Main findings
IUT, depressive symptoms
RECRUITMENT, RECRUITMENT, SECONDARY
The primary aim of the present pilot study was to investigate the feasibility of a future RCT designed to compare the effectiveness of IUT and MCT in primary health care patients with GAD. There were several uncertainties about feasibility because, to the best of our knowledge, neither treatment had previously been evaluated in a primary health care setting. These included participant recruitment and retention, willingness to receive psychological treatment, and therapists’ competence in and adherence to treatment protocols. The results showed that patients with GAD were willing to participate. Recruitment was good, and the dropout rate was low. Participants reported that they were satisfied with taking part in the study and with the treatment they received. They believed to some extent that their symptoms had predominantly psychological causes, which suggests that it is feasible to provide psychological treatment to these patients in primary health care. Following brief training in the protocols, therapists in both groups showed some competence in the treatment they delivered. MCT therapists’ adherence was rated significantly lower than that of IUT therapists.The secondary aim of the present pilot study was to conduct a preliminary evaluation of the effects of the two treatments. Both IUT and MCT significantly reduced worry from pre-treatment to post-treatment, and the effect sizes were large. Similarly, depressive symptoms decreased significantly in both treatment groups; effect sizes were moderate for IUT and large for MCT. However, functional impairment declined significantly only in the MCT group. Similarly, quality of life increased significantly from pre-treatment to post-treatment in the MCT group only. From post-treatment to the 6-month follow-up, effects on outcome measures were maintained. MCT was the superior treatment for all outcomes from pre-treatment to post-treatment, and the between-group effect sizes were large, except for quality of life, which did not differ between treatment groups. From post-treatment to follow-up, the only significant difference between groups was in functional impairment, which improved in the IUT group. At post-treatment and follow-up, more MCT than IUT participants had a reliable reduction in worry and had recovered from worry. Moreover, not only was MCT the more effective treatment, but on average, it was two sessions shorter than IUT. If the RCT replicates these findings, it would mean that MCT is more effective than IUT and can be delivered in a shorter course of therapy, which would make it useful in primary health care.