The HARMONIC Trial
Anxiety and mood disorders are common conditions affecting up to 20% of adults. These conditions take different forms (or diagnoses) such as Agoraphobia, Panic Disorder, Depressive Disorder, Social Anxiety Disorder, and so on. Currently, our best psychological treatments only focus on individual diagnoses. So, there are separate treatments for Panic Disorder, or Depressive Disorder, or Social Anxiety, etc. These ‘diagnosis-specific’ treatments work well for people whose problems fit neatly into a single diagnosis. However, they work far less well for people with complex problems involving multiple diagnoses; e.g., someone who is depressed and socially anxious and suffering panic attacks. In fact, 50% of patients fail to respond well to these existing treatments.
To address this, we have developed a new psychological treatment for anxiety and mood problems. Instead of focusing on any single diagnosis, it combines the best treatment techniques into 10 modules (with clinician instructions and materials for service-users), each of which targets problems common across all of the different mood and anxiety diagnoses (e.g., intense emotions, negative thinking, upsetting memories, distressing habits). The choice of modules is determined by the case formulation and a rating of the service-user’s top problems, therefore the delivery is flexible. This treatment should therefore be better for the large numbers of individuals whose problems do not fit neatly into a single diagnosis and for whom any treatments targeting a single diagnosis would leave significant difficulties unaddressed.
We are currently testing the feasibility of the Shaping Healthy Minds Programme in comparison to treatment-as-usual within NHS Psychological Services, with plans to conduct a full scale randomised controlled trial in the future.