Self EsteemNCT06101810
The Efficacy of Treatments to Improve Self-esteem
A study testing COMET and CBT in people with Self Esteem, run by GGZ Noord-Holland-Noord at 1 site in Netherlands.
Trial summary
The goal of this study is to examine the effectivity of two self-esteem interventions (COMET (Korrelboom) and CBT (De Neef)) in a general psychiatric population. The main questions it aims to answer are: is there a difference between the two interventions in effectiveness on increasing self-esteem? is there a… Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Self Esteem
- What is being tested?
- COMET and CBT
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 70 participants
- Where
- 1 siteNetherlands
- Study dates
- 1 Nov 2023to 1 Aug 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- A self-perceived low self-esteem established by both patient and caregiver by means of (consent to) referral for self-esteem treatment.
Who cannot join
- severe suicidality for which hospitalization or other forms of crisis care is necessary,
- acute psychosis,
- current manic episode,
- current alcohol or drug abuse,
- insufficient knowledge of the Dutch language,
- illiteracy
- being unable to identify at least one positive aspect of oneself, which does not need to be felt as convincing for the participant. The latter is an excluding criterium formulated by the COMET protocol.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Netherlands1 site, 1 recruiting
- Recruiting
Stichting GGZ Noord-Holland-Noord
Heerhugowaard, North Holland, 1703WC
Ellen de Jonge, e.dejonge@ggz-nhn.nl
About this study
Official title: Self-esteem in a General Psychiatric Population: Comparing Competitive Memory Training (COMET) and Cognitive Behavioral Therapy (CBT)
The goal of this study is to examine the effectivity of two self-esteem interventions (COMET (Korrelboom) and CBT (De Neef)) in a general psychiatric population.
The main questions it aims to answer are:
Read more
- is there a difference between the two interventions in effectiveness on increasing self-esteem?
- is there a difference between the two interventions in effect on levels of anxiety, depression and general mental health?
- are found effects on levels of anxiety, depression and general mental health associated with changes in self-esteem?
- is the ability to use imagination a moderator for outcomes in both conditions?
Participants are randomised over both conditions. At baseline (T0), end of treatment (T1) and follow-up at 6 months (T2) several outcome measures are conducted, such as RSES, DASS and MHC-SF.
Read the detailed description
In this study, the investigators will examine the effectivity of self-esteem interventions.
To achieve this goal, the primary aim of this study is to examine if there is a difference in effectiveness between two interventions that have shown to be effective in ameliorating levels of low self-esteem in previous studies (ie. COMET (Korrelboom) and CBT (De Neef)).
Secondly, the investigators would like to find out if self-esteem interventions have an effect on levels of depression, anxiety and general mental health. This would give us a better understanding of the role of self-esteem as a trans-diagnostic factor.
The final aim of this study is to find out if some patients might profit more from one intervention over the other. One of the main differences between both interventions is that COMET heavily relies on imagination techniques and CBT does not. It could be possible that the extend to which patients are able to profit from an intervention which relies on imagination, depends on the ability or vividness in which they are able to use imagery. In this study the investigators will investigate if the ability to use mental imagery has an effect on treatment effects.
Design - In this study, research questions will be answered using a randomized clinical trial. After inclusion, patients are randomly assigned to one of the two conditions: 9 weeks of COMET + (ongoing) TAU versus 9 weeks of CBT + (ongoing) TAU. After baseline assessment participants will be randomized.
Population - All participants are adult (aged 18-65) outpatients of the regional community mental health teams of GGZ Noord-Holland Noord, a large secondary mental health care centre in the Netherlands with several locations. These teams treat patients with serious and complex psychiatric problems with any DSM-5 diagnosis (except those with a primary diagnosis of drug or alcohol related disorders and those with severe learning disabilities).
Including criterium is a self-perceived low self-esteem established by both patient and caregiver by means of (consent to) referral for self-esteem treatment.
- Conditions
- Self Esteem
- Being tested
- COMET, CBT
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
COMETBehavioural
information already included in arm/group descriptions.
CBTBehavioural
information already included in arm/group descriptions.
| Study group | Role | What they receive |
|---|---|---|
| COMET (Korrelboom) | Experimental | Korrelbooms' Competitive Memory Training (2011) (abbreviated COMET) is a cognitive behavioral therapy based on counter-conditioning. It uses positive self-verbalizations, imagination, posture and facial expression and music in a protocolized intervention consisting of 8 weekly group sessions of 90 minutes. For this study the protocol is extended with 1 session, to 9 sessions, in concertation with the author. Receives: Behavioral: COMET |
| CBT (De Neef) | Experimental | The cognitive behavioural protocol by De Neef (2010; 2018) has not been specifically named but is commonly referred to as 'the whitebook method' or 'cognitive behavioral therapy' (CBT). For convenience, this intervention will be addressed to as CBT in the current study.
