Tag: Therapy

Posted on

Suvorexant 3 – PE-PC

Conditions: PTSD – Post Traumatic Stress Disorder; Insomnia; TBI (Traumatic Brain Injury)

Interventions: Drug: Suvorexant; Drug: Placebo; Behavioral: Prolonged Exposure Therapy for Primary Care (PE-PC)

Sponsors: Northern California Institute of Research and Education; Lowcountry Center for Veterans Research

Not yet recruiting
Posted on

Enhancing psychiatry education: effectiveness of a psychodynamic psychotherapy module for borderline personality disorder for psychiatry residents

BackgroundPsychodynamic psychotherapy is the treatment of choice for borderline personality disorder (BPD); however, psychiatric residents frequently report difficulty in applying it, partly due to the lack of structured training models. This study developed and evaluated the effectiveness of psychodynamic psychotherapy learning modules for BPD among Indonesian psychiatry residents.MethodsA quasi-experimental pre-/post-test control group study using mixed methods was conducted across nine psychiatric residency programs in Indonesia. Thirty-four residents were recruited, of whom 33 completed the study. Learning outcomes were assessed using multiple-choice questions and the Psychodynamic Formulation Competency Assessment Scale (PF-CAS) and Practical Competency Assessment Scale (PC-CAS). The module program was evaluated by the participants using the Indonesian version of the Kirkpatrick Level 1 questionnaire.ResultsThe intervention group showed significantly greater improvement in psychodynamic formulation skills (PF-CAS) than the control group (p < 0.001). The multiple-choice scores improved in both groups, with no significant between-group differences. The intervention group showed a numerically greater improvement in Practical Skills (PC-CAS) than the control group, although the difference was not statistically significant. Participants’ feedback was highly positive, emphasizing the usefulness of psychodynamic formulation training, psychotherapy protocols, and supervision.ConclusionImplementation of the psychodynamic psychotherapy for BPD Learning Module enhanced competencies in the cognitive and affective domains and showed promising trends in practical skills. This positive reception highlights its feasibility and potential benefits as part of the residency training curriculum.
Posted on

Institutional Member Updates: Summer 2026

Institutional Members are clinics and programs in the US and around the globe that offer residential and/or intensive treatment for OCD and related disorders, are specialty outpatient clinics with a large staff dedicated to treating OCD, or provide low-cost treatment options through research studies.

Below are quarterly updates from our Institutional Members organized alphabetically. Click the (+) to open each menu and read updates and find contact information for clinics near you:

Do you work at a residential program, intensive outpatient program (ITP), or specialty outpatient clinic and looking to advertise your services? Learn more about becoming an Institutional Member and having your program updates included below!

Anxiety Experts – Santa Barbara, CA

Anxiety Institute – Greenwich, Connecticut

Anxiety Specialists of Atlanta

Atlanta CBT – Atlanta, Georgia

Bull City Anxiety & OCD Treatment Center – Chapel Hill, North Carolina

Cambridge Psychology Group – Camrbidge, Massachusetts

Cascade Programs – Midway, Utah

Center for OCD & Anxiety-Related Disorders

Center for OCD and Anxiety

Center for OCD and Related Disorders at Massachusetts General Hospital

Compassionate Healing Institute

Hopewell Therapeutic Community

Manhattan Center for CBT

Moment, Center for Anxiety Disorders – South Carolina

Nashville OCD & Anxiety Treatment Center – Nashville, Tennessee

Northwell Health OCD Center – Glen Oaks, New York

OCD Anxiety Centers

OCD Institute of Texas – Houston, Texas

OCD North

OCD Wellness

Palo Alto Therapy – Palo Alto, California

Polaris Family Behavioral Health

Psychology Houston, PC: The Center for Cognitive Behavioral Treatment

SkinPick (Online Treatment for Skin Picking)

Specialists in OCD & Anxiety Recovery (SOAR), PLLC

NOCD – Teletherapy Only

Stanford OCD Research Lab – Palo Alto, CA

StopOCD (Online Therapy for OCD)

Stress and Anxiety Services of NJ – East Brunswick, New Jersey

The Anxiety Center

The Anxiety Treatment Center of Greater Chicago

The Center for OCD and Anxiety at Sheppard Pratt

The Concord Center – Concord, Massachusetts

TrichStop (Online Treatment for Hair-Pulling)

UPMC Western Behavioral Health

The post Institutional Member Updates: Summer 2026 appeared first on International OCD Foundation.

Posted on

Supporting Student Mental Health With the Safespace Generative AI Chatbot: Mixed Methods Feasibility Study

Background: Generative artificial intelligence (GenAI) chatbots have the potential to provide personalized mental health support to individuals at scale. Objective: This study evaluates the feasibility and usage patterns of the Safespace GenAI chatbot, an artificial intelligence (AI)–driven smartphone app that offers a large language model–powered interactive chatbot to support mental health. Methods: Using a mixed methods approach, we explored baseline attitudes toward GenAI chatbots and chatbot usage patterns, conducted a qualitative content analysis of participants’ experiences, and descriptively assessed patterns related to preintervention depressive symptoms. The study included an initial sample of 42 university students, 20 of whom actively used the chatbot over 2 to 4 weeks, generating 286 user-chatbot interactions. Results: Preintervention surveys indicated that the majority of participants anticipated that the chatbot would be helpful (27/42, 64%) and that they trusted its privacy safeguards (39/42, 93%). Usage patterns suggested that the highest levels of interaction occurred early in the morning and late at night, when peer and professional support may be inaccessible. The qualitative analysis indicated that participants appreciated using the chatbot for reflection as a blended-care tool between their counseling sessions, while also naming technical barriers and specific design needs required to sustain engagement. In addition, our exploratory analyses descriptively showed that participants with elevated depression scores engaged in emotional disclosure during 99% (38 sessions with 8 participants) of their sessions, compared to 84% (26 sessions of 12 participants) of those with low symptoms. Due to the small sample size, future adequately powered studies are needed to inferentially examine these observed patterns. Conclusions: These findings provide initial insights into the usage and engagement dynamics of the Safespace GenAI chatbot and highlight directions for future research to optimize GenAI-driven mental health interventions. Trial Registration: AEA Registry AEARCTR-0013291; https://doi.org/10.1257/rct.13291-1.0
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/8ea8d6d9a0e05f3fdb856f007cfd4549" />

