ClinicalTrials.gg
RecruitingNCT07257848CLIP_EcuadorUpdated Dec 2, 2025

Practice-Based Evidence in Psychotherapy: A Multicentric Study From Ecuador

An observational study in Psychological Distress, sponsored by Universidad de las Americas - Quito. Recruiting at 11 sites in Ecuador. Open to participants aged 11 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-12-02.

Sponsored by Universidad de las Americas - Quito · Observational

From the registry’s dates

  • Started Feb 2025; still recruiting 1 year 8 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
340
Ages
11 Years and older
Sex
All
01

Study summary

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.

Read the detailed description

This project is an exploratory, descriptive, and longitudinal naturalistic study. Its primary objective is to systematically examine client progress and treatment outcomes across a network of psychological care services in Ecuador by implementing a Routine Outcome Monitoring system. As a naturalistic investigation, the study will be conducted within existing clinical settings, ensuring that findings reflect real-world therapeutic practices with adolescent and adult populations.

The research will be implemented across multiple psychological care centers throughout Ecuador. To provide a comprehensive understanding of therapeutic processes, data will be collected at three distinct levels. At the client level, psychological distress serves as the primary outcome variable, supplemented by sociodemographic information collected at pre-treatment and post-treatment intervals and treatment satisfaction measures at post-treatment. At the therapist level, clinicians will complete client intake forms at treatment initiation and personal style questionnaires at treatment conclusion. Additionally, service-level data will be gathered from each participating center to characterize operational contexts and organizational frameworks.

The anticipated outcomes of this initiative are substantial. It will establish systematic tracking of client progress throughout therapy, enabling identification of population-specific levels of psychological distress and change trajectories. Furthermore, the project aims to create a foundational framework for the widespread implementation of outcome measurement systems in Ecuador's mental health care context.

In the long term, this project seeks to promote the consistent and generalized adoption of Routine Outcome Monitoring systems, thereby contributing to the development of a Practice-Based Evidence culture in Ecuador and throughout Latin America. It will strengthen Practice-Based Research Networks in psychological interventions, particularly through collaboration with established organizations such as the Consorcio Latinoamericano de Investigación en Psicoterapia (CLIP), fostering regional cooperation and standardizing assessment methodologies across mental health services.

02

Conditions studied

  • Psychological Distress

Keywords

  • practice-based evidence
  • routine outcome monitoring
  • psychotherapy
  • practice-oriented research
  • change
  • outcome
  • psychological distress
  • Latin America
  • Practice Research Network
  • Consorcio Latinoamericano de Investigación en Psicoterapia
03

In context

Lead sponsor

Universidad de las Americas - Quito is the lead sponsor of 3 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
11 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study 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.

Eligibility criteria

Clients

Inclusion Criteria:

  • 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.

Exclusion Criteria:

  • Present substantial cognitive deficits that do not allow the development of the evaluation.

Therapists

Inclusion Criteria:

  • Therapist providing psychological treatment at one of the mental health services included in the project.

Supervisors

Inclusion Criteria:

  • Provide clinical supervision to therapists delivering treatment at any of the project's affiliated mental health services.
05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
340 participants (estimated)
Target follow-up
12 Months
Patient registry
Yes

Groups and cohorts

  • Helpseeking Ecuadorian adult and adolescent clients

    The participants will consist of adolescent (ages 11-17) and adult (ages 18 and above) clients who present with common, non-severe mental health problems and are seeking services at the participating clinics involved in this study.

    Behavioral: Psychological Intervention

Interventions

  • BehavioralPsychological Intervention

    Real-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.

06

What researchers measure

Primary outcomes

  1. 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.

    Time frame: At baseline and immediately after treatment completion

  2. 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.

    Time frame: From the second treatment session through treatment completion (an average of 10 weeks)

  3. 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.

    Time frame: From baseline through treatment completion (an average of 10 weeks)

Secondary outcomes

  1. 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.

    Time frame: From Baseline through treatment completion (an average of 10 weeks)

  2. 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.

    Time frame: At the treatment completion visit, approximately 10 weeks post-enrollment.

Other outcomes

  1. 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.

    Time frame: CORE-A-TAF is completed by the therapists at baseline

  2. 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.

    Time frame: CORE EoT is completed by the therapists immediately after treatment completion

  3. 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.

    Time frame: Baseline (Enrollment), 12 months, 24 months, and 36 months.

  4. 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.

    Time frame: Baseline (Enrollment), 12 months, 24 months, and 36 months.

