Identifying active ingredients in cognitive-behavioral therapies: What if we didn't?

Lorenzo‐Luaces, Lorenzo

doi:10.1016/j.brat.2023.104365

Cited by 12 publications

(9 citation statements)

References 128 publications

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“…We strongly encourage researchers to follow the guidelines put forward by Kazdin (2007). As can be clearly be seen in Lorenzo-Luaces (2023) and Lemmens et al . (2016), the literature is far from reaching that goal.…”

Section: Where Should We Go From Here?mentioning

confidence: 60%

“…Why is this so? Earlier in this paper, four reasons were provided which offer an agenda for doing things better (Lorenzo-Luaces, 2023; Lorenzo-Luaces et al ., 2015; Lutz et al ., 2021; Nock, 2007; Tolin et al ., 2023): We should promote the measurement of MOC alongside the evaluation of treatments efficacy (e.g. Kazdin, 2007; Murphy et al ., 2009).…”

Section: We Have a Problem!mentioning

confidence: 99%

“…We have a problem! Evaluation of MOC in psychological treatment can be both fruitful (if mechanisms are found), but also at the same time demanding, time-consuming and difficult (Doss, 2004;Kazdin, 2007;Kraemer et al, 2002;Lorenzo-Luaces, 2023;Lorenzo-Luaces et al, 2015). Why is this so?…”

Section: Shared Mechanismsmentioning

confidence: 99%

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How effective psychological treatments work: mechanisms of change in cognitive behavioural therapy and beyond

Salkovskis,

Sighvatsson,

Sigurdsson

2023

Behav. Cogn. Psychother.

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Background: Cognitive behavioural therapy (CBT) has, in the space of 50 years, evolved into the dominant modality in psychological therapy. Mechanism/s of change remain unclear, however. Aims: In this paper, we will describe key features of CBT that account for the pace of past and future developments, with a view to identifying candidates for mechanism of change. We also highlight the distinction between ‘common elements’ and ‘mechanisms of change’ in psychological treatment. Method: The history of how behaviour therapy and cognitive therapy developed are considered, culminating in the wide range of strategies which now fall under the heading of cognitive behavioural therapy (CBT). We consider how the empirical grounding of CBT has led to the massive proliferation of effective treatment strategies. We then consider the relationship between ‘common factors’ and ‘mechanisms of change’, and propose that a particular type of psychological flexibility is the mechanism of change not only in CBT but also effective psychological therapies in general. Conclusion: Good psychological therapies should ultimately involve supporting people experiencing psychological difficulties to understand where and how they have become ‘stuck’ in terms of factors involved in maintaining distress and impairment. A shared understanding is then evaluated and tested with the intention of empowering and enabling them to respond more flexibly and thereby reclaim their life.

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Section: Where Should We Go From Here?mentioning

confidence: 60%

Section: We Have a Problem!mentioning

confidence: 99%

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How effective psychological treatments work: mechanisms of change in cognitive behavioural therapy and beyond

Salkovskis,

Sighvatsson,

Sigurdsson

2023

Behav. Cogn. Psychother.

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“…In addition to the use of ML methods, at present several 'holy grails' are being pursued in mental health research including: having data-driven classifications of psychopathology (e.g., the HiTOP), rebuilding classification from the ground up by using behavioral neuroscience (e.g., the RDoC), identifying mechanisms of effective treatments, the development of treatments that target novel mechanisms, and, as I have recommended, dissemination and implementation of existing treatments. It is not clear which, if any, of these research programs have the potential to reduce the public health burden of psychopathology (Lorenzo-Luaces, 2023).…”

Section: Another Way Forward: Simulation Modelingmentioning

confidence: 99%

“…There has been a recent interest in quantifying and formalizing assumptions of psychological research (Guest & Martin, 2021). Some work in mental health has used simulations to identify which are the best targets of mental health interventions (e.g., cognitive targets vs. behavioral targets, see Lorenzo-Luaces, 2023). Formalizing our assumptions of expected costs and benefits from using ML methods, disseminating and implementing SSIs, or other pursuits could similarly advance the field by uncovering which 'holy grails' stand on better footing.…”

Section: Another Way Forward: Simulation Modelingmentioning

confidence: 99%

Commentary: Holy grails, personalized medicine, and the public health burden of psychopathology – a reflection on Ahuvia et al. (2023)

Lorenzo‐Luaces

2023

Child Psychology Psychiatry

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Clinical psychology and psychiatry have many ‘holy grails’ or research findings that are widely sought after but remain elusive. The use of machine learning (ML) models for treatment selection is one of these holy grails. Ahuvia et al. (Journal of Child Psychology and Psychiatry, 2023) recently analyzed a large trial (n = 996) of two distinct single‐session interventions (SSIs) for internalizing distress and found little evidence that an ML model could predict differential treatment response. I discuss potential avenues for advancing SSI research. One avenue is the dissemination and implementation of SSIs, including how they interact with other treatments in routine care. Quantifying and critically questioning the promises of holy grails like ML models is sorely needed. Using simulation modeling to evaluate the relative merits of using ML models for treatment selection or using SSIs versus other treatment strategies may be another path forward.

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State of the Science: Using Digital Mental Health Interventions to Extend the Impact of Psychological Services

Ramos,

Hernandez-Ramos,

Taylor

et al. 2024

Behavior Therapy

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Identifying active ingredients in cognitive-behavioral therapies: What if we didn't?

Cited by 12 publications

References 128 publications

How effective psychological treatments work: mechanisms of change in cognitive behavioural therapy and beyond

How effective psychological treatments work: mechanisms of change in cognitive behavioural therapy and beyond

Commentary: Holy grails, personalized medicine, and the public health burden of psychopathology – a reflection on Ahuvia et al. (2023)

State of the Science: Using Digital Mental Health Interventions to Extend the Impact of Psychological Services

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