Enhancing the Personalization of Psychotherapy With Dynamic Assessment and Modeling

Abstract

Clinicians have long recognized the importance of tailoring psychotherapy interventions to the needs and characteristics of the individual patient. However, traditional approaches to clinical assessment, service delivery, and intervention research have not been conducive to such personalization. Contrary to traditional nomothetic approaches, idiographic assessment and modeling of intraindividual dynamic processes holds tremendous promise for tailoring the implementation of psychotherapy to the individual patient. In this article, we (a) present an argument for assessing person-specific dynamics, (b) provide a detailed description of a method that harnesses person-specific dynamic assessment and modeling for use in routine psychotherapy,

PTSD symptomics: network analyses in the field of psychotraumatology

“…This allows the field to move from modelling cross-sectional group-level data to modelling the temporal dynamics of causal systems across time, and might bring us closer to developing novel recommendations for intervention or prevention strategies (Bos et al, 2017). Third, more attention to modelling the dynamics of causal systems also allows a renewed focus on personalized medicine, seeing that time-series network models are not limited to modelling the symptom dynamics of groups of patients, but can also be used to obtain idiographic network structures for individual patients (Epskamp, van Borkulo et al, 2017; Fisher & Boswell, 2016; Kroeze et al, 2017). Fourth, there is evidence that biological markers are differentially related to specific psychopathology symptoms (e.g.…”

“…A new research framework entitled ‘Symptomics’ was proposed recently that aims to describe such studies under one framework, and complement diagnosis-level research with more detailed research on symptoms (Fried, 2017). Symptomics has three cornerstones:The relationship of individual symptoms with important variables such as risk factors, biomarkers, impairment of functioning, and treatment response (Bentall et al, 2012; Costello, 1993; Fried & Nesse, 2015b; Hieronymus, Emilsson, Nilsson, & Eriksson, 2016; Persons, 1986);The analysis of the potentially causal relations among symptoms in symptom networks (Borsboom, 2017; Cramer, Waldorp, van der Maas, & Borsboom, 2010; Wichers, Wigman, & Myin-Germeys, 2015);Gaining better understanding of psychopathology by investigating personalized processes at the level of individuals instead of heterogeneous groups of patients (Fisher & Boswell, 2016; Molenaar, 2004). …”

“…Gaining better understanding of psychopathology by investigating personalized processes at the level of individuals instead of heterogeneous groups of patients (Fisher & Boswell, 2016; Molenaar, 2004). …”

Attitudes of Austrian psychotherapists towards process and outcome monitoring

“…This enables practitioners to gather information on change processes in patients while they evolve, i.e. in real time, or even to plan interventions before treatment onset (Fernandez, Fisher, & Chi, 2017;Fisher & Boswell, 2016). On the client side, process monitoring allows for an increased intensity of reflection of the current treatment, which is in turn speculated to lead to increased self-efficacy, therapy motivation and even emotional competence (Schiepek & Aichhorn, 2013), but these assumptions have not yet been investigated empirically.…”

Translating Person-Specific Network Models into Personalized Treatments: Development and Demonstration of the Dynamic Assessment Treatment Algorithm for Individual Networks (DATA-IN)

“…Taking the aforementioned criticism into account, a treatment selection strategy has been proposed that is based only on individual patient data [4]. Patients are surveyed several times a day over an appreciable period of time in order to generate sufficient data to model their symptom dynamics using within-person factor analyses and dynamic factor models.…”