Assessing the Statistical and Personal Significance of the Method of Levels

Carey, Timothy A.; Carey, Margaret; Mullan, Richard J.; Spratt, Christopher G.; Spratt, Margaret B.

doi:10.1017/s1352465809005232

Cited by 83 publications

(33 citation statements)

References 36 publications

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“…An initial qualitative study looking at the experience of receiving MOL suggests that clients judged it to be a generally useful experience (Carey et al 2009). So far, however, there has not been any in-depth qualitative research that explores clients' experiences of receiving MOL, either for psychosis-related difficulties or more generally.…”

Section: Client Perspectives On Psychotherapymentioning

confidence: 99%

‘It was me answering my own questions’: Experiences of method of levels therapy amongst people with first‐episode psychosis

Griffiths

Mansell

Edge

et al. 2019

Int J Mental Health Nurs

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In this study, we aimed to understand how people with first‐episode psychosis experienced a transdiagnostic cognitive therapy called method of levels (MOL). Semistructured interviews were conducted with 12 individuals who were participants of a feasibility randomized controlled trial of MOL for first‐episode psychosis. Interviews were analysed using thematic analysis. Four superordinate themes were identified: ‘The therapist's approach’; ‘I was in control’; ‘Thinking and talking’; and ‘Looking at problems from a different perspective’. Our findings suggest that therapy was experienced as most helpful when participants perceived themselves to have control over the process of therapy, could explore and express a wide range of difficulties, and were able to generate new perspectives on their problems. MOL and its associated system of client‐led appointment scheduling were predominantly perceived to be helpful and appear suitable for further testing in a larger clinical trial.

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Section: Client Perspectives On Psychotherapymentioning

confidence: 99%

‘It was me answering my own questions’: Experiences of method of levels therapy amongst people with first‐episode psychosis

Griffiths

Mansell

Edge

et al. 2019

Int J Mental Health Nurs

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“…The questioning style used in MOL promotes a detailed exploration of cognitive processes and, in particular, the way in which different cognitive states relate to each other. MOL has been developed and evaluated in routine clinical practice in both Australia and the United Kingdom since 2002 with effect sizes such as 0.77, 1.36, and 1.45 reported [18, 19]. …”

Section: Applying a Cognitive Therapy To A Mobile Phonementioning

confidence: 99%

“…Apart from the demonstrated effectiveness of MOL [18, 19], one of the interesting clinical outcomes that has been reported anecdotally by patients is that, through repeated MOL sessions, patients begin to internalise the MOL questioning style. Since one of the priorities of MOL is to help the patient to “get along without the therapist”, it was of interest to determine if technology could be used to provide a resource for people to access MOL-style questions outside therapy sessions.…”

Section: Applying a Cognitive Therapy To A Mobile Phonementioning

confidence: 99%

MindSurf: a pilot study to assess the usability and acceptability of a smartphone app designed to promote contentment, wellbeing, and goal achievement

et al. 2016

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BackgroundThe Method of Levels (MOL) is a transdiagnostic cognitive therapy that promotes contentment, wellbeing, and goal achievement through the resolution of internal conflicts underlying psychological distress. MOL, based on Perceptual Control Theory (PCT), was developed in routine clinical practice and has been used effectively across different health services by different practitioners. Access to MOL-style questions through a smartphone app could, potentially, help both the general public maintain robust mental health, and also be a useful adjunct to therapy for clinical populations. The app is called MindSurf because of its focus on helping people explore their thinking. Prior to developing the app and using it with different populations it was necessary to determine whether such an idea would be usable for and acceptable to potential app users. Therefore, a pilot study was conducted with a non-clinical sample to assess the usability and acceptability of the app including monitoring whether the questions delivered in this way were associated with any adverse events.MethodsA pilot study using quantitative as well as qualitative methods and incorporating a repeated measures, A-B design was conducted.ResultsThe 23 participants were healthy adult volunteers who were all either undergraduate students, postgraduate students, or staff of the University of Manchester. They received MOL-style questions on their mobile phones over a 1-week period. Qualitative results were encouraging and indicated that the format and style of questioning were acceptable to participants and did not lead to increased worry or concern. A one-way, repeated measures ANOVA indicated that there was a nonsignificant decrease in scores on the 21-item Depression, Anxiety, and Stress Scale (DASS21) over a 2 week period.DiscussionThe results of the pilot study justified development of MindSurf and further testing once it is available for use. A power analysis indicated that the pilot study was underpowered to detect significant effects but provided important information regarding the appropriate sample size for future research. The pilot study also indicated that future research should investigate the effects of receiving more than three questions per day.ConclusionResults of the pilot study indicate that MindSurf will be a usable and acceptable app. Its benefits should be further explored through longer studies with larger sample of both the general population as well as clinical populations.

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“…They have also replicated this work in different health systems such as Improving professional psychological practice 14 from the Scottish NHS to the Australian public mental health service . Effect sizes of 0.80 (Carey & Mullan, 2008); 0.77 and 1.36 (Carey et al, 2009); and 1.45 measures are administered at every appointment so that when Time 2 occurs, the patient's last outcome score is used to compare with their Time 1 score. Essentially, this means that the results achieved with MOL trials may be underestimates of the actual effect size because some people will not record the progress at the time of the comparison that they will eventually go on to make beyond Time 2 .…”

Section: Trials Of Molmentioning

confidence: 99%

Improving professional psychological practice through an increased repertoire of research methodologies: Illustrated by the development of MOL.

Carey

Tai

Mansell

et al. 2017

Professional Psychology: Research and Practice

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Mental health problems present an increasing global disease burden making the development of effective and efficient psychological treatments an urgent public health priority. Despite the continued proliferation of treatments and large numbers of randomized controlled trials (RCTs), evidence suggests that pre-post effect sizes have been decreasing over time not increasing. Promoting RCTs as a gold standard of evidence has not been a useful strategy for advancing progress in the development of increasingly effective and efficient psychological treatments and has, in fact, created a divide between research and practice in professional psychology. To close this divide, other methodologies are needed that can assist in the rigorous development and evaluation of treatments in routine clinical practice. We outline some of the problems with using RCTs as the sole means of generating evidence for treatment effectiveness and efficiency and we use the development and evaluation of a transdiagnostic cognitive therapy to illustrate an alternative way of accumulating evidence through a much closer connection between research and practice. Ultimately, including other methodologies alongside RCTs that combine research and practice more seamlessly, will produce treatments of greater effectiveness and efficiency and help to reduce the global burden of mental health problems.

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Assessing the Statistical and Personal Significance of the Method of Levels

Abstract: Results suggest that MOL is a useful form of psychotherapy that warrants further investigation.

Cited by 83 publications

References 36 publications

‘It was me answering my own questions’: Experiences of method of levels therapy amongst people with first‐episode psychosis

‘It was me answering my own questions’: Experiences of method of levels therapy amongst people with first‐episode psychosis

MindSurf: a pilot study to assess the usability and acceptability of a smartphone app designed to promote contentment, wellbeing, and goal achievement

Improving professional psychological practice through an increased repertoire of research methodologies: Illustrated by the development of MOL.

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