This intervention relies heavily on positive data logging to specifically focus on evidence that is contradictory to the negative core belief. Patients keep a positive data log (the 'whitebook') to write down positive events and positive qualities of themselves to achieve cognitive bias modification. They also receive psycho-education and practice on alternative behavior such as receiving compliments (which is also regarded as exposure), lowering perfectionist behavior and receiving criticism. In this protocolized intervention patients receive 9 to 11 weekly group sessions of 90 minutes. for this study a version of the protocol with 9 sessions is used. Receives: Behavioral: CBT |
What is being measured
The primary outcome is the main question the study is designed to answer.
Rosenberg self-esteem scale (RSES)
Rosenberg self-esteem scale assesses global selfesteem on a 10-item questionnaire, items to be answered on a 4-point Likert scale ranging from 0 (strongly agree) to 3 (strongly disagree). Total scores range from 0 up to 30, with higher scores indicating a higher global self-esteem.
Measured: Baseline (T0), end of treatment (T1)(one week after the last intervention session), follow-up (T2 at 6 months)
Secondary outcomes (3)
Depression Anxiety Stress Scale (DASS)
Depression Anxiety Stress Scale is a 42-item questionnaire with items rated on a 4-point Likert scale, ranging from 0 (never) to 3 (definitely or most of the time). The DASS consists of three subscales of 14 items: Depression, Anxiety and Stress. Total scores on the subscales range from 0 up to 42, with higher scores indicating a higher levels of distress.
Measured: Baseline (T0), end of treatment (T1)(one week after the last intervention session), follow-up (T2 at 6 months)
Mental Health Continuum - Short Form (MHC-SF)
Mental Health Continuum - Short Form is a 14 item questionnaire with items to be rated on a 6-point Likert scale, ranging from 0 (never) to 5 (every day). Higher scores mean a better outcome. Total score intends to measure positive mental health as a distinct indicator of mental well-being. Three subscales are Emotional well-being (presence of positive feelings), Psychological well-being (positive functioning in individual life) and Social well-being (positive functioning in community life).
Higher scores indicate more well-being.
Measured: Baseline (T0), end of treatment (T1)(one week after the last intervention session), follow-up (T2 at 6 months)
Plymouth Sensory Imagery Questionnaire (PsiQ-NL-35)
Plymouth Sensory Imagery Questionnaire is a 35 item questionnaire. It assesses mental imagery vividness on 5 items for 7 modalities (i.e., vision, sound, smell, taste, touch, bodily sensation and emotion). Each of the 7 modalities have a heading such as 'imagine the smell of…', followed by 5 items such as 'a rose' or 'burning wood'. Items are to be rated on a 11-point scale (0-10), ranging from 0 (no image at all) to 10 (as vivid as real life).
Measured: Baseline (T0)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Oct 2023
- Study start1 Nov 2023
- Primary completion1 Aug 2026 (estimated)
- Study completion1 Aug 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Self EsteemStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 70 participants (estimated)
Sponsor and investigators
- Lead sponsor
- GGZ Noord-Holland-Noord
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Eva Velthorst, PhD, Principal investigator, GGZ-NHN
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06101810
- Sponsor's protocol ID
- GGZNHN23EJ
- Status last verified
- Jan 2026
- First submitted
- 14 Aug 2023
- Last updated
- 29 Jan 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 29 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Self-esteem in a General Psychiatric Population: Comparing Competitive Memory Training (COMET) and Cognitive Behavioral Therapy (CBT)
- ClinicalTrials.gov ID
- NCT06101810
- Acronym / sponsor ID
- GGZNHN23EJ
- Conditions
- Self Esteem
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 70 participants (estimated)
- Lead sponsor
- GGZ Noord-Holland-NoordUniversity, hospital or other
- Study start
- 1 Nov 2023 (actual)
- Primary completion
- 1 Aug 2026 (estimated)
- Study completion
- 1 Aug 2026 (estimated)
- First posted
- 26 Oct 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this study is to examine the effectivity of two self-esteem interventions (COMET (Korrelboom) and CBT (De Neef)) in a general psychiatric population.
The main questions it aims to answer are:
- is there a difference between the two interventions in effectiveness on increasing self-esteem?
- is there a difference between the two interventions in effect on levels of anxiety, depression and general mental health?
- are found effects on levels of anxiety, depression and general mental health associated with changes in self-esteem?
- is the ability to use imagination a moderator for outcomes in both conditions?
Participants are randomised over both conditions. At baseline (T0), end of treatment (T1) and follow-up at 6 months (T2) several outcome measures are conducted, such as RSES, DASS and MHC-SF.
Detailed description
In this study, the investigators will examine the effectivity of self-esteem interventions.
