The Digital Clinic: Testing the Feasibility of an Innovative Digital Mental Health Care Delivery Model Designed to Increase Access to Care (Preprint) DOI Creative Commons
Natalia Macrynikola, Kelly Chen,

Erlend Lane

et al.

Published: Aug. 8, 2024

BACKGROUND Background: Mental health concerns have become increasingly prevalent yet care often remains inaccessible to many. While digital mental interventions offer a promising solution, self-help and even coached apps not fully addressed these challenges. There is now growing interest in hybrid approaches that use as tools augment, rather than entirely guide, care. The Digital Clinic one such model, designed increase access the quality of services. OBJECTIVE Objective: To assess feasibility, acceptability, potential efficacy we conducted non-randomized open trial with participants experiencing depression, anxiety, or both, at various levels clinical severity. METHODS Methods: Clinicians were trained conducting brief transdiagnostic evidence-based treatment augmented by app (mindLAMP); navigators supporting participants’ engagement literacy while also sharing data both patients clinicians. Feasibility acceptability this 8-week program assessed against range benchmarks. Potential was calculating pre-post change depressive (PHQ-9), anxiety (GAD-7), co-morbid (PHQ-ADS) symptoms, well rates clinically meaningful remission. Secondary outcomes included functional impairment, self-efficacy managing emotions, flourishing. RESULTS Results: Participants 215 individuals, primarily White (70%) cisgender women (63%) mean age 41 (SD = 14). good excellent across domains. demonstrated efficacy: average PHQ-9 score decreased from moderate/moderately severe baseline (M 13.39, SD 4.53) sub-clinical 7.79, 4.61) end intervention, t(127) 12.50, p < .001, d 1.11. Similarly, GAD-7 moderate 12.93, 3.67) 7.35, 4.19) t(114) 13, <.001, 1.22. Participation associated high significant improvement CONCLUSIONS Conclusion: Results suggest model feasible, acceptable, potentially efficacious, warranting future RCT establish innovative

Language: Английский

State of the Science: Using Digital Mental Health Interventions to Extend the Impact of Psychological Services DOI
Giovanni Ramos, Rosa Hernandez-Ramos, Madison E. Taylor

et al.

Behavior Therapy, Journal Year: 2024, Volume and Issue: 55(6), P. 1364 - 1379

Published: April 11, 2024

Language: Английский

Citations

21
The future of psychological treatments: The Marburg Declaration DOI Creative Commons
Winfried Rief, Gordon J. G. Asmundson, Richard A. Bryant

et al.

Clinical Psychology Review, Journal Year: 2024, Volume and Issue: 110, P. 102417 - 102417

Published: March 25, 2024

Although psychological treatments are broadly recognized as evidence-based interventions for various mental disorders, challenges remain. For example, a substantial proportion of patients receiving such do not fully recover, and many obstacles hinder the dissemination, implementation, training treatments. These problems require those in our field to rethink some basic models disorders their treatments, question how research practice clinical psychology should progress. To answer these questions, group experts convened at Think-Tank Marburg, Germany, August 2022 review evidence analyze barriers current future developments. After this event, an overview state-of-the-art was drafted suggestions improvements specific recommendations were integrated. Recommendations arising from meeting cover further improving through translational approaches, methodology, bridging gap between more nomothetic (group-oriented) studies idiographic (person-centered) decisions, using network approaches addition selecting single mechanisms embrace complexity reality, making use scalable digital options assessments interventions, education psychotherapists, accepting societal responsibilities that has national global health care. The objective Marburg Declaration is stimulate significant change regarding understanding with aim trigger new era interventions.

Language: Английский

Citations

13
Algorithm‐based modular psychotherapy vs. cognitive‐behavioral therapy for patients with depression, psychiatric comorbidities and early trauma: a proof‐of‐concept randomized controlled trial DOI Open Access
Elisabeth Schramm, Moritz Elsaeßer, Carolin Jenkner

et al.

World Psychiatry, Journal Year: 2024, Volume and Issue: 23(2), P. 257 - 266

Published: May 10, 2024

Effect sizes of psychotherapies currently stagnate at a low‐to‐moderate level. Personalizing psychotherapy by algorithm‐based modular procedures promises improved outcomes, greater flexibility, and better fit between research practice. However, evidence for the feasibility efficacy modular‐based psychotherapy, using personalized treatment algorithm, is lacking. This proof‐of‐concept randomized controlled trial was conducted in 70 adult outpatients with primary DSM‐5 diagnosis major depressive disorder, score higher than 18 on 24‐item Hamilton Rating Scale Depression (HRSD‐24), least one comorbid psychiatric according to Structured Clinical Interview (SCID‐5), history “moderate severe” childhood maltreatment domain Childhood Trauma Questionnaire (CTQ), exceeding cut‐off value three measures early trauma‐related transdiagnostic mechanisms: Rejection Sensitivity (RSQ), Interpersonal Reactivity Index (IRI), Difficulties Emotion Regulation Scale‐16 (DERS‐16). Patients were 20 sessions either standard cognitive‐behavioral therapy alone (CBT) or CBT plus modules mechanism‐based algorithm (MoBa), over 16 weeks. We aimed assess MoBa, compare MoBa vs. respect participants’ therapists’ overall satisfaction ratings therapeutic alliance (using Working Alliance Inventory ‐ Short Revised, WAI‐SR), efficacy, impact mechanisms, safety. The outcome HRSD‐24 post‐treatment. Secondary outcomes included, among others, rate response (defined as reduction 50% from baseline <16 post‐treatment), remission ≤8 improvements mechanisms social threat response, hyperarousal, processes/empathy. found no difficulties selection individual patients, applying above‐mentioned cut‐offs, implementation MoBa. Both participants therapists reported had WAI‐SR CBT. approaches led reductions symptoms post‐treatment, non‐significant superiority nearly times likely experience end (29.4% 11.4%; odds ratio, OR = 3.2, 95% CI: 0.9‐11.6). Among patients showed significantly post‐treatment effect processes/empathy (p<0.05) compared who presented an exacerbation this Substantially less adverse events These results suggest acceptability complementing depressed comorbidities trauma. While initial observed, potential clinical advantages interindividual heterogeneity will have be investigated fully powered confirmation trials.

Language: Английский

Citations

11
Personalized mood prediction from patterns of behavior collected with smartphones DOI Creative Commons
Brunilda Balliu,

Chris Douglas,

Darsol Seok

et al.

npj Digital Medicine, Journal Year: 2024, Volume and Issue: 7(1)

Published: Feb. 28, 2024

Abstract Over the last ten years, there has been considerable progress in using digital behavioral phenotypes, captured passively and continuously from smartphones wearable devices, to infer depressive mood. However, most phenotype studies suffer poor replicability, often fail detect clinically relevant events, use measures of depression that are not validated or suitable for collecting large longitudinal data. Here, we report high-quality assessments mood computerized adaptive testing paired with continuous behavior smartphone sensors up 40 weeks on 183 individuals experiencing mild severe symptoms depression. We apply a combination cubic spline interpolation idiographic models generate individualized predictions future achieving high prediction accuracy severity three advance ( R 2 ≥ 80%) 65.7% reduction error over baseline model which predicts based past alone. Finally, our study verified feasibility obtaining clinical population predicting symptom collected Our results indicate possibility expanding repertoire patient-specific enable psychiatric research.

Language: Английский

Citations

10
From theory to practice: A transtheoretical treatment and training model (4TM) DOI Creative Commons
Wolfgang Lutz, Brian Schwartz, Anne‐Katharina Deisenhofer

et al.

Clinical Psychology in Europe, Journal Year: 2024, Volume and Issue: 6(Special Issue)

Published: April 9, 2024

In this paper, we present the conceptual background and clinical implications of a research-based transtheoretical treatment training model (4TM).

Language: Английский

Citations

6
Technology-based Cognitive Behavioral Therapy Interventions DOI
Jill M. Newby, Emily Upton, Elizabeth Mason

et al.

Psychiatric Clinics of North America, Journal Year: 2024, Volume and Issue: 47(2), P. 399 - 417

Published: March 23, 2024

Language: Английский

Citations

5
Predicting response to a smartphone-based cognitive-behavioral therapy for body dysmorphic disorder DOI
Jennifer L. Greenberg, Hilary Weingarden, Susanne S. Hoeppner

et al.

Journal of Affective Disorders, Journal Year: 2024, Volume and Issue: 355, P. 106 - 114

Published: March 21, 2024

Language: Английский

Citations

4
Hybrid care in mental health: a framework for understanding care, research, and future opportunities DOI Creative Commons
Kelly Chen, Jack J. Huang, John Torous

et al.

NPP—Digital Psychiatry and Neuroscience, Journal Year: 2024, Volume and Issue: 2(1)

Published: Oct. 17, 2024

Abstract Technology is playing an increasing role in healthcare, especially mental health. Traditional whether in-person or via telehealth, cannot by itself address the massive need for services. Standalone technology such as smartphone apps, while easily accessible, have seen limited engagement and efficacy on their own. Hybrid care – combination of synchronous telehealth appointments with use asynchronous digital tools applications, wearable devices, therapeutics has potential to offer best both worlds, providing increased access higher efficacy. In this paper, we present a framework highlighting key components hybrid models: intervention, human support, target population. This can be used evaluate existing models literature practice, identify areas opportunity, serve blueprint elements consider when designing new models.

Language: Английский

Citations

4
Digital mental health interventions for young people aged 16-25: scoping review (Preprint) DOI Creative Commons
Courtney Potts, Carmen Kealy,

J C McNulty

et al.

Published: Feb. 20, 2025

BACKGROUND Digital mental health interventions for young people offer a promising avenue promoting wellbeing and addressing issues in this population. OBJECTIVE This study aims to explore the range of digital supports available aged 16 - 25 years, with particular focus on types tools, modalities, delivery format, target population, retention rates. METHODS The scoping review was conducted six databases (PubMed, Web Science, Scopus, Medline, Cochrane Library PsychInfo), total 145 articles were included. findings reveal diverse landscape studies globally, equally focusing prevention promotion as well treatment ill health, most commonly using cognitive behavioural therapy, apps, web-based resources websites being common tools. RESULTS results highlight over emphasis convenience sampling participants mainly recruited from universities or colleges, lack representation marginalised groups, including LGBTQ+ youth, those socioeconomically deprived backgrounds, neurodivergent individuals. Moreover, anxiety depression leaves other conditions underrepresented. Retention rates moderate, indicating room improvement. There is need more research preventative measures under years when are at increased risk issues. includes exploring different intervention approaches modalities beyond behaviour therapy ensuring inclusivity populations. Standardising lengths incorporating long-term follow-up data could provide valuable insights into efficacy effectiveness interventions. CONCLUSIONS Future should aim greater inclusivity, groups address needs effectively. By adopting these approaches, can become accessible, engaging, impactful worldwide.

Language: Английский

Citations

0
Stepped care, stepped care “lite” & matching intervention components to individual mental health needs: A rapid scoping review of mental health and substance use interventions for post-secondary students DOI Creative Commons
Sarah Brennenstuhl,

C. Agard,

Rachel Ho

et al.

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(3), P. e0319473 - e0319473

Published: March 25, 2025

Purpose Stepped Care Models (SCM) and other approaches for organizing the delivery of services resources by individual mental health (MH) needs are being increasingly implemented in post-secondary institutions. However, no consensus definitions exist what constitutes a SCM students (PSS), there is little guidance evaluation these complex, multicomponent interventions. The purpose this research to identify characterize MH substance use interventions PSS that apply SCM, stepped approach (i.e., care “lite”), and/or organize resources/services based on needs. Methods A rapid scoping review peer-reviewed articles was conducted using OVID MEDLINE®, Embase, EBSCO CINAHL, PsycINFO®, ERIC. Eligible studies included improving or among applying another way offered according Results: 5757 abstracts were reviewed, resulting full text examination 172 studies. Data extracted from 68 eligible comprising 50 (SCMs: n = 7, “lite”: 13; organized matched needs: 30). Almost all involved website/app symptom tracking often within intervention. Most addressed either alcohol use, depression, anxiety eating disorders. variety models applied, but not generally geared look at individual-level outcomes manner captured overall effect related specific “dose” intervention received. focused symptoms, satisfaction, utilization; student-related such as academic success rarely used. Student co-design described. Conclusions/Implications Despite increasing implementation SCMs settings, few model have been published. Drawing strengths shortcomings identified, recommendations future work area presented.

Language: Английский

Citations

0