Grin Lord

Online Mental Health Communities (OMHCs), such as Reddit, have witnessed a surge in popularity as go-to platforms for seeking information and support in managing mental health needs. Platforms like Reddit offer immediate interactions with peers, granting users a vital space for seeking mental health assistance. However, the largely unregulated nature of these platforms introduces intricate challenges for both users and society at large. This study explores the factors that drive peer engagement… Show more

Online Mental Health Communities (OMHCs), such as Reddit, have witnessed a surge in popularity as go-to platforms for seeking information and support in managing mental health needs. Platforms like Reddit offer immediate interactions with peers, granting users a vital space for seeking mental health assistance. However, the largely unregulated nature of these platforms introduces intricate challenges for both users and society at large. This study explores the factors that drive peer engagement within counseling threads, aiming to enhance our understanding of this critical phenomenon. We introduce BeCOPE, a novel behavior encoded Peer counseling dataset comprising over 10,118 posts and 58,279 comments sourced from 21 mental health-specific subreddits. The dataset is annotated using three major fine-grained behavior labels: (a) intent,
(b) criticism, and (c) readability, along with the emotion labels. Our analysis indicates the prominence of “self-criticism” as the most prevalent form of criticism expressed by help-seekers, accounting for a significant 43% of interactions. Intriguingly, we observe that individuals who explicitly express their need for help are 18.01% more likely to receive assistance compared to those who present “surveys” or engage in “rants.” Furthermore, we highlight the pivotal role of well-articulated problem descriptions, showing that superior readability effectively doubles the likelihood of receiving the sought-after support. Our study emphasizes the essential role of OMHCs in offering personalized guidance and unveils behavior-driven engagement patterns. Show less

With the growing prevalence of psychological interventions, it is vital to have measures which rate the effectiveness of psychological care, in order to assist in training, supervision, and quality assurance of services. Traditionally, quality assessment is addressed by human raters who evaluate recorded sessions along specific dimensions, often codified through constructs relevant to the approach and domain. This is however a cost-prohibitive and time-consuming method which leads to poor… Show more

With the growing prevalence of psychological interventions, it is vital to have measures which rate the effectiveness of psychological care, in order to assist in training, supervision, and quality assurance of services. Traditionally, quality assessment is addressed by human raters who evaluate recorded sessions along specific dimensions, often codified through constructs relevant to the approach and domain. This is however a cost-prohibitive and time-consuming method which leads to poor feasibility and limited use in real-world settings. To facilitate this process, we have developed an automated competency rating tool able to process the raw recorded audio of a session, analyzing who spoke when, what they said, and how the health professional used language to provide therapy. Focusing on a use case of a specific type of psychotherapy called Motivational Interviewing, our system gives comprehensive feedback to the therapist, including information about the dynamics of the session (eg, therapist’s vs. client’s talking time), low-level psychological language descriptors (eg, type of questions asked), as well as other high-level behavioral constructs (eg, the extent to which the therapist understands the clients’ perspective). We describe our platform and its performance, using a dataset of more than 5,000 recordings drawn from its deployment in a real-world clinical setting used to assist training of new therapists. We are confident that a widespread use of automated psychotherapy rating tools in the near future will augment experts’ capabilities by providing an avenue for more effective training and skill improvement and will eventually lead to more … Show less

With the growing prevalence of psychological interventions, it is vital to have measures which rate the effectiveness of psychological care to assist in training, supervision, and quality assurance of services. Traditionally, quality assessment is addressed by human raters who evaluate recorded sessions along specific dimensions, often codified through constructs relevant to the approach and domain. This is however a cost-prohibitive and time-consuming method that leads to poor feasibility and… Show more

With the growing prevalence of psychological interventions, it is vital to have measures which rate the effectiveness of psychological care to assist in training, supervision, and quality assurance of services. Traditionally, quality assessment is addressed by human raters who evaluate recorded sessions along specific dimensions, often codified through constructs relevant to the approach and domain. This is however a cost-prohibitive and time-consuming method that leads to poor feasibility and limited use in real-world settings. To facilitate this process, we have developed an automated competency rating tool able to process the raw recorded audio of a session, analyzing who spoke when, what they said, and how the health professional used language to provide therapy. Focusing on a use case of a specific type of psychotherapy called Motivational Interviewing, our system gives comprehensive feedback to the therapist, including information about the dynamics of the session (e.g., therapist's vs. client's talking time), low-level psychological language descriptors (e.g., type of questions asked), as well as other high-level behavioral constructs (e.g., the extent to which the therapist understands the clients' perspective). We describe our platform and its performance using a dataset of more than 5,000 recordings drawn from its deployment in a real-world clinical setting used to assist training of new therapists. Widespread use of automated psychotherapy rating tools may augment experts' capabilities by providing an avenue for more effective training and skill improvement, eventually leading to more positive clinical outcomes. Show less

People like to be in control of their lives, and most don’t actually want advice unless they specifically ask for it. A series of studies found that people that give advice to others are more likely to be interested in seeking power and having more control over others. When people don’t want to give up control, advice-giving can become a power struggle. This article describes how to give advice with empathy.

