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408 Flashcards

1
Q

What is process-based therapy?

A

Personalized trans diagnostic psychotherapy based on patient mechanisms

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2
Q

What is a mediator?

A

Answers questions about why/how

Reveals mechanisms

IV —> mediator —> DV

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3
Q

What is a moderator?

A

Answers questions about for whom/to what extent

Tells us about individual differences in response to an intervention

Affects strength/irection of the relationship between IV and DV

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4
Q

What are some problems about treatments that target symptoms?

A

These treatments are based on the way we conceptualizer disorders and diagnose ppl with the DSM-5. This has limitations bc different disorders get different treatments even if they have the same mechanisms maintaining it.

Disorders may not be as independent from one another as the DSM claims—> comorbidity is extremely common, share similar symptoms, may have common mechanisms (i.e. avoidance, cognitive fusion, rumination)

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5
Q

How does process-based therapy differ from outcome based therapy?

A

Not focused on symtom

Focused on the contextual factors and contingencies that will reveal the personalized mechanisms for that specific patient

HOW does treatment assignment relate to different outcomes?

What change procedures work best at treating this core mechanism?

Seek to uncover mediators and moderators

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6
Q

What necessary conditions must be met for a mechanism to be considered a mediator?

A

1.Mechanism must be malleable/changeable

  1. The intervention (IV) and the outcome (DV) must relate to the mechanism
  2. Effect is specific and can be replicated across studies
  3. Temporal associations need to be made in that a change in IV leads to a change in the mechanism which will then lead to a change in DV
  4. Statistical significance does not guarantee a legitimate mechanism
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7
Q

What techniques can be used to detect mechanisms?

A

-What happens to the behavior when the contingencies are changed?

  • Use functional analysis (ABC) so that we can test through experimental manipulation each hypothesized function

-Use ecological moment assessment (self-reports, fitness watch) to gather info about patient

  • Use this data to create a personalized model using statistical approaches such as network modelling to understand connections among processes
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8
Q

What change procedures would be used to combat these change processes?

Cognitive fusion
Avoidance
Emotion dysregulation

A

Cognitive diffusion achieved through mindfulness

Avoidance targeted through exposure

Emotional regulation achieved through cognitive reappraisal/restructuring

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9
Q

What dimensions can we personalize psychotherapy?

A
  • Diagnosis —> treatment selection
  • Specific symptoms or psychological processes —> treatment selection
    -Personality traits —> treatment selection
    -Pre-existing psychological skills(i.e. capitalization/compensation —> will affect order of targeted therapy skills)
    -Response to treatment (or lack thereof —>change treatment)
    -Change in mechanisms over time
  • Session frequency (weekly vs biweekly)
  • Length of treatment (Brief vs Full)
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10
Q

What are the core treatment models of the Unified Protocol (a trans diagnostic treatment) ?

A
  • understanding emotions (awareness)

-Increasing present-focused emotional awareness (mindfulness)

-Increasing cognitive flexibility

  • Identifying/preventing patterns of emotional avoidance and maladaptive emotion-driven behaviors

-Increasing tolerance/awareness of emotion-related physical sensations

-Interoceptive (fear of fear) and situation based emotion-focused exposure

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11
Q

What research evidence supports UP when it was compared to waitlist control for anxiety disorders? What are the limitations?

A

-Outperforms waitlist
-Can work on multiple symptoms (anxiety/depression symptoms, positive affect, increased daily functioning)
-Effects maintained after 6 months

Limitations:
-No comparison to a diagnostic specific treatment
-Limited data with other populations with problems with emotion regulation (i.e did not look at ED,BPD,etc)

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12
Q

What is a SMART design?

A

Sequential multiple assignment randomized trial) —>multiple levels of randomization

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13
Q

Explain Zavala study using SMART design to test the Unified Protocol as their basis for personalized psychotherapy

A

3 conditions:

1.Full standard treatment group —> patients received all UP modules in order described in the published manual

  1. Capitalization group —> Patients received modules that focused on their strengths
  2. Compensation group —> Patients received modules that focused on their weaknesses

They were then randomized to stop after 6 sessions or complete treatment in full (2-3 modules or all 5)

Reasons for this randomization:
-does personalizing the sequence of modules have an effect on symptom improvement?
-Can treatment be brief?

