Do improved patient recall and the provision of memory support enhance treatment adherence?
Section snippets
Participants and procedures
Data were provided by participants who were recruited to participate in a pilot randomized controlled trial reported elsewhere (Harvey et al., 2016). Participants were forty-eight adults with Major Depressive Disorder (MDD), who were randomized to receive 14 weekly, 50-min sessions of either Cognitive Therapy as usual (CT-as-usual) or Cognitive Therapy plus Memory Support (CT + Memory Support). The study was approved by the Committee for the Protection of Human Subjects (CPHS) at the University
Results
Table 2 presents the descriptive statistics for all study variables in the total sample as well as in each randomized group (CT + Memory Support vs. CT-as-usual), including the therapist and patient ratings of treatment enactment and receipt, all the continuous MS variables (i.e., Total MS, No. of MS types, MS bundles ≥2, MS bundles ≥3, and specific MS strategies), and patient recall of treatment contents at mid-treatment. The ICCs were 0.43 (99% CI: [0.26, 0.63]) and 0.44 (99% CI: [0.25,
Discussion
The current study examined the extent to which patient recall and therapist use of MS were associated with patient adherence to cognitive therapy for depression. Because the two randomized treatment groups (CT + Memory Support vs. CT-as-usual) differ only in terms of the levels of MS therapist provided, we elected to focus on examining patient recall and the degree of MS used in relation to treatment adherence for the whole sample to improve statistical power, in addition to examining the
Acknowledgements
This research was supported by National Institute of Mental Health Grants R34 MH094535. The authors declare that there are no conflicts of interest. We acknowledge the contribution of Xin Zhao and Stacie Ong for additional coding of the memory support variables.
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Optimizing outcomes, mechanisms, and recall of Cognitive Therapy for depression: Dose of constructive memory support strategies
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2023, Behavior TherapyCitation Excerpt :These findings build on prior research that has found support for relationships between memory for treatment, patient adherence, utilization and competency of treatment skills, and patient outcomes. Although this prior research had established support for each individual link of the serial mediation models evaluated in the present study (e.g., Dong et al., 2017a, 2017b; Gallagher-Thompson et al., 2008; Gumport et al., 2019; Hundt et al., 2013; Strunk et al., 2014), the present study is the first, to our knowledge, to test the serial mechanistic chains linking these variables. This contribution is important, as identifying mechanisms has been highlighted as a critical step to improve treatments (Insel, 2015).
Time is a great healer: Peak-end memory bias in anxiety – Induced by threat of shock
2022, Behaviour Research and TherapyClient memory and learning of treatment contents: An experimental study of intervention strategies and relationship to outcome in a brief treatment for procrastination
2020, Journal of Behavior Therapy and Experimental PsychiatryCitation Excerpt :Finally, the relationship between memory and learning of treatment contents and outcome may depend on the timing relative to treatment. Studies investigating memory and learning of treatment contents and outcome on a shorter timeframe (i.e., week-to-week during treatment) have generally found significant relationships between these variables (Dong, Lee, et al., 2017a; Dong et al., 2017; Gumport et al., 2015; Lee & Harvey, 2015). Studies that investigated the association between memory and learning of treatment contents and outcome on a longer timeframe (e.g., months to years after treatment ended) tended to not find significant relationships between these variables (Chambers, 1991; Gumport et al., 2018; Hahlweg & Richter, 2010).
Establishing the dose of memory support to improve patient memory for treatment and treatment outcome
2020, Journal of Behavior Therapy and Experimental PsychiatryCitation Excerpt :Second, more memory impairment is associated with worse outcome (e.g., Bearden et al., 2006; Cohen, Forbes, Mann, & Blanchard, 2006; Martínez-Arán et al., 2004; Polak, Witteveen, Reitsma, & Olff, 2012), including following cognitive behavioral therapy (Aharonovich, Nunes, & Hasin, 2003; Lee & Harvey, 2015; Wild & Gur, 2008). Third, patient memory for the contents of treatment is poor (Bober, Hoke, Duda, & Tung, 2007; Chambers, 1991; Lee & Harvey, 2015) and is associated with poorer adherence to treatment recommendations (Dong, Lee, & Harvey, 2017; Kravitz et al., 1993; Pickney & Arnason, 2005; Tosteson et al., 2003) and worse outcome (Lee & Harvey, 2015). Fourth, the impact of memory impairment can be minimized by the use of memory support strategies (Almkvist, Fratiglioni, Agüero-Torres, Viitanen, & Bäckman, 2010; Ayers et al., 2014; Bamidis et al., 2014; Bunce, 2003).
The effects of retrieval versus rehearsal of online problem-solving therapy sessions on recall, problem-solving skills and distress in distressed individuals: An experimental study
2020, Journal of Behavior Therapy and Experimental PsychiatryCitation Excerpt :Second, we applied an experimental design to find out how cognitive support strategies benefit psychological treatment: by manipulating one single strategy in an experimental setting. Future studies should isolate and investigate the direct effects of potential other candidate cognitive support strategies, such as the use of interventions that modulate neural networks by use of brain stimulation techniques (Bajbouj & Padberg, 2014), or other psychological memory support strategies (Dong, Lee, & Harvey, 2017b; Harvey et al., 2017). Third, we showed that cognitive support strategies might work differently for individuals with different baseline WM scores.