When the doors close in the therapy room only the patient and therapist are privy to what’s happening inside. There are a few exceptions where this black box is opened: when a therapist is training, doing court-mandated work, or conducting research. That’s where I come in — my specialty is listening to therapists perform therapy. I’ve had the unique privilege to listen to thousands of hours of therapy sessions over the past ten years to assess the quality of the therapeutic interaction.

Many of us feel pressure to be interesting, funny, intelligent in conversation. You feel like you must have shared knowledge or interests to carry on a conversation or that you need to know the right thing to say at the right time. Small talk is avoided at all costs. Maybe you even get excited to say something and then find yourself paralyzed. These are conversation concerns that a lot of folks face — it’s not an issue just for those on the spectrum or with social anxiety.

Authors: Chris Dunn, PhD, Doyanna Darnell, PhD, Sheng Kung Michael Yi, PhD, Mark Steyvers, PhD, Kristin Bumgardner, BS, Sarah Peregrine Lord, PsyD, Zac Imel, PhD, David C. Atkins, PhD

To explore a new objective indicator of empathy, we hypothesized that synchrony in language style (i.e., matching how statements are phrased) between client and therapists would predict gestalt ratings of empathy over and above the contribution of reflections. Findings suggest empathy ratings are related to synchrony in language style, over and above synchrony of content as measured by therapist reflections. Novel indicators of therapist empathy may have implications for the study of… Show more

To explore a new objective indicator of empathy, we hypothesized that synchrony in language style (i.e., matching how statements are phrased) between client and therapists would predict gestalt ratings of empathy over and above the contribution of reflections. Findings suggest empathy ratings are related to synchrony in language style, over and above synchrony of content as measured by therapist reflections. Novel indicators of therapist empathy may have implications for the study of motivational interviewing process as well as the training of therapists. Show less

Presented novel methods for collecting MISC data and accurately assessing reliability of behavior codes at the level of the utterance. The MISC 2.1 was used to rate MI interviews from five randomized trials targeting alcohol and drug use. Sessions were coded at the utterance-level. Utterance-based coding reliability was estimated using three methods and compared to traditional reliability estimates of session tallies. Session-level reliability was generally higher compared to reliability using… Show more

Presented novel methods for collecting MISC data and accurately assessing reliability of behavior codes at the level of the utterance. The MISC 2.1 was used to rate MI interviews from five randomized trials targeting alcohol and drug use. Sessions were coded at the utterance-level. Utterance-based coding reliability was estimated using three methods and compared to traditional reliability estimates of session tallies. Session-level reliability was generally higher compared to reliability using utterance-based codes, suggesting that typical methods for MISC reliability may be biased. Show less

Authors: Douglas Zatzick, Gregory Jurkovich, Frederick P Rivara, Joan Russo, Amy Wagner, Jin Wang, Chris Dunn, Sarah Peregrine Lord, Megan Petrie, Stephen S Oʼconnor, Wayne Katon

CONCLUSIONS: Stepped care interventions can reduce PTSD symptoms and improve functioning over the course of the year after surgical injury hospitalization. Orchestrated investigative and policy efforts could systematically introduce and evaluate screening and intervention procedures for PTSD at US trauma… Show more

Authors: Douglas Zatzick, Gregory Jurkovich, Frederick P Rivara, Joan Russo, Amy Wagner, Jin Wang, Chris Dunn, Sarah Peregrine Lord, Megan Petrie, Stephen S Oʼconnor, Wayne Katon

CONCLUSIONS: Stepped care interventions can reduce PTSD symptoms and improve functioning over the course of the year after surgical injury hospitalization. Orchestrated investigative and policy efforts could systematically introduce and evaluate screening and intervention procedures for PTSD at US trauma centers. (Trial Registration: clinicaltrials.gov identifier: NCT00270959). Show less

This study provided evidence for the impact of BI on problem drug use based on a broad range of measures including self-reported drug use, urine analysis, admission to drug abuse treatment, and changes in utilization and costs of health care services, arrests, and death with the intent of informing policy and program planning for problem drug use at the local, state, and national levels.Trial registration: ClinicalTrials.gov NCT00877331.