More compensation in modules:
1. Understanding emotion
2.Mindful emotion awareness

More capitalization in modules:
1. Countering emotional behaviors
2. Confronting physical sensations (interoceptive)

Outcomes:

  1. No difference in symptom outcomes —> treatment can be shortened and order of modules does not matter
  2. Ps preferred full over brief and standard/capitalization over compensation
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14
Q

Who was dialectical behaviour therapy designed for?

A

individuals with chronic suicidality or parasuicidality behaviors who did not respond to CBT treatment

In response to the challenging nature of suicidal behaviours —> recognized more support needed for both patient and therapist

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15
Q

What is Linehan’s Biosocial theory of borderline personality disorder?

A

Emotionally vulnerable person :
- strong emotions
-quick to react
-trouble neutralizing emotions

PLUS

An invalidating environment

EQUALS

Problems with:
-Ability to understand and label feelings
-Coping skills
-emotion modulation

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16
Q

In DBT, what are patients’ counterintuitive dilemma?

A
  1. Emotional vulnerability vs self-invalidation —> switch between wanting attention vs. Telling themselves they are overreacting
  2. Unrelenting crisis vs. Inhibited grieving —> Always finding problems vs. Having trouble allowing themselves to feel stress when there IS something wrong
  3. Active passivity vs. Apparent competence —> Approach life in a passive way vs appearing to be able to hold themselves together
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17
Q

How should therapists approach patient’s in DBT?

A
  1. Accept client as they are but encourage change
  2. Centred and firm by setting boundaries but flexible when needed
  3. Nurturing and empathetic but benevolently demanding in order to push client beyond where they think they can go.
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18
Q

What is the wise mind?

A

Want to balance/incorporate between the rational mind and the emotional mind.

Can be achieved through mindfulness

Want to balance between change/solving problem vs accepting and validating themselves

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19
Q

What are the components of DBT treatment?

A
  1. Individual therapy sessions
  2. Group skills training sessions —> to work on skills with others
  3. Telephone contact —> during crisis before self-harm to deescalate situation
  4. therapist consultation meetings > to support therapist

Must commit to all parts of treatment for min. 1 year.

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20
Q

What are the 5 functions of DBT?

A
  1. Enhancing capabilities
    -Improve life skills in the context of group sessions

2.Generalizing capabilities
- Homework assignments so practice skills in natural environment

  1. Improving motivation and reducing dysfunctional behaviours
    -accomplished through individual therapy
  2. Enhancing and maintaining therapist motivation and capabilities
    -through therapist consultation
  3. Structuring environment
    - To maximize effective behaviour/progressand not reinforce maladaptive behaviour (i.e. do not engage with client if they call after cutting)
    -Client needs to change their environment too —> cutting out toxic ppl
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21
Q

What is the hierarchy of therapy targets?

A
  • Suicidal and parasuicidal behaviours (cutting)
    -Therapy interfering behaviors (cancelations)
    -Behaviors that interfere with quality of life (ed behaviour)
    -behaviors related to post-traumatic stress
    -improve self-esteem
    -individual targets negatiated with client

WHAT IS DONE IN THERAPY ISN”T NECESSARILY WHAT THE CLIENT BRINGS TO THE TABLE

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22
Q

What is a diary card used for in DBT?

A

Client self-monitors their behaviors during the past week

Used to prioritize session time

If they didn’t engage in maladaptive behaviors, what did they do otherwise? Did they use their skills learned in therapy?

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23
Q

What are the 4 skills learned in DBT?

A

1.Mindfulness skills
- Observe, describe, participate
- Non-judgementally using wise
Mind
2. Interpersonal effectiveness skills
- objectiveness (interactions aren’t only focus on one’s objective), relationship with others, self-respect —> setting personal boundaries
3. Emotion regulation skills
-Identify and describe emotions, ride the wave, do not oppose emotions
4. Distress tolerance skills
- distraction, self-soothing, acceptance

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24
Q

What were the findings of DBT compared to community treatment (CBTE) for BPD women with suicidal behaviors?

