About this trial
The goal of this observational study is to learn about the progress and outcomes of clients receiving psychotherapy for common mental health problems in Ecuador. The main questions it aims to answer are:
* How much do clients' psychological distress typically change during the course of their psychotherapy? * What factors are associated with outcomes in real-world mental health services in Ecuador?
This study involves clients who are about to start psychotherapy at one of the participating mental health clinics in Ecuador. Participants will continue their regular psychotherapy sessions as usual. The only addition is that before their sessions, they will be asked to complete questionnaires about their general well-being. This routine check-in process will continue throughout their time in therapy. Contextual information will be collected before starting treatment, and satisfaction with the treatment and any contextual changes will be collected after treatment ends.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Be 11 years of age or older.
Have sufficient ability to communicate in Spanish.
Undergo psychological treatment at one of the mental health services included in the project.
Disqualifiers
Present substantial cognitive deficits that do not allow the development of the evaluation.
Therapist providing psychological treatment at one of the mental health services included in the project.
Provide clinical supervision to therapists delivering treatment at any of the project's affiliated mental health services.
Trial population
The participant pool will consist of three groups: (1) help-seeking clients engaged in treatment, (2) therapists providing services, and (3) supervisors from the project's affiliated mental health services in Ecuador.
Trial design
Cohort
Prospective
Treatments tested in this trial
Psychological Intervention
BehavioralReal-world application of psychological care, adapted to the individual needs of clients within the normal workflow of clinical practice. Treatments are delivered by licensed practitioners in routine clinical settings, ensuring that interventions are tailored to each client's specific characteristics and therapeutic goals.
Treatment groups
Trial outcomes
Primary outcomes
Change in Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM)
The CORE-OM is a 34-item self-report instrument designed for use across heterogeneous services and grounded in a pan-theoretic core of psychological distress, including subjective well-being, problems, risk, and functioning. Items are scored on a scale from 0 (never) to 4 (always or almost always). Higher scores indicate greater psychological distress. This instrument is suitable as an initial assessment tool and as an outcome measure. The Spanish version of this measure will be used. This version was translated in Spain and has shown good psychometric properties in Spain and Ecuador. CORE-OM is administered to adult clients.
Change in Clinical Outcomes in Routine Evaluation-10 (CORE-10)
The CORE-10 is a generic, short, and easy-to-use assessment measure. Its items were drawn from the CORE-OM. The CORE-10 is an instrument that has shown good psychometric properties and is practical for use on a session-by-session basis with people presenting with psychological distress in mental health settings. Its Spanish version will be used. In Ecuador, this version has shown good psychometric properties. CORE-10 is administered to adult clients.
Change in Young Person's-Clinical Outcomes in Routine Evaluation (YP-CORE)
The YP-CORE is a brief self-report instrument capable of detecting psychological distress in adolescents, generated by a wide range of problems, while providing information about the person's general functioning. It has 10 items, which must be answered on a 5-point scale (0 to 4). Its Spanish version will be used. The YP-CORE was translated into Spanish and showed adequate psychometric properties. In the present study, we will use a version of this measure, adapted for Ecuador and Latin America, which has good psychometric properties in Ecuador. YP-CORE is administered to adolescents.
Secondary outcomes
Emotional and Psychological Outcome (EPO-1)
The EPO-1 is a single-item outcome measure in which clients assess their current emotional and psychological state by responding to the question: "At this moment, how are you doing emotionally and psychologically?" This item is scored on a 5-point scale ranging from 0 ("Very bad; I can barely handle things") to 4 ("Very well; I have no significant complaints"). EPO-1 is administered to all clients.
Satisfaction with the Treatment Received Scale (CRES-4)
The CRES-4 scale has 4 items: one question on satisfaction, one on the level of resolution of the main problem, one on emotional state before the start of treatment, and one on emotional state when completing the questionnaire. These questions allow interpretations of the perceived change in their emotional state, satisfaction, and problem resolution. In this study, the Spanish version of this measure will be used.CRES-4 is administered to all clients.
Other outcomes
CORE Therapy Assessment Form (CORE-A-TAF)
The CORE-A-TAF is a pragmatic form intended to be completed by therapists at baseline. The CORE-TAF includes referral information, sociodemographic data on the client, and data on the nature, severity, and duration of the client's problems. We will use its Spanish version, which is currently being translated and adapted for use by the CLIP.
CORE End of Therapy (CORE-A-EoT)
The CORE-A-EoT is a pragmatic form designed to be filled out by therapists immediately after treatment completion. The CORE-A-EoT reports on the completed treatment, including the number of sessions, type of therapy, length and frequency of sessions, whether the ending was planned or unplanned, and the potential benefits of therapy. We will use its Spanish version, which is currently being translated and adapted for use by the CLIP.
Assessment questionnaire on the personal style of the therapist (PST-Q)
The PST-Q is a 20-item self-report instrument with a 7-point Likert scale (1 "Completely Disagree" to 7 "Completely Agree"). It assesses the therapist's position across five dimensions: instructional, expressive, involvement, attentional, and operative. Therapists will complete the PST-Q.
Service Information Form
This form is intended to be completed by the supervisors or authorities of each service. It collects general data about the center, such as the type of population it serves, its annual average number of users, etc. Supervisors will complete this form.
Sponsors and contacts
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