We wrote this piece for coding teams around the world, hoping to raise some measurement issues, to inspire, and to entertain (perhaps not in that order). This one’s for you, coders and for you, trainers of coders, you who work so hard to measure Motivational Interviewing using the standardized coding systems such as the MISC, MITI, and SCOPE.

The objective of this investigation was to assess the feasibility of a culturally tailored care management intervention for physically injured American Indian/Alaska Native (AI/AN) patients. Among intervention patients, 60% either requested or participated in traditional Native healing practices and 75% reported that the intervention was helpful.

Authors: Sarah Geiss Trusz, Amy W. Wagner, Joan Russo, Jeff Love and Douglas F. Zatzick

Conclusions: Only 8.5% of all intervention patients were able to complete CBT. Lack of engagement, clinical and logistical barriers had the greatest impact on CBT entry. Based on the first trial, we developed a CBT readiness assessment tool. We implemented and evaluated the tool in a second early intervention trial. Lack of engagement emerged again as the primary impediment to CBT entry. Patients who… Show more

Authors: Sarah Geiss Trusz, Amy W. Wagner, Joan Russo, Jeff Love and Douglas F. Zatzick

Conclusions: Only 8.5% of all intervention patients were able to complete CBT. Lack of engagement, clinical and logistical barriers had the greatest impact on CBT entry. Based on the first trial, we developed a CBT readiness assessment tool. We implemented and evaluated the tool in a second early intervention trial. Lack of engagement emerged again as the primary impediment to CBT entry. Patients who were willing to enter CBT treatment but demonstrated high rates of past trauma or diagnosis of PTSD were also the least likely to engage in any PTSD treatment one month post-discharge.
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Authors: Douglas Zatzick M.D., Frederick Rivara M.D., M.P.H., Gregory Jurkovich M.D., Joan Russo Ph.D., Sarah Geiss Trusz B.A., Jin Wang Ph.D., Amy Wagner Ph.D., Kari Stephens Ph.D., Chris Dunn Ph.D., Edwina Uehara Ph.D., Megan Petrie B.A., Charles Engel M.D., M.P.H., Dimitri Davydow M.D. and Wayne Katon M.D.
Conclusions: Stepped care protocols targeting PTSD may enhance the population impact of early interventions developed for survivors of individual and mass trauma by extending the reach… Show more

Authors: Douglas Zatzick M.D., Frederick Rivara M.D., M.P.H., Gregory Jurkovich M.D., Joan Russo Ph.D., Sarah Geiss Trusz B.A., Jin Wang Ph.D., Amy Wagner Ph.D., Kari Stephens Ph.D., Chris Dunn Ph.D., Edwina Uehara Ph.D., Megan Petrie B.A., Charles Engel M.D., M.P.H., Dimitri Davydow M.D. and Wayne Katon M.D.
Conclusions: Stepped care protocols targeting PTSD may enhance the population impact of early interventions developed for survivors of individual and mass trauma by extending the reach of collaborative care interventions to acute care medical settings and other nonspecialty posttraumatic contexts.
Keywords: PTSD; Stepped collaborative care; Acute care; Population impact; Traumatic injury
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Authors: Douglas F. Zatzick, MD; Frederick P. Rivara, MD, MPH; Gregory J. Jurkovich, MD; Charles W. Hoge, MD; Jin Wang, MS, PhD; Ming-Yu Fan, PhD; Joan Russo, PhD; Sarah Geiss Trusz, BA; Avery Nathens, MD, PhD, MPH; Ellen J. Mackenzie, PhD

Conclusions: More severe TBI was associated with a diminished risk of PTSD. Regardless of TBI severity, injured patients with PTSD demonstrated the greatest impairments in self-reported health and cognitive function. Treatment programs for patients… Show more

Authors: Douglas F. Zatzick, MD; Frederick P. Rivara, MD, MPH; Gregory J. Jurkovich, MD; Charles W. Hoge, MD; Jin Wang, MS, PhD; Ming-Yu Fan, PhD; Joan Russo, PhD; Sarah Geiss Trusz, BA; Avery Nathens, MD, PhD, MPH; Ellen J. Mackenzie, PhD

Conclusions: More severe TBI was associated with a diminished risk of PTSD. Regardless of TBI severity, injured patients with PTSD demonstrated the greatest impairments in self-reported health and cognitive function. Treatment programs for patients with the full spectrum of TBI severity should integrate intervention approaches targeting PTSD. Show less