A

DBT had:
-less dropout and change of therapist than CBTE
-half the rate of suicide attempts as CBTE
-Less use of crisis services and hospital admissions than CBTE

Both interventions improved symptoms of depression, suicidal ideation, and reasons for living

No difference in non-suicidal self injury between groups

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25
Q

What is some miscellaneous research evidence for DBT

A

-Shortened version of DBT is efficacious for suicidal adolescents

  • As efficacious as CBT to treat BN and BED
  • Just teaching DBT skills (without the full package) can be helpful in symptom improvement —> can be a stand-alone treatment
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26
Q

How does DBT work for jail inmates?

A

Inmates unselected for emotional/behavioral problems —>treated everyone

No statistical significance in coping skills or emotional/behavioural regulation —> likely due to small sample size (N=16)

Participant feedback was positive

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27
Q

What is psychodynamic therapy and give some examples?

A

-Originates from psychoanalysis ( but shorter with less analysis)

-Focus on unconscious processes that impact client’s present behaviour

Ex:
1. Short-term psychodynamic therapy
2. Mentalization-based therapy (for borderline)
3. Transference-focused psychotherapy (for personality disorders)

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28
Q

What are humanistic/experiential therapies and what are some examples?

A

-originates from Roger’s client centered therapy

-Based on the premise that individuals are self-actualizing —> can be the best versions of themselves

Ex:
Gestalt therapy
Existential therapy
Emotion-focused therapy

Other
Interpersonal psychotherapy

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29
Q

Why was interpersonal psychotherapy originally developed?

A

Developed as a supportive control condition for pharmacotherapy for treating depression

-shown to be equally effective

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30
Q

What distinguishes psychodynamic and humanistic therapies from CBT?

A
  1. A focus on affect and the expression of emotions
    -not solely intellectual insight but also emotional insight
    -encourage expression rather than management/control
    -want to draw attention to negative feelings
  2. Explore patient’s attempts to avoid topics or engage in activities that hinder therapy process
    -figure out why they are resistant to change —> what is the unconscious meaning
  3. Identify patterns of actions, thoughts, feelings, experiences, relationships, etc.
    -Interested in more than just thoughts
    -patterns are identified through interpretation —> reveal to client and see if it rings true to them or if they’re defensive
  4. An emphasis on past experienc
    -Identify origin of patient difficulties and how they manifest
    -Still want to focus mainly on the present but incorporate past to the extent that it is possible
  5. A focus on interpersonal experiences
    - What problematic relationships do they have? Do they have trouble seeing how they impact others through their own behaviour?
  6. Emphasis on therapeutic relationship
    -TR is a medium of chance —> if boundaries can be set with therapist, they can generalize this to their real life
    -Talk about transference
  7. Explore patient’s wishes, dreams and fantasies
    -Gives us clues to unconscious functioning
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31
Q

What is the goal, structure and candidature of short-term psychodynamic therapy?

A

Goals:
Short term —> symptom relief
Long-term —> character change (hope they will generalize skills)
Work on 1 area of focus

Structure:
-once a week for <1 year (16 sessions)
-Therapist must keep focus on chosen area

Candidature:
-Patient should be psychologically minded, insightful and motivated —> must be ready for change
-patient must have capacity to engage/disengage

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32
Q

What are the supportive techniques of short-term psychoynamic therapy?

A

-Defining therapeutic frame (therapist sets boundaries)
-Therapist demonstrates interest and respect(common factor)
-Noting gains (to help client see progress and increase self-efficacy)
-Maintain here-and-now perspective (bc short term)

33
Q

What are expressive techniques of short-term psychodynamic therapy?

A

-Offering empathetic comments
-confrontation (when needed)
-interpretation (suggestion of patterns no conclusions

Monitor countertransference (how am I reacting towards the client?)

34
Q

Why do people think CBT is more efficacious than psychodynamic therapy?

A

Because it doesn’t lend itself well to treatment manuals.