07

Study locations

10 of 11 sites recruiting
  • Centro de Psicología Aplicada, Universidad de Las Américas, Ecuador
    Quito, (P)Pichincha EC170503, Ecuador
    Recruiting
  • Jorge López Consultorios
    Manta, Manabí EC130203, Ecuador
    Recruiting
  • PsicoNeuro Manta
    Manta, Manabí, Ecuador
    Recruiting
    • Thays Bravo · Contactthaysbf20@gmail.com · +593996828343
    • Itaty Benálcazar-Betancourt, MSc · Principal investigator
  • Historie
    Quito, Pichincha EC100450, Ecuador
    Recruiting
  • Kumpana
    Quito, Pichincha EC170102, Ecuador
    Recruiting
    • Sebastián Velasco · Contactsvelascoc00@gmail.com · +593983576120
    • Itaty Benálcazar-Betancourt, MSc · Principal investigator
  • Mentis Psicología
    Quito, Pichincha EC170506, Ecuador
    Recruiting
    • Andrea De la Torre · Contactbelendelatorrepsi@gmail.com · +593991633932
    • Itaty Benálcazar-Betancourt, MSc · Principal investigator
  • Equimente
    Quito, Pichincha EC170517, Ecuador
    Not yet recruiting
    • Andrea Oña · Contactandreaona27@gmail.com · +593989710306
    • Itaty Benálcazar-Betancourt, MSc · Principal investigator
  • Sentir Psicología Integral
    Quito, Pichincha EC170517, Ecuador
    Recruiting
  • Solo Psique
    Quito, Pichincha EC170523, Ecuador
    Recruiting
    • Abigail Galahorrano · Contactsolopsique@hotmail.com · +593984544862
    • Itaty Benálcazar-Betancourt, MSc · Principal investigator
  • Renova - Mentis Habitus Positive
    Quito, Pichincha EC17103, Ecuador
    Recruiting
  • Psico Estratégico
    Quito, Pichincha EC17503, Ecuador
    Recruiting
08

References and documents

Publications

  • Valdiviezo-Ona J, Ortiz-Mancheno N, Valdivieso-Arias G, Erazo-Perez D, Rodriguez-Lorenzana A, Evans C, Paz C. Assessing the suitability and psychometric properties of the Spanish version of the YP-CORE for adolescents in Latin America: a study in Ecuador. BMC Psychol. 2024 Nov 18;12(1):671. doi: 10.1186/s40359-024-02169-8. PubMed 39558391 ↗
  • Paz C, Mascialino G, Proano K, Evans C. Psychological intervention change measurement in Latin America: Where from? Where to? Psychother Res. 2021 Jan;31(1):132-141. doi: 10.1080/10503307.2020.1750728. Epub 2020 Apr 16. PubMed 32297845 ↗
  • Trujillo A, Feixas G, Bados A, Garcia-Grau E, Salla M, Medina JC, Montesano A, Soriano J, Medeiros-Ferreira L, Canete J, Corbella S, Grau A, Lana F, Evans C. Psychometric properties of the Spanish version of the Clinical Outcomes in Routine Evaluation - Outcome Measure. Neuropsychiatr Dis Treat. 2016 Jun 21;12:1457-66. doi: 10.2147/NDT.S103079. eCollection 2016. PubMed 27382288 ↗
  • Paz C, Mascialino G, Evans C. Exploration of the psychometric properties of the Clinical Outcomes in Routine Evaluation-Outcome Measure in Ecuador. BMC Psychol. 2020 Sep 1;8(1):94. doi: 10.1186/s40359-020-00443-z. PubMed 32873334 ↗
  • Evans C, Connell J, Barkham M, Margison F, McGrath G, Mellor-Clark J, Audin K. Towards a standardised brief outcome measure: psychometric properties and utility of the CORE-OM. Br J Psychiatry. 2002 Jan;180:51-60. doi: 10.1192/bjp.180.1.51. PubMed 11772852 ↗
  • Valdiviezo-Ona J, Montesano A, Evans C, Paz C. Fostering practice-based evidence through routine outcome monitoring in a university psychotherapy service for common mental health problems: a protocol for a naturalistic, observational study. BMJ Open. 2023 May 24;13(5):e071875. doi: 10.1136/bmjopen-2023-071875. PubMed 37225267 ↗
  • Paz C, Benalcazar-Betancourt I, Valdiviezo-Ona J, Evans C. Generating practice-based evidence for common mental health problems using routine outcome monitoring: a protocol for a longitudinal naturalistic study in Ecuadorian mental health services. BMJ Open. 2026 May 18;16(5):e115254. doi: 10.1136/bmjopen-2025-115254. PubMed 42150825 ↗

Individual participant data

Plan to share: Undecided

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 2, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07257848
Lead sponsor
Universidad de las Americas - Quito
Responsible party
Clara Paz (Researcher, Universidad de las Americas - Quito) — Principal investigator
First posted
Dec 2, 2025
Start date
Feb 21, 2025
Primary completion
Feb 29, 2028 (estimated)
Completion
Aug 31, 2028 (estimated)
Last update
Dec 2, 2025

Study contacts

Clara Paz, Ph.D.
Contact
clara.paz@udla.edu.ec
+593960154522
Itaty Benalcázar Betancourt, M.Sc.
Contact
itatyerika.benalcazar@udla.edu.ec
+593996482602

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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