psychotherapy - scaling up psychotherapy

what did Kazdin (2017) address?

treatment gap, difference in people who have a disorder and proportion who receive care

what did the WHO mental health survey across 14 countries find?

0.9% (Nigeria) to 15.3% (US) received treatment who needed it

what did the National Comorbidity Survey-Replication in US find?

only a third of people with psychiatric problems received adequate treatment

what reasons does Kazdin (2017) list for the treatment gap?

treatment provided on a one-to-one basis, administered by highly-trained professional, and sessions held at a specific location

what novel models of delivery related to therapy are proposed in Kazdin (2017)?

task shifting, best-buy interventions, disruptive innovations, interventions in everyday settings

what is task shifting?

redistributing work to a broad range of individuals with less training and fewer qualifications

what are best-buy interventions?

selected based on cost-effectiveness, feasibility, and appropriateness to implement in setting

what are disruptive innovations?

distinct change from what is being done currently?

what novel models of delivery not necessarily related to therapy are proposed in Kazdin (2017)?

entertainment education, use of social media, use of technology, and community partnership model

what are potential uses of technology in treatment?

psychoeducational or self-help formats, digital treatments, digital assessment, digital training and dissemination

what are psychoeducational or self-help formats of technology in treatment?

collection of “tools” designed to be educational that are presented as lessons rather than sessions

how are digital treatments similar to original treatments?

retain structure and components

how are digital treatments different from original treatments?

“session” times set aside by user for intervention, user can select most relevant components

what is a benefit of doing questionnaires digitally?

they can be automatically scored and interpreted with the information transmitted to clinician

what can clients do with digital assessments?

can self-monitor thoughts, mood, activities or track non self-report phenomena like sleep or physical activity

what are benefits of digital training and dissemination?

can reach more users, lower costs, standardized training provided

what has been found about digital interventions’ popularity?

they are popular and reach many but completion rates are low without accompanying support

how does the addition of support affect the impact of interventions?

supported interventions have a greater impact than unsupported ones, though not always by much

how do digital interventions with support compare to face-to-face interventions?

outcomes are similar, but need larger scale studies to systematically test this

what are the types of single-session interventions?

pre-therapy or waitlist intervention, post-assessment intervention with therapeutic resources, and delivered online with or without support

what are the advantages of single-session interventions?

brief, so less costly, scalable, especially digital, reach more people

what was the Schleider et al (2022) study?

nationwide RCT of online single-session interventions for adolescent depression

what did Schleider et al (2022) compare?

growth mindset (GM-SSI) and behavioral activation (BA-SSI) to active control

what were the primary outcomes of Schleider et al (2022)?

hopelessness and agency post-treatment and depressive symptoms at 3 months

who were the participants in Schleider et al (2022)?

2,451 13-16 yos recruited via Instagram who reported elevated depression

what does GM-SSI teach?

neuroplasticity, growth mindsets to persevere, personality can change

what is included in BA-SSI?

values assessment, activity action plan, benefits/obstacles

what was the control condition in Schleider et al (2022)?

supportive SSI that encourages emotion expression but does not teach behavioral skills

what did Schleider et al (2022) find about depressive symptoms at 3 months?

decreases in GM-SSI and BA-SSI relative to control

what did Schleider et al (2022) find about hopelessness and agency?

decreases in hopelessness and increases in agency in GM-SSI and BA-SSI relative to control

what is a strength of the Schleider et al (2022) study?

it shows acceptability and efficacy of interventions for a diverse sample since 80% of participants ID’d as sexual minority