Develop effective psychotherapies faster

Simon Blackwell of the Research and Treatment Center for Mental Health
Credit: Research and treatment center for mental health

The increasing number of mental illnesses is a growing problem for society. The development of psychotherapies on the traditional path cannot keep pace with this.

Researchers at the Ruhr University Bochum (RUB) asked themselves whether there could be a faster and more efficient way to develop and improve psychological interventions. In the journal "Psychological Medicine" they present the so-called Leapfrog design, with which various interventions can be compared efficiently without having to carry out several clinical studies one after the other. The Bochum team around Dr. Simon Blackwell together with a colleague of the Ludwig Maximilians University in Munich in the journal "Psychological Medicine", published online.

Adapted method from cancer research

"Clinical studies are mostly time consuming and inefficient," says Blackwell of the RUB's Research and Treatment Center for Mental Health. “You can take years and require hundreds of participants - and in the end it may turn out that the intervention tested is not effective. And even if the intervention were effective, it would probably be wanted to improve it again quickly, because in the meantime, for example, new relevant research data have been published. This in turn means that you have to plan and conduct another, probably even larger and more time-consuming clinical study."

In order to find an alternative to traditional clinical research, the psychology team adapted methods from cancer research. In the Leapfrog design, interventions that prove to be ineffective are abandoned early and replaced directly by new interventions. In addition, new findings from basic research can be seamlessly integrated into an ongoing clinical study so that they can be immediately checked for their clinical benefit. It is also important in the context of the Leapfrog design that the most effective intervention is not only quickly identified - it also becomes the new yardstick for the effectiveness of all other interventions. In this way, existing interventions can be continuously and systematically optimized with the Leapfrog process.

Interventions that are not effective are quickly discarded

In the current publication, the researchers showed that the method can be implemented. They compared different versions of online training for people who feel depressed. The strength of the depressive symptoms was recorded at different times with questionnaires. As part of the online training, those affected learned to imagine positive everyday situations. A total of 188 people took part. Four different versions of the training were tested. In the end, the researchers identified a training version that significantly alleviated the symptoms. The training focused in particular on reducing the anhedonic symptoms of depression, i.e. the loss of the ability to look forward to and enjoy activities. It is precisely these symptoms that are particularly important for new interventions, since they often do not respond to the current interventions.

"We were able to quickly determine which training courses were less effective than others and then replace them with new training courses during the ongoing study," said Simon Blackwell, who received the Early Career Scientist Practitioner Award from the European Association for Behavioral and Cognitive Therapies in 2022 got. “Compared to a study with a classic test design, we also used significantly fewer participants with the Leapfrog method to identify the most effective training version."

The researchers have published all materials for the implementation of the Leapfrog design - from planning to data analysis - freely accessible. "We hope that other researchers will use the design to develop and improve urgently needed psychotherapies faster than before," summarizes the Bochum researcher. “Something has to change in the way we research mental health interventions. We are convinced that the Leapfrog design is a promising approach for this."

Source/Credit: Ruhr University Bochum | Julia Weiler

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