CBT is focused on symptom change whereas psychodynamic therapy is more focused on character change which takes longer

35
Q

Describe the study that compared short-term psychodynamic to an established treatment

A

Meta analysis
-Both treatments used treatment manuals
-Both ammeanable to research design
-Comparable in length
-Primary outcome: target symptoms
-Secondary outcome: general functioning

Results
- no meaningful differences between the two
-slight favor for CBT but magnitude is so small that its insignificant
-Psychodynamic was better at improving functioning (secondary outcomes) at follow up points (small effect size)

36
Q

What was emotion-focused therapy originally called and what is its theory?

A

-Originally called process-experiential therapy
-emotions are a key determinant of self-organization
-emotions are useful from an evolutionary standpoint but how we make sense of them is influenced by culture

-Goal of therapy is to relearn meaning of emotions in a constructive way

37
Q

What are the 4 types of emotions according to emotion-focused therapy?

A
  1. Primary —> direct initial reactions
  2. Secondary —>reactions to/judgement of our emotions (cognitive component)
  3. Adaptive —> Primary emotions that communicate information (i.e. fight/flight)
  4. Maladaptive —> do not communicate information bc they are reitively stable regardless of environment (what keeps you stuck)

The same emotion can be placed into any of the 4 categories based on the situation

38
Q

What are the 3 principles targeted in emotion-focused therapy treatment?

A

-emotion awareness
-emotion regulation
-emotion transformation

39
Q

In EFT, what is emotion awareness?

A

-Become aware of primary emotions
-Don’t think about feeling but actually feel the feeling in session
-Accept rather than avoid emotional situations
-Express emotions , including what you feel in words
-Ask yourself what these emotions make you want to do

40
Q

In EFT, what is emotion regulation?

A

-Primary emotions do not need to be regulated (only secondary and maladaptive ones)
-Teach emotional regulation skills such as self-soothing, and tolerance

41
Q

In EFT, what is emotion transformation?

A

-Replace maladaptive with adaptive
-Change emotion with emotion (fight fire with fire)
-Shift attention to the negative to positive, use positive imagery, remember another emotion (i.e. when you felt better)

42
Q

In EFT what is two-chair and empty chair dialogue?

A

Two-chair —>For self-critical conflicts, one side of you wants to be more confident and one side is self-critical —> play out both sides of the conversation —> used to externalize emotions

Empty chair —> talk to an empty chair to deal with unfinished business you have with others (that are dead or no longer in your life)

43
Q

What research evidence is there in EFT?

A

EFT for major depression
- EFT similar outcomes to CBT but showed greater improvements in interpersonal problems

-Symptom remission greater in EFT than client-centered therapy (better than supportive psychotherapy)

44
Q

What is Interpersonal therapy? What is its structure and suitability?

A

-Concerns with relational factors that predispose (vulnerabilities), precipitate (Before onset) and perpetuate (maintenance factors) distress

12-16 sessions

Candidature:
-Secure attachment with a SPECIFIC interpersonal problems and a good support system (Cannot be abusive)

45
Q

What are some problem areas targeted in IPT?

A
  1. Role transitions (move, new job, divorce)
    2.Role disputes (infidelity, unmet expectations, ongoing problems)
  2. Grief
    4.interpersonal sensitivity (LAST RESORT, general patterns of of difficulties in relationships)
46
Q

What is the IPT structure?

A

-note interpersonal inventory to assess life experiences and choose 1 problem area

-work collaboratively to develop problem solutions

-Patient implements solutions between sessions

47
Q

What are IPT techniques?

A

interpersonal incidents
—>reviewing recent conflicts to help clients understand their role in these situations and to process their emotions

Communication analysis
—> Examining a recent interaction to help clients identify ineffective communication and to understand their role impact of their words/actions to thus develop more adaptive ways to express themselves

Problem-solving
—>developing strategies to address interpersonal issues

Role play
—>rehearsing new ways of interacting in specific situations

Encouragement of affect
—> to express/explore emotions related to interpersonal issues to promote emotional processing and resolution.

48
Q

What research evidence is there for IPT?

A

IPT outperformed other psychotherapies in meta analysis for depression (d=0.62)

-For BN and BED, CBT and IPT is comparable but IPT takes much longer to show the same improvements

49
Q

What are the 3 pillars of mindfulness?

A

1.Intention (to what we are doing and why)

  1. Attention (to the present without being preoccupied with the past/future)
  2. Attitude (HOW do we pay attention, i.e. nonjudgementally)
50
Q

What are the 7 attitudinal foundations of mindfulness?

A
  1. Non-judging
    -Being an impartial witness to one’s experience
  2. Patience
    -Letting things unfold on their own time

3.Beginners mind
-Being receptive to new possibilities that mindfulness may bring to you

  1. Trust
    -In yourself, your feelings, the process
  2. Non-striving
    -Goal is to be yourself not to achieve something

6.Acceptance
-Seeing things as they are in the present

  1. Letting go/ non-attachment
    -Go with the flow, like letting yourself all asleep
51
Q

What is formal mindfulness meditation practice?

A

Setting aside time to do this

-Mindful breathing
-body scan
-Mountain meditation (picture yourself as a mountain that is and always will be no matter the weather)
-Loving kindness mediation (fostering warm thoughts for yourself and others)

52
Q

What is informal mindfulness practice ?

A

Day to day —> incorporated into routine

-Awareness of thoughts/emotions/bodily sensations/sensory input during everyday activities

53
Q

What is Mindfulness-based stress reduction (MBSR)?

A

-Formal program (NOT a psychotherapy)
- 8 week workshop
-Compliment to traditional treatment
- Certified teachers only need a 7 day course (highly commercialized)

-Designed to reduce stress, burnout, etc (things that aren’t formal diagnoses)

54
Q

What is mindfulness based cognitive therapy (MBCT)?

A

-Developed as a depression relapse prevention
-Group treatment that incorporates MBSR with CBT
-Move away from CBT’s emphasis on changing content of negative thinking towards attending to the ways you process emotions/thoughts
-3rd wave behavioral therapy

-At the end of CBT treatment, there is much less relapse from those assigned MBCT than TAU

55
Q

What research evidence is there for MBCT and MBSR?

A

MBCT For depression, anxiety, physical ailments, mental conditions
—>moderate-large effects for anxiety and mood
—>large effects for anxiety and mood for those with mood/anxiety disorders

MBSR for healthy ppl
—> medium effect for mindfulness, depression, anxiety, distress, and quality of life
—>large effects on stress
—> evidence that MBSR is helpful to everyone regardless of condition

56
Q

What is Acceptance and commitment therapy theory?

A

-Uses acceptance and mindfulness processes and commitment and behaviour change processes to produce PSYCHOLOGICAL FLEXIBILITY

-Does not posit itself as a treatment for any kind of disorder —>goal is to be psychologically flexible

-Pain does not equal suffering —> suffering comes from our attempts to change/control our experiences /pain

57
Q

What is the philosophical foundation of ACT?

A

Relational frame theory

-Our mind makes arbitrary connections between things, with connections based on history and context

-The way in which we navigate our world is based on what we’ve already learned

-We make sense of our emotions/thoughts based on past experiences and context

-our suffering is based on language

58
Q

Describe each treatment target of the ACT hexaflex and what is the corresponding treatment technique

A

Inflexibility —> flexibility

1.Cognitive fusion —> cognitive defusion
—> Thoughts do not define us
—> notice your thoughts as they passively go by and recognize they are just thoughts

  1. Experiential avoidance —> Acceptance
    —> Do not try to attempt to avoid /alter internal experiences or negative emotions
    —> adapt a flexible and curious posture to our moment-to-moment experiences, accept them

3.Loss of flexible contact with the present —>Attend to present
—> use mindfulness to be present and to stop wishing you were somewhere else
—> use language to describe the present instead of judging/predicting the future

  1. Attachment to conceptualized self —> contact with observing self
    —> take an observer perspective and promote contact with the here-and-now version of yourself
    —> stop attaching yourself to this idealized version of who you want to be
  2. values problems —> Values identification exercises
    —> identify what’s important to you
    —> Persist/change your behavior so that it is in line with your values
    —> Values should be your own should be well defined, and should not promote avoidance (preventing something negative from happening)
  3. Inaction, impulsivity, and avoidance persistence —> short/medium/long term SMART-goal setting
    —> develop goals that are related to your values and that are specific, measurable, achievable, relevant, time-bound
59
Q

What two metaphors does ACT use to illustrate creative hopelessness?

A

Creative hopelessness: Making patients aware that what they have done so far is unhelpful. Even creative ways have been unhelpful and this furthers feelings of hopelessness

Chinese finger trap: the more you struggle, the harder it becomes
Tug of war: Put down the rope, you can have a fulfilling life be with those negative thoughts in the background

60
Q

What research evidence is there for ACT?

A

Less RCT evidence bc its not developed for a specific disorder

-Research focuses more on processes of change rather than symptom outcomes —> focused more on functional improvements

Evidence of efficacy for depression, anxiety conditions, chronic pain, OCD, psychosis

61
Q

What are some differences between. Top-down and bottom-up processing?

A

Top-down
- Mediated by PFC
-Slow
-Deliberate
-Explicit
-Strategic processing
-Uses rule based knowledge
-Main target CBT
-Cognitive restructuring increases top-down control over negative emotions

Bottom-up
- Mediated by lower-brain regions
-Automatic
-Effortless
-Implicit
-Pre-conscious processing
-based on salient features/situational cues
-Not targeted in CBT but changes nonetheless
-Medication decreases bottom-up processing of emotional stimuli

62
Q

What brain regions does CBT alter in depression?

A

-Dorsolateral, ventrolateral, and medial PFC
- Anterior and Posterior cingulate cortex

-higher order areas
-Modulation of top-down processes in encoding/retrieving negative memories, rumination,etc

Modulation of TOP-DOWN structures

63
Q

What brain regions ones CBT in anxiety?

A

-Dorsolateral, ventrolateral, and medial PFC
-Postulate cingulate cortex
-Reduces amygdala activation
- reduces Hippocampusctivity
-Anterior and medial temporal cortex

Modulation of BOTTOM-UP and TOP-DOWN structures

64
Q

HOW does CBTchange the brain?

A

Exerts cognitive control over emotion.

—> cognitive reappraisal increases activation of Dorsolateral and ventrolateral PFC and posterior cingulate cortex

—> decreases amygdala activity by increasing functional connection to the PFC both at resting and while doing tasks—> can exert more control over it and dampen down its responses

65
Q

How does mindfulness change your brain?

A

After 8 week of MBSR program
-increased activation in the left side of the brain
-increased optical thickening in higher brain areas
-decreased activity of amygdala but stronger connection to PFC

66
Q

What is recommended as the first line of pharmacological treatment for depression? Why is it considered superior to tricyclics and monamine inhibitors? Who benefits the most? What are some risks?

A

SSRIs
-fewer side effects
-less fatal if overdose
-aren’t more effective

—>benefited the most for severe depression bc this population cannot engage in CBT (too much effort)

—> Should stay on medication for min 1 year to avoid relapse —> most ppl discontinue 3 months due to symptom alleviation but most episodes last 9 months

67
Q

What is deep-brain stimulation? Why is it good for research? Which population is it recommended for?

A

Neurotransmitters are implanted in the brain and sends electrical signals to SPECIFIC/TARGETTED subcortical brain areas

-Good for research bc control is built in —> sham vs active stimulation

-Not recommended as a first line of treatment but is effective for those who have resistant disorders

-subgenual cingulate targeted for treatment resistant depression —> 4/6 improved

68
Q

What psychedelics are used to treat disorders?

How does psychedelic assisted therapy ?

A

Psilocybin
LCD
Ayahuasca
MDMA

  1. Preparatory therapy (safety planning)
    2.Psychedelic accompanied sessions (1-3 normal doses)
    3.follow up processing in integrative therapy
69
Q

Why would you combine psychedelics with psychotherapy?

A

-May be a synergetic treatment —> greater than the sum of its parts

-Psychodelics may increase neuroplasticity which may facilitate brain changes during psychotherapy

needs to be tested using a factorial design (not sure what that would be)
What is a drug placebo?

