Emotional Awareness and Expression Therapy for Patients With Persistent Physical Symptoms in Routine Psychiatric Care: A Pilot Study

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorDaniel Maroti

About this trial

Emotional Awareness and Expression Therapy (EAET) has emerged as a promising approach for addressing persistent physical symptoms (PPS). Investigating EAET within the context of routine psychiatric care is crucial for several reasons:

Many patients with PPS experience significant distress and functional impairment, yet traditional medical treatments often fail to provide adequate relief. Integrating EAET into routine care could offer a valuable therapeutic option for this population.

Preliminary studies suggest that EAET can lead to significant reductions in pain and other somatic symptoms. Investigating its effectiveness in routine care settings could enhance treatment outcomes for patients who have not responded to conventional therapies.

There is often a disconnect between mental health and physical health treatment in routine care. Investigating EAET can help bridge this gap, fostering collaboration between mental health professionals and primary care providers to address the complexities of patients\' health issues.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

The participant certifies that they have undergone a medical assessment for their physical symptoms (see separate certificate).

The participant rates either moderate distress from physical symptoms on the PHQ-15 questionnaire (over 10 points) or significant distress from a single physical symptom (at least 2 points for that symptom).

The participant expresses interest in exploring whether emotional factors, such as stress, may contribute to their symptom profile.

Any prescribed medications must have been stable for at least one month.

Disqualifiers

Participants suffer from ongoing substance abuse (alcohol or drugs) or are assessed to have severe mental health issues (psychotic disorders, moderate to high suicide risk, antisocial personality disorder, etc.).

Participants are currently prescribed medications that are clearly addictive and sedative in nature (e.g., benzodiazepines).

Participants are involved in other psychological treatments focused on physical symptoms. However, other psychological treatments are permitted as long as the supportive therapy does not occur more than once a month.

Participants do not have sufficient proficiency in the Swedish language.

Trial design

Design model

Single group

Treatments tested in this trial

  • Emotional Awareness and Expression Therapy (EAET)

    Behavioral

    Emotional Awareness and Expression Therapy (EAET) is a manualized, short-term psychodynamic therapy that, in this instance, is delivered in a group format. The core of Emotional Awareness and Expression Therapy (EAET) involves helping individuals identify, understand, and express their emotions in a therapeutic setting. The therapy emphasizes the connection between unprocessed emotions and physical symptoms, encouraging participants to explore the emotional underpinnings of their distress. Through guided discussions, psychoeducation, and expressive exercises, participants learn to recognize patterns of emotional avoidance, develop self-compassion, and improve interpersonal communication. This process aims to reduce somatic symptoms and enhance overall emotional well-being by fostering a greater awareness of emotional experiences.

Treatment groups

50 Participants
are divided into 1 treatment group
Group A: Emotional Awareness and Expression TherapyOther 1 intervention

Trial outcomes

Primary outcomes

1

Patient Health Questionnaire-15 (PHQ-15)

Somatic symptom severity during the "last week " are assessed with the Patient Health Questionnaire-15 (PHQ-15). Items are rated 0 ("not bothered at all"), 1 ("bothered a little"), or 2 ("bothered a lot"); total scores range from 0 to 30.

Time frame
Pre-post treatment (at treatment termination)
2

Visual Analoge Scales

A second primary outcome is the two Visual Analoge Scales suggested by the EURONET-SOMA network (Rief et al., 2017). Somatic symptom intensity is measured from 1 ("No symptom") to 10 ("Symptom as bad as you can imagine") and somatic symptom interference from 1 ("No interference") to 10 ("Maximum interference").

Time frame
Pre-post treatment (at treatment termination)

Secondary outcomes

1

Sheehan Disability Scale

SDS consist on three visual analogue scales ranging from 0-10 for symptom interference in daily life. Higher scores indicate worse symptom/functioning, with a maximum score of 30.

Time frame
1. Pre-post treatment (at treatment termination). 2. Pre-Follow up (12 weeks after intervention).
2

Post traumatic symptom Check List-5 (PCL-5),

PCL-5 consists of 20 questions with ratings 0-4 on impact of post traumatic symptoms. Higher scores indicate worse symptom/functioning with a maximum score of 80.

Time frame
1. Pre-post treatment (at treatment termination). 2. Pre-Follow up (12 weeks after intervention).
3

Patient Health Questionaire-9 (PHQ-9)

PHQ-9 consists of nine questions withs ratings 0-3 (0= "not at all", 3= "almost every day") on impact of depressive symptoms. Higher scores indicate worse symptom/functioning with a maximum score of 27.

Time frame
1. Pre-post treatment (at treatment termination). 2. Pre-Follow up (12 weeks after intervention).
4

Generalized Anxiety Disorder 7-item scale (GAD-7)

GAD-7 consists of seven questions with ratings 0-3 (0= "not at all", 3= "almost every day") on impact of anxiety symptoms. Higher scores indicate worse symptom/functioning functioning with a maximum score of 21.

Time frame
1. Pre-post treatment (at treatment termination). 2. Pre-Follow up (12 weeks after intervention).

Other outcomes

1

Credibility and Expectancy Questionaire (CEQ)

The questionnaire consists of several items that participants respond to on a Likert scale (e.g., from 1 to 7), where they rate their level of agreement or belief regarding various statements related to the treatment\'s credibility and their expected outcomes.

Time frame
Three weeks into treatment
2

Negative Effects Questionnaire (NEQ)

The questionnaire includes a series of statements or questions that participants respond to using a Likert scale, where they indicate how often they have experienced these negative effects.

Time frame
At FU (12 weeks after intervention).
3

8 visual analgue scales

2 question on 1-10 on symptom intensity and inferference 2 questions on 1-10 on the capacity of self-compassion 2 questions on 1-10 on the capacity of emotional processing 2 question on 1-10 on symptom attribution

Time frame
Mediational measure: Every week during the 12 week long treatment (i.e. 11 measurement points.)

Locations

This trial has no locations.

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Daniel Maroti

Lead sponsor

Stockholm University

Sponsor institution

This trial is not recruiting at the moment. You can still explore other options: