Precision Mental Health and Data-Informed Decision Support in Psychological Therapy: An Example

Administration and Policy in Mental Health and Mental Health Services Research, Год журнала: 2023, Номер 51(5), С. 674 - 685

Опубликована: Дек. 15, 2023

Abstract Outcome measurement including data-informed decision support for therapists in psychological therapy has developed impressively over the past two decades. New technological developments such as computerized data assessment, and feedback tools have facilitated advanced implementation several seetings. Recent try to improve clinical decision-making process by connecting practice better with empirical data. For example, psychometric can be used clinicians personalize selection of therapeutic programs, strategies or modules monitor a patient’s response real time. Furthermore, treatment patients at risk negative outcome. Therefore, measurement-based care seen an important integral part competence, practice, training. This is comparable many other areas healthcare system, where continuous monitoring health indicators common day-to-day (e.g., fever, blood pressure). In this paper, we present basic concepts system tailoring individual interventions specific patient needs, discuss implications implementing form precision mental practice.

Язык: Английский

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Hybrid care in mental health: a framework for understanding care, research, and future opportunities

NPP—Digital Psychiatry and Neuroscience, Год журнала: 2024, Номер 2(1)

Опубликована: Окт. 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.

Язык: Английский

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Study protocol: perinatal mood treatment study

Trials, Год журнала: 2024, Номер 25(1)

Опубликована: Авг. 6, 2024

Abstract Perinatal depression (PND) affects up to 20% of women and is associated with significant impairment disability in affected women. In addition, perinatal broader public health multigenerational consequences. Innovative approaches are needed reduce the burden through identification, tracking, treatment depressive symptoms during period. This study a randomized clinical trial comparing relative efficacy multi-tiered system care, Screening Treatment Anxiety Depression (STAND) care delivered by reproductive psychiatrist reducing anxiety. A sample 167 individuals was between week 28 pregnancy 6 months postpartum. secondary aim compares original online therapy intervention used first half newer program second for assigned STAND treatment. The measures, groups, analysis methods described, as well expected implications. findings from this may improve tracking symptom changes over time, monitoring response, providing personalized PND. As such, lives patients PND their families lower related costs society. Trial registration NCT: 9/24/2021 NCT direct link: https://www.clinicaltrials.gov/study/NCT05056454?term=NCT05056454&rank=1&a=1 .

Язык: Английский

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The Digital Clinic: Testing the Feasibility of an Innovative Digital Mental Health Care Delivery Model Designed to Increase Access to Care (Preprint)

Опубликована: Авг. 8, 2024

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: 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: 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: 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 Conclusion: Results suggest model feasible, acceptable, potentially efficacious, warranting future RCT establish innovative

Язык: Английский

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The Digital Clinic: Testing the Feasibility of an Innovative Digital Mental Health Care Delivery Model Designed to Increase Access to Care (Preprint)

JMIR Mental Health, Год журнала: 2024, Номер 12, С. e65222 - e65222

Опубликована: Ноя. 6, 2024

Background Mental health concerns have become increasingly prevalent; however, care remains inaccessible to many. While digital mental interventions offer a promising solution, self-help and even coached apps not fully addressed the challenge. There is now growing interest in hybrid, or blended, approaches that use as tools augment, rather than entirely guide, care. The Digital Clinic one such model, designed increase access high-quality services. Objective To assess feasibility, acceptability, potential efficacy of this study aims conduct nonrandomized open trial with participants experiencing depression, anxiety, both, at various levels clinical severity. 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 8-week program assessed against range benchmarks. Potential was calculating pre-post change symptoms depression (Patient Health Questionnaire-9; PHQ-9), anxiety (7-item Generalized Anxiety Disorder; GAD-7), comorbid Questionnaire Depression Scale; PHQ-ADS), well rates clinically meaningful improvement remission. Secondary outcomes included functional impairment, self-efficacy managing emotions, flourishing. Results Of 258 enrolled participants, 215 (83.3%) completed program. Most White (n=151, 70.2%) identified cisgender women (n=136, 63.3%), mean age 41 (SD 14) years. good excellent across domains. demonstrated efficacy: average PHQ-9 score moderate moderately severe baseline (mean 13.39, SD 4.53) decreased subclinical 7.79, 4.61) end intervention (t126=12.50, P<.001, Cohen d=1.11). Similarly, GAD-7 from 12.93, 3.67) 7.35, 4.19) (t113=13, d=1.22). Participation associated high significant Conclusions suggest model feasible, acceptable, potentially efficacious, warranting future randomized controlled establish innovative

Язык: Английский

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The Science of Psychiatric Measurement

Psychiatric Annals, Год журнала: 2023, Номер 53(9), С. 400 - 404

Опубликована: Сен. 1, 2023

In this article, we compare and contrast mental health measurement based on classical test theory (CTT) with computerized adaptive testing (CAT) multidimensional item response (MIRT). We show that MIRT-based CAT has numerous advantages over the traditional CTT approach in terms of maximizing precision while at same time decreasing burden both for clinician patient. review literature depression, anxiety, mania/hypomania, posttraumatic stress disorder, suicidality psychosis, substance use disorders. highlight two interesting applications, one national prevalence determination, student health. Applications to special populations where item-level bias may exist integration electronic medical records systems are also discussed. [ Psychiatr Ann . 2023;53(9):400–404.]

Язык: Английский

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