Posted on

Fine-Tuning Large Language Models for Motivational Interviewing in Health Behavior Change: Development and Evaluation Study

Background: Motivational interviewing (MI) is an effective counseling approach for promoting health behavior change, but its scalability is constrained by the need for highly trained human counselors. Large language models (LLMs) may provide a scalable way to support MI counseling, but evidence remains limited, especially for Chinese MI resources and evaluations based on standardized MI fidelity frameworks. Objective: This study aimed to develop Chinese large language models for motivational interviewing (MI-LLMs) and evaluate whether MI-focused fine-tuning could improve their ability to generate counseling responses consistent with MI principles. Methods: We first curated 5 publicly available Chinese psychological counseling datasets and assessed sampled conversations in terms of comprehensiveness, professionalism, authenticity, and safety. The 2 highest-scoring datasets, CPsyCounD and PsyDTCorpus, were selected for MI-style data construction. Using GPT-4 with a structured MI-informed prompt, we transformed 2040 multiturn counseling conversations into MI-style dialogs. Among these, 2000 dialogs were used for training and 40 for testing. Three Chinese-capable open-source LLMs (Baichuan2-7B-Chat, ChatGLM-4-9B-Chat, and Llama-3-8B-Chinese-Chat-v2) were fine-tuned with low-rank adaptation on the training dataset and were referred to as MI-LLMs. Automatic evaluation was conducted on the testing dataset using Bilingual Evaluation Understudy–4 (BLEU-4) and Recall-Oriented Understudy for Gisting Evaluation (ROUGE) metrics. Manual evaluation was conducted using the Motivational Interviewing Treatment Integrity Coding Manual 4.2.1. Thirty simulated counseling dialogs generated by the MI-LLMs were compared with 30 real MI dialogs sampled from AnnoMI and translated into Chinese. Two trained graduate student raters coded global scores and behavior counts, from which summary scores were subsequently calculated. Results: In automatic evaluation, fine-tuning substantially improved BLEU-4 and ROUGE scores across all 3 models compared with the base models. In manual evaluation, the MI-LLMs achieved technical and relational global scores, as well as total MI-adherent ratios that approached those of real MI dialogs. The MI-LLM based on ChatGLM-4-9B-Chat showed the strongest overall global performance. However, MI-LLMs produced fewer complex reflections and had lower reflection-to-question ratios than real MI dialogs. Conclusions: This study provides preliminary evidence that MI focused fine-tuning can help Chinese LLMs acquire core counseling behaviors consistent with MI principles. It also offers a scalable approach for constructing MI style dialog resources in Chinese. Nevertheless, current MI-LLMs should be regarded as early-stage tools for supporting, rather than replacing human counselors. Future work should expand real MI training data and strengthen the complex reflective skills of MI-LLMs. Further studies are needed to evaluate their effectiveness, acceptability, and safety in health behavior change settings in the real world.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/1c43f039686485cb31ea711826f22d05" />

Posted on

Psychotherapy initiation is associated with discontinuation of psychotropic medications without dose escalation: a ten-year real-world cohort study (2014-2024)

BackgroundIncreasing psychotropic prescribing has raised concerns about long-term safety and regimen complexity in mental health care. Although psychotherapy is an established treatment, its role in medication optimization and psychotropic medication reduction in real-world practice across patient subgroups remains insufficiently characterized.ObjectiveTo evaluate whether initiation of psychotherapy is associated with short-term changes in psychotropic medication exposure and regimen complexity, and to examine differences by sex, age, and diagnostic category. Methods: A retrospective cohort study was conducted using anonymized pharmacy dispensing data from the Mental Health Service of Hospital Marina Baixa (Alicante, Spain) between 2014 and 2024. Patients with at least one active prescription for a benzodiazepine or antidepressant within 90 days before psychotherapy initiation were included. Psychotropic exposure was compared in symmetric 90-day pre- and post-therapy windows using number of active agents, total Defined Daily Doses, and prevalence of benzodiazepine and antidepressant use, with stratified analyses by sex, age group, and diagnosis.ResultsThe cohort comprised 86,502 patients and 20.76 million dispensations. The median number of psychotropic medications decreased from 5 to 2 (p < 0.001), while total dose remained stable (median Defined Daily Dose ≈ 21.7; p = 0.999). Benzodiazepine use declined from 87.6% to 67.5% and antidepressant use from 81.8% to 68.8% (both p < 0.001). Men were more likely than women to discontinue benzodiazepines (odds ratio 1.27, 95% confidence interval 1.13–1.43), and simplification increased with age (median reduction −1 in <18 years to −4 in ≥65 years). The largest benzodiazepine reductions occurred in depressive, personality, and episodic mood disorders (−23 to −27 percentage points).ConclusionsIn routine public mental health care, psychotherapy initiation is associated with substantial simplification of psychotropic treatment regimens without increasing overall medication dose, supporting a potential role in facilitating rational medication simplification.