This project was designed to be implemented over a three year period, between 2011- 2014, and it was extended through October 2015.
The following milestones have been achieved so far:
- Selecting the project team, including the recruitment of new members that weren’t nominated in the initial application. The project team is formed of University members, clinical psychologists and psychology PhDs, with expertise in clinical psychology and cognitive-behavioral psychotherapies, as well as in evolutionary psychology. The team also includes international consultants, experts in the field of evolutionary psychology, working at universities from the United States of America (for example, David Buss – www.DavidBuss.com, or Todd Shackelford – http://toddkshackelford.com).
- Developing the technical and administrative infrastructure necessary for the project to run in optimal conditions, via equipment acquisition and adaptation of psychological instruments for the Romanian population.
- Creating a references database in Zotero. The database contains approx. 300 references, and it is permanently updated.
- Development of an online evaluation package. All the psychological instruments administered to the patients enrolled in the study, with the exception of one administered by clinicians (Structured Clinical Interview for DSM-IV) are completed online through web forms developed by one member of the project team. This significantly reduces the completion time and eliminates the inherent errors which can appear in the manual completion of the forms. In total, 19 instruments, evaluating different dimensions of psycho-social functioning relevant for the study, are being administered online.
- Finalizing the main instrument used for measuring fitness (a.k.a., Fitness Evaluation Scale; FES), the key concept of the enhanced intervention protocol proposed in the project. The construction of this instrument consisted of several steps:
– Identification of the relevant fitness dimension areas and development of the items. The scale consists of 61 items.
– The development of an English parallel of the instrument, necessary for its cross-cultural validation.
– The preliminary validation of the instrument conducted by the project director on a sample of participants from the United States. Preliminary results show good internal consistency (alpha Cronbach coefficient: =~ 0.9)
- Drafting the intervention manual for the Cognitive Evolutionary Therapy for Depression (CET), which integrates elements from evolutionary psychology in CBT. The 50-page manual resulted from the collaboration between (1) experts in the field of clinical psychology and cognitive-behavioral psychotherapies (Daniel David, PhD, Aurora Szentagotai-Tatar, PhD) and (2) experts in the field of evolutionary psychology (David Buss, Todd Shackelford, Aurelio Jose Figueredo). The project director was the liaison between all the experts.
- The adaptation of a standard protocol of cognitive psychotherapy for depression, to be used in this project.
- Training of the psychotherapists administering the CET. These therapist have a background in clinical psychology and cognitive-behavioral psychotherapies and are certified by the Romanian Board of Psychologists.
- Recruitment of the patients to be enrolled in the study. Recruitment started in the fall of 2012. The recruitment of the participants is a continuous process running in parallel with (1) clinical evaluations, which indicate the participants that are potentially eligible to be enrolled in the study, (2) therapy provided to the participants already enrolled in the study, (3) final evaluations and follow-ups of the participants who completed the study. The following recruitment strategies are being used:
– Posters advertising the project, including contact data, placed in heavily trafficked areas from Cluj-Napoca (central squares, bus stations, student campuses), with an average rate of twice a week.
– Facebook announcements.
– Personalized Facebook page, containing the name of the project (https://www.facebook.com/psihoterapie.depresie?fref=ts).
– Announcements in local newspapers (Piata, and www.Piata AZ.ro).
– Participation in TV shows with psychology themes (SOS, Jurnal de Psiholog, at LookTV Cluj), with the purpose of communicating the opportunity of a free treatment for depression.
– Printed announcements distributed in public institutions that are attended by students (Central University Library of Cluj Napoca, various departments at Babes-Bolyai University)
– The patients of the University Psychology Clinic were informed about our program and its services.
– Announcements made to the Family Medical Associations, through which family medics informed their patients about the program.
– Placement of announcements on depression-focused websites, such as www.depresiv.ro
– Regular announcements made to students (master or undergraduate level) at Babes-Bolyai University, regarding the psychological services offered by the program.
- Evaluating the potential eligible participants to be enrolled in the study. The evaluation procedure is implemented by clinical psychologists with competencies in clinical evaluation, certified by the Romanian Psychologists Association. Until now (November 2014), 542 persons got in contact with us and asked for information about the services provided by the program. About 175 persons entered the process of psychological evaluation. After the evaluation, 124 of these persons were deemed ineligible to be enrolled in the study (for example, they did not have symptoms of clinical intensity, or they had another mental disorder, etc.). As of this writing, 8 more persons are in the process of evaluation.
- Enrollment of the participants in the study and the implementation of the intervention protocol. A total of 49 patients have been enrolled in the study program, being randomly assigned to one of two therapeutic conditions: (1) classical cognitive psychotherapy, and (2) cognitive-evolutionary psychotherapy. By the end of 2014 we estimate that 10 more participants will be enrolled.
- The implementation of the final clinical evaluation and follow-up procedures. Until now, 20 patients finalized the therapy and 18 of them received the three-month follow-up evaluation.
- The construction of the project web site, www.DarwinianPsychotherapy.com, and its constant updating, with the purpose of popularizing the project and centralizing the data regarding the project (the project main ideas and goals, information regarding the financing and the institution that hosts the implementation of this project, the implementation team, evolution of the implementation process, etcetera).
- The permanent dissemination of the project and preliminary results through publications in peer-reviewed journals and presentations at international conferences.