To achieve this goal, the primary aim of this study is to examine if there is a difference in effectiveness between two interventions that have shown to be effective in ameliorating levels of low self-esteem in previous studies (ie. COMET (Korrelboom) and CBT (De Neef)).
Secondly, the investigators would like to find out if self-esteem interventions have an effect on levels of depression, anxiety and general mental health. This would give us a better understanding of the role of self-esteem as a trans-diagnostic factor.
The final aim of this study is to find out if some patients might profit more from one intervention over the other. One of the main differences between both interventions is that COMET heavily relies on imagination techniques and CBT does not. It could be possible that the extend to which patients are able to profit from an intervention which relies on imagination, depends on the ability or vividness in which they are able to use imagery. In this study the investigators will investigate if the ability to use mental imagery has an effect on treatment effects.
Design - In this study, research questions will be answered using a randomized clinical trial. After inclusion, patients are randomly assigned to one of the two conditions: 9 weeks of COMET + (ongoing) TAU versus 9 weeks of CBT + (ongoing) TAU. After baseline assessment participants will be randomized.
Population - All participants are adult (aged 18-65) outpatients of the regional community mental health teams of GGZ Noord-Holland Noord, a large secondary mental health care centre in the Netherlands with several locations. These teams treat patients with serious and complex psychiatric problems with any DSM-5 diagnosis (except those with a primary diagnosis of drug or alcohol related disorders and those with severe learning disabilities).
Including criterium is a self-perceived low self-esteem established by both patient and caregiver by means of (consent to) referral for self-esteem treatment.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| COMET (Korrelboom) | Experimental | Behavioral: COMETKorrelbooms' Competitive Memory Training (2011) (abbreviated COMET) is a cognitive behavioral therapy based on counter-conditioning. It uses positive self-verbalizations, imagination, posture and facial expression and music in a protocolized intervention consisting of 8 weekly group sessions of 90 minutes. For this study the protocol is extended with 1 session, to 9 sessions, in concertation with the author. |
| CBT (De Neef) | Experimental | Behavioral: CBTThe cognitive behavioural protocol by De Neef (2010; 2018) has not been specifically named but is commonly referred to as 'the whitebook method' or 'cognitive behavioral therapy' (CBT). For convenience, this intervention will be addressed to as CBT in the current study. This intervention relies heavily on positive data logging to specifically focus on evidence that is contradictory to the negative core belief. Patients keep a positive data log (the 'whitebook') to write down positive events and positive qualities of themselves to achieve cognitive bias modification. They also receive psycho-education and practice on alternative behavior such as receiving compliments (which is also regarded as exposure), lowering perfectionist behavior and receiving criticism. In this protocolized intervention patients receive 9 to 11 weekly group sessions of 90 minutes. for this study a version of the protocol with 9 sessions is used. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- A self-perceived low self-esteem established by both patient and caregiver by means of (consent to) referral for self-esteem treatment.
Key exclusion criteria (7 listed)
- severe suicidality for which hospitalization or other forms of crisis care is necessary,
- acute psychosis,
- current manic episode,
- current alcohol or drug abuse,
- insufficient knowledge of the Dutch language,
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| COMETinformation already included in arm/group descriptions. | Behavioural | COMET (Korrelboom) |
| CBTinformation already included in arm/group descriptions. | Behavioural | CBT (De Neef) |
Primary outcome
Rosenberg self-esteem scale (RSES)
Time frame: Baseline (T0), end of treatment (T1)(one week after the last intervention session), follow-up (T2 at 6 months)
Rosenberg self-esteem scale assesses global selfesteem on a 10-item questionnaire, items to be answered on a 4-point Likert scale ranging from 0 (strongly agree) to 3 (strongly disagree). Total scores range from 0 up to 30, with higher scores indicating a higher global self-esteem.
3 secondary outcomes
Depression Anxiety Stress Scale (DASS)
Time frame: Baseline (T0), end of treatment (T1)(one week after the last intervention session), follow-up (T2 at 6 months)
Mental Health Continuum - Short Form (MHC-SF)
Time frame: Baseline (T0), end of treatment (T1)(one week after the last intervention session), follow-up (T2 at 6 months)
Plymouth Sensory Imagery Questionnaire (PsiQ-NL-35)
Time frame: Baseline (T0)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jan 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Eva Velthorst, PhD principal investigator
GGZ-NHN
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing COMET and CBT in people with Self Esteem, run by GGZ Noord-Holland-Noord at 1 site in Netherlands.
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 1 inclusion and 7 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: looking for participants now, as of the sponsor's last update on 29 Jan 2026. 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 Netherlands. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Ellen de Jonge, MSc ((0031) 06 12526264, e.dejonge@ggz-nhn.nl), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Rosenberg self-esteem scale (RSES) (time frame: Baseline (T0), end of treatment (T1)(one week after the last intervention session), follow-up (T2 at 6 months)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 Jan 2026.