The efficacy of pandemic-adjusted family/systemic constellation therapy in improving psychopathological symptoms: A randomized controlled trial

Abstract

The aim of this pre-registered (NCT05051462), randomized controlled trial was to investigate the efficacy and safety of a pandemic-adjusted version of family/systemic constellation therapy in the general population. Altogether, 80 individuals were randomized (85% retained; 67.6% women, M_age = 41.9 ± 9.2 years) and followed up 1- and 6 months after participation in the single-day intervention. Numerous indicators of psychopathology and addiction as well as wellbeing were assessed. Members of the intervention group improved significantly in terms of the a priori primary outcome (overall psychopathology: d_1-month = 0.41, p_1-month = 0.003; d_6-month = 0.31, p_6-month = 0.028) as well as numerous secondary outcomes (obsession-compulsion, interpersonal sensitivity, anxiety, hostility, phobic anxiety, and paranoid ideation). However, the magnitude of improvements was small and mostly disappeared by 6-months. Further, no significant treatment benefit emerged considering time x group interactions regarding any of the outcomes (although statistical power was low). Due to the significant, pandemic-related deviations from the protocol of the intervention, these results may not be generalizable to systemic constellation interventions in general; instead - considering the previous, more favorable data regarding efficacy/effectiveness and tolerability - they rather call attention to the importance of process-related factors regarding this intervention specifically as well as the potential disadvantages of pandemic-related treatment modifications of in-person (non-virtual) group interventions in general.

Keywords: COVID-19 pandemic; Efficacy; Family constellation therapy; Systemic constellations; Tolerability.