Implementing precision methods in personalizing psychological therapies: Barriers and possible ways forward

• Type of Material: Article
• Authors: Anne-Katharina Deisenhofer, University of Trier; Michael Barkham, University of Sheffield; Esther T. Beierl, University of Oxford; Brian Schwartz, University of Trier; Katie Aafjes-van Doorn, Yeshiva University; Christopher G. Beevers, University of Texas at Austin; Isabel M. Berwian, Princeton University; Simon E. Blackwell, Ruhr University Bochum; Claudi L. Bockting, University of Amsterdam; Eva-Lotta Brakemeier, University of Greifswald; Gary Brown, Royal Holloway University of London; Joshua E. J. Buckman, University College London; Louis G. Castonguay, Pennsylvania State University; Claire E. Cusack, University of Louisville; Tim Dalgleish, University of Cambridge; Kim de Jong, Leiden University; Jaime Delgadillo, University of Sheffield; Robert J. DeRubeis, University of Pennsylvania; Ellen Driessen, Radboud University; Jill Ehrenreich-May, University of Miami; Aaron J. Fisher, University of California, Berkeley; Eiko I. Fried, Leiden University; Jessica Fritz, University of Cambridge; Toshi A. Furukawa, Kyoto University; Claire M. Gillan, Trinity College Dublin; Juan Martin Gomez Penedo, University of Buenos Aires; Peter Frank Hitchcock, Emory University; Stefan G. Hofmann, Philipps University of Marburg; Steven D. Hollon, Vanderbilt University; Nicholas C. Jacobson, Dartmouth Geisel School of Medicine; Daniel R. Karlin, Tufts University; Chi Tak Lee, Trinity College Dublin; Cheri A. Levinson, University of Louisville; Lorenzo Lorenzo-Luaces, Indiana University; Riley McDanal, Stony Brook University; Danilo Moggia, University of Trier; Mei Yi Ng, Florida International University; Lesley A. Norris, Brown University; Vikram Patel, Harvard Medical School; Marilyn L. Piccirillo, University of Washington; Stephen Pilling, University College London; Julian A. Rubel, Osnabrück University; Gonzalo Salazar-de-Pablo, King's College London; Rob Saunders, University College London; Jessica L. Schleider, Stony Brook University; Paula P. Schnurr, National Center for PTSD; Stephen M. Schueller, University of California, Irvine; Greg J. Siegle, University of Pittsburgh; Rudolf Uher, Dalhousie University; Ed Watkins, University of Exeter; Christian A. Webb, Harvard Medical School; Shannon Wiltsey Stirman, Stanford University; Laure Wynants, Maastricht University; Soo Jeong Youn, Harvard Medical School; Sigal Zilcha-Mano, University of Haifa; Wolfgang Lutz, University of Trier; Zachary D. Cohen, University of California, Los Angeles
• Language: English
• Date: 2024-01-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Authors. Published by Elsevier Ltd.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1016/j.brat.2023.104443
• Title of Journal or Parent Work: Behaviour Research and Therapy
• Volume: 172
• Start Page: 104443
• Grant/Funding Information: Marilyn L. Piccirillo was supported by a grant from National Institutes of Health, AA029459 .; Claire Cusack was supported by the National Science Foundation Graduate Research Fellowship under Grant No. 2021320143 (CEC). The content of this manuscript does not necessarily represent the official views of the National Science Foundation.; Dr Rudolf Uher is supported by the Canada Research Chairs Program.; A grant from the Dutch Research Council (NWO; 016.Veni.195.215 6806) provided financial support for Ellen Driessen's contributions to the preparation of this article.; Jessica Schleider has received funding for her research from the National Institutes of Health Office of the Director ( DP5OD028123 ), National Institute of Mental Health ( R43MH128075 ), National Science Foundation ( 2141710 ), Health Research and Services Association (U3NHP45406-01-00), the Society for Clinical Child and Adolescent Psychology, Hopelab, the Upswing Fund for Adolescent Mental Health, and the Klingenstein Third Generation Foundation. Preparation of this article was supported in part by the Implementation Research Institute (IRI), at the George Warren Brown School of Social Work, Washington University in St. Louis; through an award from the National Institute of Mental Health ( R25MH080916 ; JLS is an IRI Fellow).; Vikram Patel was supported by NIMH R01 for a precision medicine study of depression treatment in primary care in India ( 1R01MH121632-01A1 ).; Greg J. Siegle is supported by R01 AT011267, MH074807, MH106591-01, MH096334.; Isabel Berwian's work on "Precision psychiatry or treatment selection in depression" is supported by Wellcome Leap as part of the Multi-Channel Psych Program.; Christopher Beevers was supported in part by funding from the National Institute of Mental Health ( R01MH131750 ).; Toshi A. Furukawa reports personal fees from Boehringer-Ingelheim, DT Axis, Kyoto University Original, Shionogi, SONY and UpToDate, and a grant from Shionogi, outside the submitted work; In addition, TAF has patents 2020–548587 and 2022–082495 pending, and intellectual properties for Kokoro-app licensed to Mitsubishi-Tanabe. And no external funding used for this research.; Anne-Katharina Deisenhofer, Julian A. Rubel, Brian Schwartz and Wolfgang Lutz were supported by the German Research Foundation (DFG) under Grant Nr. LU 660/19-1 (504507043) and LU 660/16-1 (493169211) .; Dr. Webb was partially supported by NIMH R01MH116969, NCCIH R01AT011002, the Tommy Fuss Fund and a Young Investigator Grant from the Brain & Behavior Research Foundation.; Nicholas C. Jacobson was partially funded by the National Institute of Mental Health and the National Institute of General Medical Sciences under grant 1 R01 MH123482-01 . This work was also supported by an institutional grant from the National Institute on Drug Abuse under grant NIDA-5P30DA02992610.; Lorenzo Lorenzo-Luaces has received funding from the Indiana Clinical and Translational Sciences Institute (CTSI) KL2 Program (Grant: KL2TR002530, PI: B. Tucker Edmonds, PI, institution: NCATS; Grant: UL1TR002529, PIs: S. Moe and S. Wiehe, co-PIs, institution: NACTS).
• Keywords: Implementation barriers; Data-driven psychological therapies; Personalizing psychological treatments; Precision mental health care methods
• Research Categories: Psychology, Clinical

Abstract

Personalization of psychological therapies has always been used by clinicians and describes all efforts to select, adjust, or modify a treatment for the individual to improve outcomes. Precision mental health care approaches can be considered under the umbrella term personalization and specify methods that are algorithmic, quantitative, and empirically derived. Despite a growing research literature demonstrating the efficacy of these approaches, they are rarely tested in clinical practice. A statistically optimized, targeted clinical recommendation is not by itself sufficient to influence clinical practice in a beneficial way; barriers related to dissemination and implementation require increased attention. This article describes clinical and practical factors, technical aspects, statistical considerations, and fundamental contextual issues that should be considered to facilitate data-driven treatments in mental health care contexts in clinical practice.