Assessing and promoting the use of implementation intentions in clinical practice

Duhne, Paulina Gonzalez Salas; Horan, Andrew J.; Ross, Caitlin; Webb, Thomas L.; Hardy, Gillian E.

doi:10.1016/j.socscimed.2020.113490

Cited by 14 publications

(7 citation statements)

References 61 publications

(79 reference statements)

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“…Therapists may overestimate their adherence to practice guidelines, as 32% reported not providing all parts of treatments [ 32 ], while this study suggests that adherence rates are much smaller. Session summary, or feedback, can be perceived as a method for prompting clients to form implementation intentions, thereby likely facilitating greater treatment impact; however, prior research has found that therapists do not often explicitly discuss with their clients to plan actions as a result of the treatment session [ 33 ]. Further, higher-caseload therapists reported feeling that learning about new EBTs would be time-consuming, which consequently could serve as a barrier to implementing these techniques [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

A Comparison Between Clinical Guidelines and Real-World Treatment Data in Examining the Use of Session Summaries: Retrospective Study

Sadeh‐Sharvit¹,

Rego²,

Jefroykin³

et al. 2022

JMIR Form Res

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Background Although behavioral interventions have been found to be efficacious and effective in randomized clinical trials for most mental illnesses, the quality and efficacy of mental health care delivery remains inadequate in real-world settings, partly owing to suboptimal treatment fidelity. This “therapist drift” is an ongoing issue that ultimately reduces the effectiveness of treatments; however, until recently, there have been limited opportunities to assess adherence beyond large randomized controlled trials. Objective This study explored therapists’ use of a standard component that is pertinent across most behavioral treatments—prompting clients to summarize their treatment session as a means for consolidating and augmenting their understanding of the session and the treatment plan. Methods The data set for this study comprised 17,607 behavioral treatment sessions administered by 322 therapists to 3519 patients in 37 behavioral health care programs across the United States. Sessions were captured by a therapy-specific artificial intelligence (AI) platform, and an automatic speech recognition system transcribed the treatment meeting and separated the data to the therapist and client utterances. A search for possible session summary prompts was then conducted, with 2 psychologists validating the text that emerged. Results We found that despite clinical recommendations, only 54 (0.30%) sessions included a summary. Exploratory analyses indicated that session summaries mostly addressed relationships (n=27), work (n=20), change (n=6), and alcohol (n=5). Sessions with meeting summaries were also characterized by greater therapist interventions and included greater use of validation, complex reflections, and proactive problem-solving techniques. Conclusions To the best of our knowledge, this is the first study to assess a large, diverse data set of real-world treatment practices. Our findings provide evidence that fidelity with the core components of empirically designed psychological interventions is a challenge in real-world settings. The results of this study can inform the development of machine learning and AI algorithms and offer nuanced, timely feedback to providers, thereby improving the delivery of evidence-based practices and quality of mental health care services and facilitating better clinical outcomes in real-world settings.

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Section: Discussionmentioning

confidence: 99%

A Comparison Between Clinical Guidelines and Real-World Treatment Data in Examining the Use of Session Summaries: Retrospective Study

Sadeh‐Sharvit¹,

Rego²,

Jefroykin³

et al. 2022

JMIR Form Res

View full text Add to dashboard Cite

show abstract

“…Recent studies have achieved positive intervention effects by integrating II interventions with other BCTs [71,72], such as MCII [73]. Undoubtedly, as a necessary "bridge" between intention and behavior [13], IIs have broader application value in the field of PA.…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of Implementation Intentions Interventions in Promoting Physical Activity among University Students

