follow-ups.

    The BAI is a 21-item self-report measure designed to assess anxiety severity. Each item has a 4-point severity scale (e.g., not at all, mildly, moderately, and severely), addressing symptoms experienced during the past week. The internal consistency of the Spanish version has been found to range from .85 to .94.

    Measured: Up to 9 months

Secondary outcomes (7)
  1. Change in Positive and Negative Affect Schedule (PANAS) (Watson, Clarck, & Tellegen, 1988); Spanish adaptation (López-Gómez, Hervás, & Vázquez, 2015) at pre, post intervention and at 3, 6 and 9 month follow-ups

    The PANAS is a 20-item self-report measure designed to assess negative and positive affect in the last week. Each item has a 5-point severity scale (e.g., not at all, mildly, moderately, quite a lot, and severely) with a total score from 20 to 100. The internal consistency of the Spanish version was .92 for positive affect subscale and .88 for negative affect subscale.

    Measured: Up to 9 months

  2. Change in the Pemberton Happiness Index (PHI) (Hervás & Vázquez, 2013) at pre, post intervention and at 3, 6 and 9 month follow-ups

    The PHI is a 21-item measure designed to assess integrative well-being using a scale from 0 (fully disagree) to 10 (fully agree) in the first 11 items and dichotomy answers (yes/no) in the last 10 items. It includes two subscales: remember well-being (general, hedonic, eudaimonic, and social well-being) and experienced well-being. Cronbach´s alpha of Spanish version was .84.

    Measured: Up to 9 months

  3. Change in the Short-Form Health Survey Health Questionnaire (SF-12) (Ware, Kosinski, & Keller, 1996); Spanish adaptation (Vilagut et al., 2008) at pre, post intervention and at 3, 6 and 9 month follow-ups

    The SF-12 is a generic health status instrument with 12 items, and eight subscales (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional and mental health). These eight subscales can be combined into two scores for physical health (PH) and mental health (MH), and a total score, ranged from 0 to 100, where higher scores reflect better self-reported health. The internal consistency of the Spanish version was α = .85 for PH and α = .78 for MH.

    Measured: Up to 9 months

  4. Change in the Social Support Questionnaire (SSQ) (Sarason, Sarason, Shearin, & Pierce, 1987); Spanish adaptation (Martínez-López et al., 2014) at pre, post intervention and at 3, 6 and 9 month follow-ups.

    The SSQ is a 6 items measure of social support. It includes two scales: number and satisfaction with social support (on a scale ranging from 1 to 9). The Spanish version has shown good internal consistency for both dimensions (α = 0.90 and α = 0.93, respectively).

    Measured: Up to 9 months

  5. Change in the Satisfaction with Life Domain Scale (SLDS) (Baker e Intagliatta, 1982); Spanish version by Muñoz, Panadero, & Rodríguez (2010) at pre, post intervention and at 3, 6 and 9 month follow-ups.

    This questionnaire was adapted for use in rehabilitation centers for people with mental disorders by Muñoz et al. (2010). It is a 18-item self-report measure that was designed for assessing their actual satisfaction in various aspects of the life. An 8-point visual analog scale with faces is used.

    Measured: Up to 9 months

  6. Overall Depression Severity and Impairment Scale (ODSIS) (Bentley, Gallagher, Carl, Barlow, 2014); Spanish version (Mira et al., 2019) at intersession assessment

    The ODSIS is a 5-item self-report measure that was designed for assessing the frequency and intensity of depression symptoms, the functional impairment related to these depressive symptoms, as well as behavioral avoidance across emotional disorders over the past week. Response items are coded from 0 to 4 and can be summed to obtain a total score ranging from 0 to 20. The internal consistency of the Spanish version was between .91 and .94.

    Measured: Up to 3 months

  7. Overall Anxiety Severity and Impairment Scale (OASIS) (Norman, Cissell, Means-Christensen, & Stein, 2006); Spanish version (González-Robles et al., 2018) at intersession assessment

    The OASIS is a self-report questionnaire designed to evaluate the severity and functional impairment associated with anxiety. The scale presents five items with a 5-point likert scale ranging from 0 (I didn't feel anxious) to 4 (Constant anxiety). The total scale score, which ranges from 0 to 20, is obtained by summing all items. Cronbach's alpha of the Spanish version was 0.86.

    Measured: Up to 3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 May 2020
  2. Study startJan 2017
  3. Primary completionJun 2021
  4. Study completionJun 2021

Why it stopped: COVID-19 Pandemic

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
All women in a homeless situation attending any of the collaborating shelters will be asked to participate in the present study. Once inclusion criteria are met, each participant will be assigned to experimental condition or control condition. This research is composed by two sequential studies. The first study will deliver the UP in a group format, while the second study will deliver the UP on a one-to-one basis. Since these studies will not be performed concurrently, women will be assigned within each study to intervention or control condition. In the first study, participants will be assigned to one of two conditions: experimental condition (Unified Protocol, UP in group delivery) or waitlist control condition (WLC). In the second study, participants will be assigned to one of two conditions: experimental condition (Unified Protocol, UP in individual delivery) or control condition (WLC).
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04392856
Sponsor's protocol ID
FEM2016-75317-R
Acronym
UPHW
Status last verified
May 2020
First submitted
13 May 2020
Last updated
29 Oct 2021
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Marin C, Guillen AI, Rodriguez-Moreno S, Dieguez S, Panadero S, Farchione T. Application of the unified protocol for transdiagnostic treatment of emotional disorders among homeless women: A feasibility study. Psychotherapy (Chic). 2021 Jun;58(2):242-247. doi: 10.1037/pst0000357. Epub 2021 Feb 4.

    PubMed 33539144

Questions about this trial

What is this clinical trial studying?

A study testing Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) and Same than experimental condition (UP), after it finishes in people with Anxiety and Depression, run by Universidad Complutense de Madrid at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 29 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: COVID-19 Pandemic). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in the Beck Depression Inventory (BDI-II) (Beck, Steer, & Brown, 1990); Spanish adaptation (Sanz, Navarro, & Vázquez, 2003) at pre, post intervention and at 3, 6 and 9 month follow-ups. (time frame: Up to 9 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04392856, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Oct 2021.

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