70
Q

Describe the study on beliefs about psychotherapy

A

Ps with elevated depresses on

Pre-test: received biological explanation for depression the randomized to 3 conditions

-Brain level psychotherapy description: Educated on how psychotherapy affects the brain
-Mind-level psychotherapy description (Active control): educated on how psychotherapy has benefits
-inactive control: received nothing

Brain level: rated psychotherapy as more effective
Inactive contro: rated psychotherapy as less efective
Mind-level: no change

71
Q

What is the treatment gap? How does is vary by location?

A

The difference between people who have a disorder and the proportion who receive care

-Treatment gap varies by location but most people who needs psychotherapy do not receive it (even in the US 33%)

72
Q

Why is there a treatment gap? What are the barriers to receiving treatment?

A

-Treatment provided on a 1-1 basis
-Treatment administered by highly trained professionals (low numbers)
-Sessions held in private office/clinic which requires client displacement
-Stigma
-Cost
Cultural barriers

73
Q

What are some models of delivery that reduce the treatment gap?

A
  1. task-shifting: Redistributing work to a larger range of people with less training and fewer qualifications
  2. Best Buy interventions: Selection on cost-effectiveness and feasibility or appropriateness to implement in the environment —> interventions that will indirectly reduce symptoms —> i.e taxing cigarettes, promoting excersize
  3. Disruptive innovations: Distinct change to what is being done right now, i.e. telemedicine
  4. Interventions in everyday settings: reach people where they are in high volumes
  5. Entertainment education: embedded information in television/radio, i.e. through characters

6.Use of social media: Content online that can aid in recovery

  1. Use of technologies: internet/app based treatment delivery, i.e. better help

8.Community partnership model: figuring out what the community needs and collaboratively develop action plans

74
Q

What are some uses of technology in treatment?

A
  1. Psychoeducational or self-help formats
    —> collection of tools designed to be educational
    —> presented as lessons instead of sessions that each tackle 1 topic
    —>Ex: Steven Hayes 7 part mini series
    —> NOT treatments

2.Digital treatments
—>Retain structure and components of treatment
—>May have some degree of personalization (machine learning may improve this)

  1. Digital assessment
    —> questionnaires that are automatically sores and interpreted
    —> information transmitted to clinician
    —> can be used to self-monitor
    —> potential for real-time interventions: client reports high levels of symptoms and resources can be sent to their house

4.Digital training and dissemination
—> clinical training websites with client-therapist interaction videos
—> standardized training
—> lower costs

75
Q

What does research suggest about technological treatment?

A

-Popular and reach a lot of people
-Completion rates are low without accompanying support
-Online clinics (Mindspot) can produce clinically relevant change on a large scale
- supported interventions have greater impact that unsupported ones
-with support, outcomes are similar to face-to-face

76
Q

What are future research questions for technological treatments?

A

-How can interventions be tailored to the nature of the psychopathology? How can it be more personalized
-How do we evaluate the efficacy of digital interventions (RCTs too slow)
-How much support is necessary for improved outcome to have an impact (what is the balance between scalability and support)

77
Q

What are the types of single-session interventions?

A
  1. Pre-therapy or waitlist intervention
    —> provides psychoeducation or prepares them for therapy
  2. Delivered following cognitive assessment and combined with therapeutic resources
  3. Delivered online with/without support (through social media)
78
Q

What are the advantages of single-session interventions?

A

-Brief and thus cheaper
-Scalable, especially when implemented online
-Can reach people who can’t afford regular therapy or those with barrier to receiving treatment

79
Q

Describe the study for the online single-session interventions for adolescent depression

A

Compared 2 single session interventions to active control

Growth mindset: teaches them that personality and the can be changed
Behavioral activation : promotes activity engagement to elicit pleasure and mastery
Active control: supportive SSI that encourages emotional expression

Primary outcomes: Hopelessness and agency post treatment

Decreased depression post 3 months for all 3 groups but changes were more significant for the GM and BA groups

Compared to control, both decreased hopelessness, increased agency (small effect size)

Diverse sample (most were a sexual minority)

BA more increase in agency
GM more decreases in anxiety

large implication —> very scalable despite small effects

PSYC332 (2 decks)

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