et al. 2023

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Implementation intentions (II) have demonstrated their efficacy in promoting physical activity (PA) among various populations, including adults, the general population, and those with chronic conditions. However, there is a dearth of meta-analyses examining this efficacy among university students. This meta-analysis aims to determine the effectiveness of II interventions in improving PA among university students. Six online databases (PubMed, Embase, Web of Science, Cochrane Central, PsycINFO, and PsycArticle) were comprehensively searched. Recursive searching and grey literature collection strategies were employed to identify relevant studies. The meta-analysis employed a random-effects model to combine effect sizes for different PA outcomes. The Cochrane Risk of Bias tool was used to assess the quality of the included studies, and sensitivity analysis was performed to assess the robustness of the results. Twelve studies involving 1916 participants met the inclusion criteria. The findings indicated that II interventions significantly increased PA among university students compared to control groups (standardized mean difference [SMD] = 0.31, 95% confidence interval [CI]: 0.12, 0.50, p < 0.001). Subgroup analyses revealed larger effect sizes in the following groups: publication year after 2013, inactive university students, the reinforcement group, the action planning group, and the intervention period of fewer than six weeks. The above findings offer compelling evidence that II interventions can effectively promote PA among university students. The integration of IIs with e-health platforms and the implementation of individualized and multifaceted intervention models exhibit promising sustainability for promoting PA on campus.

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“…Another promising area of future research is to examine whether direct antecedent-focused strategies also facilitate the initiation of other interventions in real-life contexts. There is some preliminary support for this suggestion (Duhne et al, 2020;Rowe et al, 2016;Sheeran et al, 2007). Future research should further examine whether and how direct antecedent-focused strategies (e.g., implementation intentions or goal priming) may support the initiation of other intervention strategies, particularly in reaction to feelings of craving (e.g., 'If I experience craving, then I will perform the Go/No-Go task').…”

Section: Reflection On the Three Main Hypothesesmentioning

confidence: 99%

“…In one illustrative study, self-compassion priming resulted in higher willingness to engage in mindfulness training through increased state mindfulness (Rowe et al, 2016). Formation of implementation intentions has also shown to increase attendance for psychotherapy (Sheeran et al, 2007) and can help patients achieve their goals (Duhne et al, 2020). The need to examine whether and how direct antecedent-focused strategies might engage initial use of response-focused intervention strategies is warranted and forms an important avenue for future research.…”

Section: Direct Antecedent-focused Strategies Support Other Intervention Strategiesmentioning

confidence: 99%

Targeting automatic processes to reduce unhealthy behaviours: a process framework

Larsen

Hollands

2021

Health Psychology Review

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While previous frameworks to address health behaviours through targeting underlying automatic processes have stimulated an improved understanding of related interventions, deciding between intervention strategies often remains essentially arbitrary and atheoretical. Making considered decisions has likely been hampered by the lack of a framework that guides the selection of different intervention strategies targeting automatic processes to reduce unhealthy behaviours. We propose a process framework to fulfil this need, building upon the process model of emotion regulation. This framework differentiates types of intervention strategies along the timeline of the unfolding automatic response, distinguishing between three broad classes of intervention strategiesdirect antecedent, indirect antecedent, and responsefocused. Antecedent-focused strategies aim to prevent the exposure to or activation of automatic responses directly through the avoidance of unwanted stimulus-response associations (i.e., situation modification or situation-specific response selection), or indirectly through automatising self-control (i.e., attentional deployment or cognitive change). Responsefocused strategies aim to directly downregulate automatic unwanted responses (i.e., response modulation). Three main working hypotheses derived from this process framework provide practical guidance for selecting interventions, but await direct testing in future studies.

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Assessing and promoting the use of implementation intentions in clinical practice

Cited by 14 publications

References 61 publications

A Comparison Between Clinical Guidelines and Real-World Treatment Data in Examining the Use of Session Summaries: Retrospective Study

A Comparison Between Clinical Guidelines and Real-World Treatment Data in Examining the Use of Session Summaries: Retrospective Study

Meta-Analysis of Implementation Intentions Interventions in Promoting Physical Activity among University Students

Targeting automatic processes to reduce unhealthy behaviours: a process framework

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