The following is a summary of “Action recommendations review in community-based therapy and depression and anxiety outcomes: a machine learning approach,” published in the February 2024 issue of Psychiatry by Spinard et al.
Research has extensively documented the beneficial effects of completing homework on symptom reduction, yet the importance of therapists’ involvement in reviewing these assignments still needs to be explored more.
They examined 2,444 therapy sessions conducted within community-based behavioral health programs. Employing machine learning models and natural language processing techniques aimed to identify action recommendations and assess their subsequent reviews. The review process’s depth was measured through the proportion of session dialogues dedicated to reviewing action recommendations, termed the “review percentage.” Utilizing Generalized Estimating Equations modeling, investigated the association between this metric and shifts in clients’ depression and anxiety scores. Researchers conducted a retrospective study to investigate therapists’ implementation of assigning and reviewing action recommendations during therapy sessions and its association with patients’ outcomes in depression and anxiety.
The results showed that our models attained a precision of 76% in identifying action recommendations and 71.1% in reviewing them. Utilizing these models, they observed that therapists typically offered clients
One to eight action recommendations per session for activities outside therapy. Only around half of the sessions included a review of previously assigned action recommendations. We detected a significant interaction between the initial depression score and the review percentage (P=0.045). After adjusting for this interaction, it was found that there was a positive and significant correlation between the review percentage and a decrease in depression score (P=0.032). This suggests that more frequent reviews of action recommendations during therapy are linked to greater improvements in depression symptoms. Further analysis revealed this association for mild depression (P=0.024) but not for anxiety or moderate to severe depression.
Investigators concluded that therapists reviewing past therapy recommendations are linked to better outcomes for those with mild depression, suggesting revisiting “homework” could boost overall therapy effectiveness.
Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05570-0