Stefan Elbers

161 Preventing relapse after successful treatment Applicability of the Workbook in Existing Treatment Programs Based on their own experiences, patients and HCPs discussed how the workbook could be optimally implemented and adopted throughout the treatment program. Regarding the introduction of the workbook, there was no consensus among HCPs about when to introduce the workbook during treatment. An early introduction of VBG was believed to facilitate the formulation of treatment goals at the start of the program, and Insight Cards were considered useful to immediately capture important experiences at the start of the program (e.g., the initial experiment of exposure in vivo). On the other hand, HCPs were hesitant to add more instruction time to an already information-dense start of the program. If you provide patients with the workbook at the start of the program, you will also have to educate them on how it should be used. ... Yes, this will add to an already long queue of things that require explanation. [T2] From the patients’ perspective, an early introduction did not seem crucial: patients who received the workbook in later stages still evaluated its use as relevant. Although patients reported substantial variation on time spent on the workbook during treatment sessions ranging from discussing the workbook during each contact to no integration at all, HCPs found Insight Cards easy to integrate into their therapy sessions. The interaction with the treatment program was more difficult for VBG. Sometimes, value-based goals relate to higher order goals than the goals we can work with. If you start discussing patients’ values, you can fill plenty of sessions. However, this will be a different type of treatment than we are currently providing. [T1] In general, HCPs commented that regular checks of the content were preferable within treatment contact time but that the total time spent should be limited. Both patients and HCPs specifically considered these checks important during the final phase of treatment. For example, a patient commented on whether it would be relevant to evaluate the workbook during the final phase of treatment. Yes, absolutely. That makes sense to me. It is not necessary to discuss the workbook every week, but it would help to ask at certain moments how things are going. Then, patients can show how they are using the workbook. They might be using it improperly. That sometimes by evaluating and also discuss this during the final evaluation: what’s the status? How far did you come? [P2]